培菲康联合复方小檗碱保留灌肠预防急性放射性直肠炎的临床观察

Application of Bifidobacterium Triple Viable Powder and Compound Berberine Retention Enema in Preventing Acute Radiation Proctitis

目的探讨培菲康联合复方小檗碱保留灌肠预防急性放射性直肠炎的临床疗效。方法选择2016年1月-2017年12月我院收治的直肠癌根治术后行辅助放化疗的100例患者为研究对象,随机分为观察组(n=50)和对照组(n=50)。两组患者均接受卡培他滨(825 mg·m^-2,2次/天,口服.)同期放疗(DT 45 Gy/25 F),观察组在此基础上采用培菲康口服(2包/次,3次/天)联合复方小檗碱保留灌肠(20 mL/次/天)。比较两组患者急性放射性直肠炎的发生情况、卡氏功能状态(KPS)评分、乏力状况及生活质量(QOL)评分。结果治疗4周时,观察组患者急性放射性直肠炎的发生率和级别均明显低于对照组(P<0.05);观察组患者KPS评分(80.02±7.34)显著高于对照组(76.64±7.08)(P<0.05);观察组患者中重度乏力的发生率(20%)显著低于对照组(48%)(P<0.05);观察组患者QOL评分(41.26±5.08)显著高于对照组(39.02±4.90)(P<0.05)。观察组因放射性肠炎而减少口服化疗药物剂量或中断放疗的比例(4%)均显著低于对照组(18%)(P<0.05)。结论培菲康联合复方小檗碱保留灌肠对预防急性放射性直肠炎效果较好,患者依从性好,值得临床推广应用。

Objective To investigate the clinical efficacy of bifidobacterium triple viable powder and compound berberine retention enema in the prevention of acute radiation proctitis.Methods One hundred cases of postoperative rectum adenocarcinoma were randomly divided into obsenvation group(n=50)and control group(n=50).All patients were treated with total radical resection of rectal carcinoma and concurrent chemoradiotherapy.The total dose of radiation was 45 Gy/25 F.Capecitable(825 mg·m^2,twice a day)was orally administrated during radiotherapy.Patients in obsenvation group were added with bifidobacterium triple viable powder and compound berberine retention enema.Compare the incidence and the level of acute radiation proctitis,IKPS score,fatigue status and quality of life score between two groups.Results At four weeks of concurrent chemoradiotherapy,the incidence and the level of acute radiation proctitis of the observation group were lower than those of the control group(P<0.05).The incidence of moderate to severe fatigue in observation group(20%)was also lower than in control group(48%)(P<0.05).Meanwhile,at four weeks of concurrent chemoradiotherapy,the KPS score of the observation group(80.02±7.34)were significantly higher than that of the control group(76.64±7.08),so were the life quality(41.26±5.08 vs.39.02±4.90)(P<0.05).The rate of radiotherapy interruption or dose-reduction of chemotherapy of obsenvation group(4%)was lower than that of control group(18%)(P<0.05).Conclusion The bifidobacterium triple viable powder in combined with compound berberine retention enema had good preventing effects on acute radiation proctitis caused by radiotherapy.It is worthy to be popularized in clinical application.