清热促愈方联合康复新液灌肠治疗放射性肠炎急性期的疗效观察

Observation on the Therapeutic Effect of Qingre Cuyu Decoction Combined with Kangfuxin Solution Enema for Acute Stage of Radiation Enteritis

目的观察清热促愈方联合康复新液灌肠治疗放射性肠炎急性期疗效并探讨其作用机制。方法 62例患者随机分为治疗组与对照组两组各31例。两组均正行放疗或放疗后1月内出现放射性肠炎,其中对照组给予康复新液灌肠治疗,治疗组给予自拟清热促愈方口服联合康复新液灌肠治疗。观察两组治疗有效率、放射性损伤分级、中医证候量表评分、C反应蛋白(CRP)、丙二醛(MDA)、超氧化物歧化酶(SOD)、不良反应等。结果治疗组总缓解率96.77%高于对照组的93.55%(P <0.05),治疗后治疗组放射性损伤(EORCT)分级优于对照组(P <0.05)。两组治疗后中医证候量表评分与治疗前均降低,且治疗组低于对照组(均P <0.05)。两组治疗7 d后,CRP、MDA与治疗前比较均降低,而SOD则升高(均P <0.01),治疗组改善均优于对照组(均P <0.05)。两组口服中药及灌肠均未出现不良反应。结论清热促愈方联合康复新液灌肠对治疗放射性肠炎急性期确有良好疗效,其机制可能与肠黏膜细胞抗氧化作用相关。

Objective:To explore the therapeutic effect and mechanism of Qingre Cuyu Decoction combined with Kangfuxin Solution enema in the treatment of radiation enteritis in acute stage.Methods:A total of 62 patients were randomly divided into the treatment group and control group,31 cases in each group.Both groups had radiation enteritis in the first month after radiotherapy.The control group was treated with Kangfuxin Solution enema,and the treatment group was treated with self-made Qingre Cuyu Decoction combined with Kangfuxin Solution enema.The treatment effectiveness,radiation injury grade,TCM syndrome scale score,C-reactive protein(CRP),malondialdehyde(MDA),superoxide dismutase(SOD),adverse reactions,in the two groups were observed.Results:The total remission rate of the treatment group was 96.77%,which was higher than 93.55%of the control group(P<0.05).After treatment,the RTOG grade of the treatment group was better than that of the control group(P<0.05).The scores of TCM syndrome scale before treatment were not significantly different between the two groups(P>0.05).The scores of TCM syndrome scale of the two groups decreased after treatment compared with before treatment,and the treatment group was lower than the control group(both P<0.05).There were no significant differences in CRP,MDA,and SOD levels between the two groups before treatment(all P>0.05);after 7 days of treatment,CRP and MDA levels were lower than before treatment,while SOD level was increased(all P<0.01),and the improvement in the treatment group was better than that of the controlgroup after treatment(all P<0.05).There were no adverse reactions in the two groups.Conclusion:Qingre Cuyu Decoction combined with Kangfuxin Solution enema has a good effect on the treatment of radiation enteritis in acute stage,and its mechanism may be related to the anti-oxidation effect of intestinal mucosa cells.