参苓白术散加味联合美沙拉嗪栓治疗慢性放射性肠炎的临床疗效及对患者胃肠功能的影响

Effects of Modified Shenlingbaizhu Powder Combined with Mesalazine Suppository in the Treatment of Chronic Radiation Enteritis and Its Influence on Gastrointestinal Function

目的探讨参苓白术散加味联合美沙拉嗪栓治疗慢性放射性肠炎的临床疗效及对患者胃肠功能的影响。方法选取2019年2月至2020年2月在灯塔市中医医院中医科病房及门诊治疗的慢性放射性肠炎患者69例作为研究对象,按随机数字表法分为对照组34例与观察组35例,因在后期随访受限,对照组随访失败1例,观察组随访失败2例,最终纳入研究为对照组33例,观察组33例。两组给予常规对症治疗,对照组在常规治疗基础上予以美沙拉嗪栓治疗,观察组在对照组基础上采用参苓白术散加味治疗。比较两组患者临床疗效、炎症介质水平、生活质量量表(QOL)评分、中医证候积分、胃肠功能情况。结果观察组治疗有效率为97.0%,明显高于对照组的78.8%,差异有统计学意义(χ^(2)=5.121,P=0.024)。治疗后,观察组肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、超敏C反应蛋白(hs-CRP)、中医证候积分、大便次数、腹痛次数、便血次数及肠鸣音次数低于对照组(P<0.05),QOL评分高于对照组(P<0.05)。结论参苓白术散加味联合美沙拉嗪栓治疗慢性放射性肠炎的效果确切,患者生命质量明显提高,症状体征明显改善,胃肠功能明显提高,远期疗效可观。

Objective To investigate the clinical efficacy of modified Shenling Baizhu Powder combined with mesalazine suppository in the treatment of chronic radiation enteritis and its effect on gastrointestinal function of patients.Methods A total of 69 patients with chronic radiation enteritis treated in wards and outpatients of Traditional Chinese Medicine Department,Dengta Hospital of Traditional Chinese Medicine from February 2019 to February 2020 were selected as the research objects.According to the random number table method,they were divided into a control group(34 cases)and an observation group(35 cases).Due to the limited follow-up in the later period,1 case failed in the control group and 2 cases in the observation group.Finally,33 cases in the control group and 33 cases in the observation group were included in the study.Both groups were given conventional symptomatic treatment,the control group was treated with mesalazine suppository on the basis of conventional treatment,and the observation group was treated with modified Shenlingbaizhu Powder on the basis of the control group.The clinical efficacy,levels of inflammatory mediators,quality of life scale(QOL)scores,TCM syndrome scores,and gastrointestinal function were compared between the 2 groups of patients.Results The effective rate of treatment in the observation group was 97.0%,which was significantly higher than the 78.8%in the control group.The difference was statistically significant(χ^(2)=5.121,P=0.024).After treatment,the observation group’s TNF-α,IL-1β,hs-CRP,TCM syndrome scores,stool frequency,abdominal pain,blood in the stool,and bowel sounds were lower than those in the control group(P<0.05),and the QOL score was higher than the control group(P<0.05).Conclusion Modified Shenling Baizhu Powder combined with mesalazine suppository has a definite effect in the treatment of chronic radiation enteritis.The quality of life of the patients has been significantly improved,symptoms and signs have been significantly restored,gastrointestinal function has been significantly improved,and long-term effect is considerable.