高压氧联合隔药脐灸或保留灌肠治疗急性放射性直肠炎疗效的对比研究

Comparative study of hyperbaric oxygen combined with herbal cake-separated moxibustion on umbilicus and retention enema in treating acute radiation proctitis

目的:比较高压氧联合隔药脐灸或保留灌肠治疗急性放射性直肠炎(ARP)的临床疗效,并统计其接受度和满意率。方法:选取2016年6月 至2021年12月临沂市中心医院中医肿瘤科收治的宫颈癌放疗后发生ARP患者64 例作为研究对象,按随机数字表法分为观察组( n=32)和对照组( n=32)。对照组予以思密达和康复新液保留灌肠并联合高压氧治疗,观察组采用隔药脐灸联合高压氧治疗。采用全美放射肿瘤治疗协作组分级标准评估治疗前后直肠损伤程度,并统计临床疗效。采用国际放疗远期并发症评分标准计算ARP患者症状积分和总积分,并统计患者满意率和接受度。 结果:治疗4个疗程后,根据临床症状分级,与同组治疗前比较,观察组和对照组患者治疗后分级均明显改善( P<0.01)。观察组患者治疗后分级改善情况及临床治疗效果与对照组比较差异无统计学意义( P>0.05)。观察组患者对隔药脐灸治疗方式的接受度和满意率明显高于对照组( P<0.01)。 结论:高压氧联合隔药脐灸或保留灌肠治疗ARP均能取得较好的临床治疗效果,但隔药脐灸治疗ARP无侵入性,可避免反复药物灌肠加重直肠黏膜和肛周损伤;同时隔药脐灸操作简便,患者痛苦少,可接受度和治疗满意率均较高,可推广应用。

Objective To compare the clinical efficacy of hyperbaric oxygen combined with herbal cake-separated moxibustion on umbilicus and retention enema in treating acute radiation proctitis(ARP),and to statistically analyze their rates of acceptance and satisfaction.Methods A total of 64 patients with ARP after radiotherapy for cervical cancer treated in Linyi Central Hospital from June 2016 to December 2021 were selected and divided into observation group(n=32)and control group(n=32)according to the number table method.The control group was treated with(Smecta and Kangfuxin solution)retention enema combined with hyperbaric oxygen,and the observation group was treated with herbal cake-separated moxibustion on umbilicus combined with hyperbaric oxygen.The degree of rectal injury before and after radiotherapy was evaluated according to the criteria of the Radiation Therapy Oncology Group(RTOG),and the clinical efficacy was analyzed.The symptom score and total score of ARP patients were calculated by international scoring standards for long-term complication of radiotherapy,and the satisfaction rate and acceptance rate of the two groups were analyzed.Results After four courses of treatment,compared with the same group before treatment,the classifications of clinical symptoms in both the observation group and the control group were significantly improved(P<0.01),but there was no significant difference between the observation group and the control group(P>0.05).The acceptance rate and satisfaction rate of patients treated with herbal cake-separated moxibustion on umbilicus in the observation group was significantly higher than that in the control group(P<0.01).Conclusion Both hyperbaric oxygen combined with herbal cake-separated moxibustion on umbilicus and retention enema in treating ARP can achieve good clinical therapeutic effect.As a non-invasive approach,the herbal cake-separated moxibustion on umbilicus can avoid aggravating rectal mucosa and perianal injury caused by repeated drug enema.Meanwhile,the herbal cake-separated moxibustion on umbilicus is simple and easy to operate,with less pain for patients,high rates of acceptability and satisfaction,which can be popularized and applied.