化浊灌肠方保留灌肠治疗热毒伤络型急性放射性直肠炎临床观察

Clinical efficacy of Huazhuo Guanchang Formula for acute radiation proctitis of heat-toxin injury-collateral type

目的观察化浊灌肠方保留灌肠治疗热毒伤络型急性放射性直肠炎的临床疗效。方法将80例热毒伤络型急性放射性直肠炎患者按照随机数字表法分为2组,对照组40例予蒙脱石散+地塞米松磷酸钠注射液灌肠,治疗组40例予化浊灌肠方保留灌肠治疗。2组均治疗4周。比较2组治疗前后中医证候评分变化;比较2组中医证候疗效;比较2组治疗前后急性放射性直肠炎分级、卡氏功能状态(KPS)评分变化。结果2组治疗后中医证候各项评分及总评分均较本组治疗前降低(P<0.05),治疗组治疗后中医证候各项评分及总评分均低于对照组(P<0.05)。治疗组总有效率90.0%(36/40),对照组总有效率72.5%(29/40),治疗组中医证候疗效优于对照组(P<0.05)。治疗后治疗组急性放射性直肠炎分级优于对照组(P<0.05)。2组治疗后KPS评分均较本组治疗前升高(P<0.05),治疗后治疗组KPS评分高于对照组(P<0.05)。结论化浊灌肠方保留灌肠治疗热毒伤络型急性放射性直肠炎,能减轻患者腹痛、腹泻、便血、黏液便等症状,改善生活质量,无不良反应。

Objective To observe the clinical efficacy of Huazhuo Guanchang Formula for acute radiation proctitis(ARP)of heat-toxin injury-collateral type.Methods Totally 80 ARP patients(heat-toxin injury-collateral type)were randomly assigned to receive either enema intervention of montmorillonite powder+dexamethasone sodium phosphate injection(the control group,n=40)or retention enema intervention of Huazhuo Guanchang Formula(the treatment group,n=40).Treated for 4 weeks,the aim was to compare traditional Chinese medicine(TCM)syndrome score,TCM curative effect,grading of ARP,Karnofsky Performance Status(KPS)scores.Results After treatment,TCM symptom scores in groups were decreased(P<0.05),which were decreased in the treatment group compared with the control group(P<0.05).The overall effective rate in the treatment group and the control group was 90.0%(36/40)and 82.5%(29/40),respectively,the TCM curative effect was better in the treatment group than the control group(P<0.05).The grading of ARP in the treatment group was superior to the control group(P<0.05).KPS scores in groups were increased,which were increased in the treatment group relevant to the control group(P<0.05).Conclusion For ARP patients(heat-toxin injury-collateral type),retention enema intervention of Huazhuo Guanchang Formula can relieve abdominal pain,diarrhea,hematochezia,mucous stool and other symptoms,improve quality of life,without adverse reactions.