超声介导下中药经穴渗透治疗氟脲嘧啶相关性腹泻临床研究

Clinical Study on Ultrasound-Mediated Point Penetration with Chinese Medicine for Fluorouracil-Associated Diarrhea

目的:观察超声介导下中药经穴渗透治疗氟脲嘧啶相关脾虚湿阻型腹泻的临床疗效。方法:选择采用FOLFOX方案(5-氟尿嘧啶+亚叶酸钙+奥沙利铂)治疗期间出现氟脲嘧啶相关腹泻的100例结直肠癌患者,按随机数字表法分为对照组和观察组各50例。2组均接受FOLFOX方案化疗,对照组在FOLFOX方案化疗基础上给予常规西药治疗,观察组在对照组基础上采用超声介导下中药经穴渗透技术治疗。评价2组临床疗效,比较2组临床症状消失时间、肠道黏膜屏障功能及健康状况,观察2组治疗期间不良反应发生情况。结果:观察组总有效率为96.00%,对照组为80.00%,2组比较,差异有统计学意义(P<0.05)。观察组腹泻、腹胀、腹痛消失时间及肠鸣音恢复时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,2组二胺氧化酶(DAO)、D-乳酸(D-LA)、内毒素水平较治疗前降低(P<0.05),且观察组DAO、D-LA、内毒素水平低于对照组(P<0.05)。治疗后,2组卡氏(KPS)评分较治疗前升高(P<0.05),且观察组KPS评分高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:超声介导下中药经穴渗透治疗氟脲嘧啶相关脾虚湿阻型腹泻疗效确切,可缩短患者临床症状改善时间,改善肠道黏膜屏障功能及健康状况,且不良反应轻微。

Objective:To observe the clinical effect of ultrasound-mediated point penetration with Chinese medicine for Fluorouracil-associated diarrhea of spleen deficiency and dampness obstruction type.Methods:A total of 100 cases of patients with colorectal cancer who developed Fluorouracil-associated diarrhea during the treatment with FOLFOX regimen(5-Fluorouracil+Calcium Leucovorin+Oxaliplatin)were divided into the control group and the observation group according to the random number table method,with 50 cases in each group.Both groups were treated with chemotherapy with FOLFOX regimen;the control group was additionally treated with routine western medicine based on FOLFOX regimen,and the observation group was additionally treated with ultrasound-mediated point penetration with Chinese medicine based on the treatment of the control group.The clinical effects in the two groups were evaluated.The disappearance time of clinical symptoms,intestinal mucosal barrier function,and health conditions were compared between the two groups.The incidence of adverse reactions during treatment were observed in the two groups.Results:The total effective rate was 96.00%in the observation group and 80.00%in the control group,the difference being significant(P<0.05).The disappearance time of diarrhea,abdominal distension,and abdominal pain,and the recovery time of bowel sounds in the observation group were shorter than those in the control group,the difference being significant(P<0.05).After treatment,the levels of diamine oxidase(DAO),D-lactate(D-LAC)and endotoxin in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of DAO,D-LA and endotoxin in the observation group were lower than those in the control group(P<0.05).After treatment,the scores of Karnofsky Performance Scale(KPS)in the two groups were increased when compared with those before treatment(P<0.05),and the KPS score in the observation group was higher than that in the control group(P<0.05).There was no significance being found in the comparison of incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ultrasound-mediated point penetration with Chinese medicine has a definite curative effect in treating Fluorouracil associated diarrhea of spleen deficiency and dampness obstruction type,which can shorten the improvement time of clinical symptoms,and improve intestinal mucosal barrier function and health conditions,with mild adverse reactions.