[1]陈十昔,赵 彦,韩宁宁,等.白头翁汤保留灌肠联合rhGMCSF治疗Ⅱ~Ⅲ期宫颈癌盆腔放疗〖JZ〗所致急性放射性直肠炎疗效及对患者炎症反应的影响*[J].陕西中医,2020,(1):46-49.
 CHEN Shixi,ZHAO Yan,HAN Ningning,et al.Effect of Baitouweng decoction retention enema combined with rhGMCSF on acute radiation 〖JZ〗proctitis caused by pelvic radiotherapy of stage Ⅱ~Ⅲ cervical cancer and its inflammatory response[J].,2020,(1):46-49.
点击复制

白头翁汤保留灌肠联合rhGMCSF治疗Ⅱ~Ⅲ期宫颈癌盆腔放疗〖JZ〗所致急性放射性直肠炎疗效及对患者炎症反应的影响*
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2020年1期
页码:
46-49
栏目:
临床研究
出版日期:
2020-01-05

文章信息/Info

Title:
Effect of Baitouweng decoction retention enema combined with rhGMCSF on acute radiation 〖JZ〗proctitis caused by pelvic radiotherapy of stage Ⅱ~Ⅲ cervical cancer and its inflammatory response
文章编号:
DOI:10.3969/j.issn.10007369.2020.01.012
作者:
陈十昔1赵 彦1韩宁宁2韩旭华3王思童4刘婷婷5王 璐6
1.石家庄市中医院(石家庄 050000);2.河北港口集团有限公司港口医院 (秦皇岛 066000); 〖JZ〗3.河北省安平县中医院(安平 053600);4.华北理工大学中医学院 (唐山 063210);〖JZ〗5.河北省唐山市妇幼保健院 (唐山 063000);6.河北北方学院 (张家口 075000)
Author(s):
CHEN ShixiZHAO YanHAN Ningninget al.
Shijiazhuang Traditional Chinese Medicine Hospital (Shijiazhuang 050000)
关键词:
rhGMCSF白头翁汤保留灌肠宫颈癌放疗放射性直肠炎炎症反应
Keywords:
Key words 〖WT5BZ〗〖HT5”SS〗rhGM CSFPulsatilla decoctionRetention enemaCervical cancerRadiotherapyRadiation proctitisInflammatory response
分类号:
R516.1
文献标志码:
A
摘要:
摘 要 目的:观察白头翁汤保留灌肠联合rhGMCSF对Ⅱ~Ⅲ期宫颈癌盆腔放疗所致急性放射性直肠炎的疗效及对炎症反应的影响。 方法:将83例Ⅱ~Ⅲ期宫颈癌盆腔放疗所致的急性放射性直肠炎患者随机分为观察组(41例)和对照组(42例),两组均接受消炎止痛止泻等对症治疗,对照组在其基础上给予rhGMCSF治疗,观察组在对照组基础上加用白头翁汤保留灌肠治疗,两组疗程均为两周。比较两组的临床疗效,记录两组治疗前后中医症状积分、直肠黏膜评分及KPS评分、血清炎性细胞因子的变化。结果:观察组临床总有效率为92.68%(38/41),对照组为71.43%(30/42),观察组显著高于对照组(P<0.05)。与治疗前比较,两组治疗后腹痛、腹泻、腹胀、便血、里急后重、食少、身体困重、身热不扬积分和中医症候总积分均明显降低(P<0.05),治疗后以上积分观察组较对照组改善更明显(P<0.05);与治疗前比较,观察组直肠黏膜评分明显降低,KPS评分则有明显增加(P<0.05),治疗后观察组直肠黏膜评分低于对照组(P<0.05),KPS评分显著高于对照组(P<0.05)。与治疗前比较,两组治疗后血清肿瘤坏死因子α(TNFα)、白细胞介素6(IL6)和白细胞介素1(IL1)水平明显降低(P<0.05);治疗后观察组以上指标均低于对照组(P<0.05)。结论:白头翁汤保留灌肠联合rhGMCSF治疗Ⅱ~Ⅲ期宫颈癌盆腔放疗所致急性放射性直肠炎的疗效确定,可显著改善患者临床症状及生活质量,抑制肠道黏膜损伤,抑制炎症反应。
Abstract:
Abstract 〖WT5BZ〗〖HT5”SS〗Objective:To observe the effect of Baitouweng decoction retention enema combined with rhGMCSF on acute radiation proctitis caused by pelvic radiotherapy of stage Ⅱ~Ⅲ cervical cancer and its effect on inflammatory response.Methods:83 patients with acute radiation proctitis caused by pelvic radiotherapy of stage Ⅱ~Ⅲ cervical cancer were randomly divided into two groups:the observation group (41 cases) and the control group (42 cases).The two groups were treated with antiphlogistic,analgesic,antidiarrheal and other symptomatic treatment.The control group was treated with rhGM CSF.The observation group was treated with Baitouweng decoction retention enema on the basis of the control group.The two groups were treated for two weeks.The clinical effects of the two groups were compared,and the changes of TCM symptom score,rectal mucosa score,KPS score and serum inflammatory cytokines were recorded before and after treatment.Results:the total clinical effective rate was 92.68% (38/41) in the observation group and 71.43% (30/42) in the control group,which was significantly higher in the observation group than in the control group (P<0.05).Compared with before treatment,the scores of abdominal pain,diarrhea,abdominal distention,hematochezia,urgency,less food,body distress,body heat stagnation and the total scores of TCM symptoms in the two groups were significantly reduced (P<0.05).After treatment,the rectal mucosa score of the observation group was lower than that of the control group (P<0.05),and the KPS score was higher〖LM〗 than that of the control group (P<0.05).Compared with before treatment,the levels of TNF  α,IL6 and IL1 in the two groups were significantly lower after treatment (P<0.05),and those in the observation group were lower than those in the control group (P<0.05).Conclusion:rhGM CSF combined with Baitouweng decoction retention enema can significantly improve the clinical symptoms and quality of life of patients with stage Ⅱ~ Ⅲ cervical cancer caused by pelvic radiotherapy,inhibit intestinal mucosal damage and inflammatory response,which is worthy of clinical recommendation.

参考文献/References:

[1] 陈宇杰,石志敏,李雪青.乌梅丸联合驻车丸灌肠防治宫颈癌放疗所致急性放射性直肠炎的临床观察[J].中华中医药杂志,2018,33(7):29752977.
[2] 要雪品,翟福山,李 楠,等.腹、盆腔肿瘤放疗后急性放射性肠道损伤的剂量学因素分析[J].现代肿瘤医学,2016,24 (5):133137.
[3] 廖丽华,蓝 川,吴 燕.康复新液联合塞来昔布胶囊保留灌肠治疗放射性肠炎疗效研究[J].陕西中医,2018,39(2):160162.
[4] 中国医师协会外科医师分会,中华医学会外科学分会结直肠外科学组.中国放射性直肠炎诊治专家共识(2018版)[J].中华胃肠外科杂志,2018,21(12):13211336.
[5] 国家中医药管理局.中医病证诊断疗效标准\[S\].南京:南京大学出版社,1994:67.
[6] 国家食品药品监督管理局.中药新药临床研究指导原则\[S\].北京:中国医药科技出版社, 2002:219.
[7] D'Haens G,Sandborn WJ,Feagan BG,et al.A review of activity indices and efficacy end points for clinicaltrialsof medical therapy in adults with ulcerative colitis[J].Gastroenterology,2007,132(2):763786.
[8] 汤钊猷.现代肿瘤学[M].上海:复旦大学出版社,2011:211212.
[9] 苏 进,李 毅,刘 孜.宫颈癌二维与三维适形近距离治疗剂量学的比较研究[J].西安交通大学学报:医学版,2018,39(3):409413.
[10] 何新颖,高志远,孙云川.安肠组方灌肠治疗急性放射性肠炎临床疗效及对血清IL2、IFNγ、IL10的影响[J].中国中西医结合杂志,2018,38(7):795798.
[11] 黄薇隗,张 炜,徐内卫,等.复方苦参注射液联合平溃散保留灌肠治疗急性放射性直肠炎疗效及对机体炎症反应的影响[J].现代中西医结合杂志,2018,27(24):2830.
[12] 李思聪.肠复康方对急性放射性肠炎大鼠一般情况及小肠黏膜炎性因子的影响[J].中国中西医结合消化杂志,2016,24(8):594599.
[13] 包 兴,白明华,王中卫,等.重组人粒巨噬细胞集落刺激因子漱口液预防和治疗局部晚期鼻咽癌同步放化疗所致口腔黏膜炎[J].肿瘤研究与临床,2018,30(3):184189.
[14] 龚 芸,何旭东.重组人粒细胞巨噬细胞集落刺激因子联合传统西药保留灌肠治疗放射性肠炎的临床疗效观察[J].临床消化病杂志,2017,29(6):383384.
[15] 蒋伟冬,陆金根,殷立新,等.红萸饮治疗放射性肠炎临床研究[J].陕西中医,2018,39(8):10081010.
[16] 崔国宁,刘喜平,董俊刚,等.白头翁汤治疗溃疡性结肠炎研究进展[J].山东中医药大学学报,2018,42(4):370373.

备注/Memo

备注/Memo:
*河北省中医药管理局科研计划课题(2016160) 华北理工大学研究生创新项目(2019S36)
更新日期/Last Update: 2020-02-17