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疗效及对患者炎症反应的影响  

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 inflammatory response

作　　者：陈十昔 赵彦[1] 韩宁宁 韩旭华 王思童 刘婷婷 王璐 CHEN Shixi;ZHAO Yan;HAN Ningning(Shijiazhuang Traditional Chinese Medicine Hospital,Shijiazhuang 050000;不详)

机构地区：[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 [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 [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

出　　处：《陕西中医》2020年第1期46-49,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：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)

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。Objective:To observe the effect of Baitouweng decoction retention enema combined with rhGM-CSF on acute radiation proctitis caused by pelvic radiotherapy of stageⅡ~Ⅲcervical cancer and its effect on inflammatory response.Methods:83 patients with acute radiation proctitis caused by pelvic radiotherapy of stageⅡ~Ⅲcervical 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 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 stageⅡ~Ⅲcervical cancer caused by pelvic radiotherapy,inhibit intestinal mucosal damage and infla

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 

分 类 号：R516.1[医药卫生—内科学]