硫普罗宁联合糖皮质激素治疗放射性肠炎的临床观察  

Clinical observation of tiopronin combined with glucocorticoid in the treatment of radiation enteritis

作　　者：查琳[1] 王跃华[1] 汪金云[1] 任光平[1] 乔田奎 ZHA Lin;WANG Yue-hua;WANG Jin-yun;REN Guan-ping;QIAO Tian-kui(Tongling Peopled Hospital,244000 Tongling,Ahhui Province,China;Jinshan Hospital,Medical Center of Fudan University,201508 Shanghai,China)

机构地区：[1]安徽省铜陵市人民医院肿瘤二科,安徽铜陵244000 [2]复旦大学附属金山医院肿瘤科,上海201508

出　　处：《临床消化病杂志》2021年第4期277-280,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]探讨硫普罗宁联合糖皮质激素治疗放射性肠炎的作用。[方法]选择接受盆腔精确放疗的64例患者,随机分为实验组与对照组,实验组33例,对照组31例。实验组使用糖皮质激素联合硫普罗宁、对照组单纯使用糖皮质激素控制急性放射性肠炎症状,记录所有患者放疗前后一般状况、体质量、血象等指标;并跟踪随访1年左右时间,对比2组慢性放射性肠炎发生情况。[结果]实验组急性放射性肠炎控制率为90.90%,高于对照组的78.26%,但2组比较差异无统计学意义(P>0.05);实验组食欲下降、乏力不适发生率及重度中性粒细胞减少率为24.24%及30.30%,对照组为54.84%及58.06%,2组比较均差异有统计学意义(χ2=5.07、P<0.05及χ2=5.01,P<0.05)。实验组、对照组慢性放射性肠炎发生率分别为3.03%、25.81%,2组比较差异有统计学意义(χ2=5.11,P<0.05);放疗完成后,实验组、对照组KPS评分下降10分以上的发生率分别为15.15%、38.71%,2组比较差异有统计学意义(χ2=4.55,P<0.05);实验组总体体质量均数下降(5.38±2.76)%,对照组下降(7.71±2.64)%,2组比较差异有统计学意义(t=3.45,P<0.01)。[结论]硫普罗宁联合糖皮质激素治疗放射性肠炎,能有效控制腹痛、腹泻、便血等局部症状,缓解患者放疗过程中食欲下降、乏力全身不适,改善患者营养状况和机体功能状态,防治骨髓抑制及减少慢性放射性肠炎的发生,提高患者对放疗耐受性,有助于改善预后,为临床治疗放射性肠炎提供新思路。[Objective]To investigate the effects of tiopronin combined with glucocorticoid in the treatment of radiation enteritis.[Methods]All the 64 patients,who received pelvic precise radiotherapy in the cancer center of our hospital from January 2014 to November 2018,were randomly assigned to experimental group and control group.Patients diagnosed as radiation enteritis,were treated with tioprenin and glucocorticoid in the experimental group,while glucocorticoid in the control group.The symptoms,the body weight,the Karnofsky Performance Status Scale(KPS)and the blood profile of patients were observed.[Results]The control of local symptoms of acute radiation enteritis was similar between the two groups(P>0.05).The incidences of systemic symptoms,severe neutropenia,chronic radiation enteritis,and the decline of KPS levels were lower in the treatment group compared to the control group(24.24%,30.30%,3.03%and 15.15%vs 54.84%,58.06%,25.81%and 38.71%,respectively,P<0.05).Patients lost(5.38±2.76)%of their body weight in the treatment group,while(7.71±2.64)%in the control group(P<0.01).[Conclusion]Tiopronin and glucocorticoid administration during pelvic radiotherapy were shown to relieve local and systemic symptoms of acute radiation enteritis,improve patients’nutritional status,and to reduce the incidence of severe neutropenia and chronic radiation enteritis.Our study provides a new treatment regimen for radiation enteritis.

关 键 词：放射性肠炎 放射治疗 糖皮质激素 硫普罗宁 

分 类 号：R516.1[医药卫生—内科学]