补肾健脾温肠方联合灌肠治疗慢性放射性肠炎(脾肾双虚)的临床研究  

Clinical study on the treatment of chronic radiation enteritis(spleen and kidney deficiency)with Bushen Jianpi Wenchang Prescription combined with enema

作　　者：吴昊 丁井永 耿碧竹 吴易超 谢燕东 WU Hao;DING Jinyong;GENG Bizhu;WU Yichao;XIE Yandong(Department of Traditional Chinese Medicine,Second Affiliated Hospital,Air Force Military Medical University of People's Liberation Army,Xian,710038,China;Department of Gastroenterology,Second Affiliated Hospital,Air Force Military Medical University of People's Liberation Army)

机构地区：[1]空军军医大学第二附属医院中医科,西安710038 [2]空军军医大学第二附属医院消化科

出　　处：《中国中西医结合消化杂志》2023年第4期274-278,284,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：2021年度社会人才资助计划(No:2021SHRC006、2021SHRC068)。

摘　　要：目的:探讨补肾健脾温肠方口服联合重组人粒细胞巨噬细胞集落刺激因子(granulocyte macrophage colony-stimulating factor,GM-CSF)灌肠治疗慢性放射性肠炎的疗效及安全性。方法:选取61例慢性放射性肠炎患者为研究对象,随机分为治疗组(31例)和对照组(30例)。治疗组给予补肾健脾温肠方口服联合GM-CSF灌肠,对照组给予谷氨酰胺肠溶胶囊口服联合地塞米松加蒙脱石散灌肠;两组均连续治疗30 d。观察两组治疗前后的疗效、肠道放射反应程度分级、维也纳肠镜评分、患者自评-主观全面评定(patient-generated subjective global assessment,PG-SGA)评分、中医证候评分(腹痛、腹泻)、不良反应。结果:治疗组缓解率为93.5%(29/31),对照组缓解率为80.0%(24/30),两组比较差异有统计学意义(Z=-2.202,P=0.043);两组患者治疗后的肠道放射反应程度分级、维也纳肠镜评分、中医证候评分均较治疗前改善;治疗后治疗组的肠道放射反应程度分级、维也纳肠镜评分、中医证候评分均优于对照组(均P<0.05);治疗后两组患者的PG-SGA评分均优于治疗前,治疗后两组比较差异无统计学意义(P>0.05)。结论:补肾健脾温肠方口服联合GM-CSF保留灌肠可降低慢性放射性肠炎患者的肠道损伤程度,改善患者的维也纳肠镜评分以及腹泻、纳差、营养状态,并且安全性好。Objective:To investigate the efficacy and safety of Bushen Jianpi Wenchang Prescription combined with granulocyte-macrophage colony-stimulating factor(GM-CSF)enema in the treatment of chronic radiation enteritis.Methods:Sixty-one patients with chronic radiation enteritis were selected as research objects and randomly divided into a treatment group(3l cases)and a control group(30 cases).The treatment group was given Bushen Jianpi Wenchang Prescription oral combined with GM-CSF enema,and the control group was given glutamine enteric coated capsule oral combined with dexamethasone+montmorillonite powder enema for 30 consecutive days.Observe the symptom response rate,the grade of intestinal radiation reaction,the Vienna enteroscopy score(VRS),patient-generated subjective global assessment(PG-SGA),the Traditional Chinese Medicine(TCM)syndrome score(abdominal pain,diarrhea),and adverse reactions before and after treatment.Results:The remission rate in the treatment group was 93.5%(29/31),and that in the control group was 80.0%(24/30).The difference between the two groups was statistically significant(Z=-2.202,P=0.043);after treatment,the degree of intestinal radiation reaction,the VRS and TCM syndrome score of the two groups were improved compared with those before treatment;after treatment,the treatment group was superior to the control group in the grading of intestinal radiation reaction,the VRS and the iscore of TCM syndromes(P<0.05);the PG-SGA score of the two groups after treatment was better than that before treatment,and there was no significant difference between the two groups after treatment(P>0.05).Conclusion:Bushen Jianpi Wenchang Prescription combined with retention enema can reduce the degree of intestinal injury in patients with chronic radiation enteritis,improve the patients enteroscopy score,diarrhea,anorexia,and nutritional status,and is safe.

关 键 词：补肾健脾温肠方 慢性放射性肠炎 脾肾双虚证 重组人粒细胞巨噬细胞集落刺激因子 复方谷氨酰胺肠溶胶囊 灌肠 

分 类 号：R574[医药卫生—消化系统]