中药灌肠对宫颈癌急性放射性直肠炎患者临床疗效及血清IL-1β、IL-8、TNF-α水平的影响  

Effect of Traditional Chinese Medicine Enema on Clinical Efficacy and Serum IL-1β,IL-8 and TNF-αLevels in Patients with Acute Radiation Proctitis of Cervical Cancer

作　　者：罗琼玉 李文全 陈磊 冯磊 李明武 龙慧 LUO Qiong-yu;LI Wen-quan;CHEN Lei;FENG Lei;LI Ming-wu;LONG Hui(Graduate School of Hunan University of Chinese Medicine,Changsha,Hunan,410000,China;Department of Hematology and Oncology,Shaoyang Central Hospital,Shaoyang,Hunan,422000,China;Department of Vascular and Tumor Intervention,Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine,Changsha,Hunan,410000,China;Department of Intensive Care Unit,The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan,410000,China)

机构地区：[1]湖南中医药大学研究生院,湖南长沙410000 [2]邵阳市中心医院血液肿瘤内科,湖南邵阳422000 [3]湖南省中医药研究院附属医院血管肿瘤介入科,湖南长沙410000 [4]湖南中医药大学第二附属医院重症医学科,湖南长沙410000

出　　处：《现代生物医学进展》2024年第4期788-791,777,共5页Progress in Modern Biomedicine

基　　金：湖南省中医药管理局科研课题(D2022087)。

摘　　要：目的:探讨中药灌肠对宫颈癌急性放射性直肠炎(ARP)患者临床疗效及血清白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)水平的影响。方法:选取2021年3月-2023年3月期间在邵阳市中心医院收治行放疗的宫颈癌ARP患者180例,采用随机数字表法将患者分为A组(常规治疗,n=90)和B组(A组的基础上接受中药灌肠,n=90)。观察两组临床疗效、放射损伤疗效、中医证候积分和IL-1β、IL-8、TNF-α水平变化情况,并对比不同放射性直肠炎分级患者的血清IL-1β、IL-8、TNF-α水平。结果:B组的临床总有效率高于A组(P<0.05)。两组治疗后黏液血便、腹痛、里急后重、稀便或便秘、肛门灼痛坠痛、口干口苦、尿赤等证候积分下降,且B组低于A组(P<0.05)。B组的放射损伤总有效率高于A组(P<0.05)。放射性直肠炎分级III级、Ⅱ级血清IL-1β、IL-8、TNF-α水平高于I级,且III级高于Ⅱ级(P<0.05)。两组治疗后血清IL-1β、IL-8、TNF-α水平下降,且B组低于A组(P<0.05)。结论:中药灌肠治疗宫颈癌ARP患者,可提高临床疗效,改善临床症状,可能与改善血清IL-1β、IL-8、TNF-α水平有关。Objective:To investigate the effect of traditional chinese medicine enema on clinical efficacy and serum levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and interleukin-8(IL-8)in patients with acute radiation proctitis(ARP)of cervical cancer.Methods:180 patients with cervical cancer ARP who underwent radiotherapy in Shaoyang Central Hospital from March 2021 to March 2023 were selected,patients were divided into A group(conventional treatment,n=90)and B group(traditional chinese medicine enema on the basis of A group,n=90)by random number table method.The clinical efficacy,efficacy radiation injury,chinese medicine syndrome scores and serum IL-1β,IL-8 and TNF-αlevels in two groups were observed.And compare of serum IL-1β,IL-8 and TNF-αlevels in patients with different grades of radiation proctitis.Results:The total clinical effective rate in B group was higher than that in A group(P<0.05).The scores of mucous bloody stool,abdominal pain,tenesmus,loose stool or constipation,anal burning pain,mouth dry mouth bitter and red urine in two groups decreased after treatment,and those in B group were lower than those in A group(P<0.05).The total effective rate of radiation injury in B group was higher than that in A group(P<0.05).Serum IL-1β,IL-8 and TNF-αlevels in grades of radiation proctitis III and II were higher than grade I,and grade III was higher than that of grade II(P<0.05).Serum IL-1β,IL-8 and TNF-αlevels in two groups decreased after treatment,and those in B group were lower than A group(P<0.05).Conclusion:Chinese medicine enema in the treatment of cervical cancer ARP patients can improve the clinical efficacy and clinical symptoms,which may be relate to the improvement of serum IL-1β,IL-8 and TNF-αlevels.

关 键 词：中药灌肠 宫颈癌 急性放射性直肠炎 临床疗效 IL-1β IL-8 TNF-α 

分 类 号：R737.33[医药卫生—肿瘤] R242[医药卫生—临床医学]