肠炎平正I号方加味治疗放射性肠炎疗效观察

唐建清1，邓天好1,杨春华2

（1.湖南中医药大学附属中西医结合医院，湖南长沙410006; 2.湖南中医药大学第一附属医院,湖南长沙410007）

〔摘要〕目的观察肠炎平正I号方加味灌肠治疗放射性肠炎的临床疗效。方法将90例放射性肠炎患者随机分为治疗组与对照组，各45例。两组均进行基础治疗，治疗组采用肠炎平正I号方加味灌肠治疗，对照组采用常规西药灌肠治疗。观察比较两组的临床疗效及腹泻、腹痛等症状积分、KPS积分，并检测治疗前后CD3+、CD4+、CD8+等免疫指标水平的变化。结果治疗组总有效率为93.3%，高于对照组的75.6%（P＜0.05）；除对照组乏力症状外，两组其他症状积分治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P＜0.01，P＜0.05）;治疗组CD4+、CD8+、CD4+/CD8+治疗前后组内比较，差异均有统计学意义（P＜0.05）；治疗后两组CD3+、CD4+、CD8+组间比较，差异无统计学意义（P＞0.05），但两组CD4+/CD8+组间比较，差异有统计学意义（P＜0.05）。KPS积分治疗组治疗前后组内比较，差异有统计学意义（P＜0.05）；治疗后组间比较，差异有统计学意义（P＜0.05）。结论肠炎平正I号方加味灌肠治疗放射性肠炎疗效显著。

〔关键词〕放射性肠炎；中医药疗法；灌肠；肠炎平正I号方

Clinical Effect Observation of Modified Changyanpingzheng No. I Prescription on Treatment of Radiation Enteritis

TANG Jianqing1, DENG Tianhao1, YANG Chunhua2

(1. The Affiliated Integrated Chinese and Western Hospital, Hunan University of Chinese Medicine, Changsha, Hunan 410006, China; 2. The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China)

〔Abstract〕Objective To observe the clinical efficacy of modified Changyanping No. I enema in the treatment of radiation enteritis.Methods Ninety patients with radiation enteritis were randomly divided into the treatment group and control group, 45cases in each group. In addition to basic treatment, modified Changyanping No. I enema was given to the treatment group, while a conventional Western medicine enema to the control group. The two groups were compared in terms of clinical outcome, scores of diarrhea, abdominal pain, and other symptoms, and Karnofsky Performance Scale (KPS) score, and the changes of immune indices such as CD3+, CD4+, and CD8+T cells were detected. Results The total effective rate of treatment group was 93.33%, which was higher than 75.6% of the control group (P<0.05). Except for the fatigue symptom in the control group, the two groups showed significant changes in other symptom scores, which also varied significantly between the two groups (P<0.01, P<0.05). After treatment, the treatment group showed significant changes in CD4+and CD8+T cells and CD4+/CD8+ratio (P<0.05), there were no significant differences in CD3+, CD4+, and CD8+T cells between the two groups (P>0.05), but a significant difference in CD4+/CD8+ratio was observed between the two groups (P<0.05). After treatment, the treatment group showed a significant change in KPS score (P<0.05), there was a significant difference in KPS score between the two groups (P<0.05). Conclusion Modified Changyanping No. I enema shows significant efficacy in treatment of radiation enteritis.

〔Keywords〕radiation enteritis; traditional Chinese medicine treatment; enema; Changyanping No. I

放射性肠炎(Radiation Enteritis，RE)是放射治疗盆腔、腹腔或腹膜后恶性肿瘤引起的肠道疾病，以腹痛、腹泻、黏液脓血便甚至鲜血便，最终致肠道狭窄、肠梗阻、瘘管形成为特点。接受照射的患者几乎100%可发生肠道组织学改变，严重肠道放射性损伤的病死率为22%[1]。因此，积极探索有效的治疗方法缓解患者症状、减轻痛苦、提高其生活质量与生存期具有重要意义。……