甘　远，黄方华，王瑞云，黄旭达(贵港市第二人民医院消化内科，广西 贵港　537132)



布地奈德与蒙脱石散联合治疗放射性肠炎的疗效观察

甘远*，黄方华，王瑞云，黄旭达(贵港市第二人民医院消化内科，广西 贵港537132)

DOI10.14009/j.issn.1672-2124.2016.02.015

摘要目的：探讨布地奈德与蒙脱石散联合治疗放射性肠炎的临床疗效。方法：选取贵港市第二人民医院2012年1月—2014年12月收治的放射性肠炎患者120例，按随机数字表法分为3组各40例，观察组患者给予布地奈德联合蒙脱石散灌肠治疗，对照1组患者给予布地奈德灌肠治疗，对照2组患者给予蒙脱石散口服治疗，2周为1疗程，疗程结束后，分别比较观察组与对照1组和对照2组的临床疗效。结果：观察组患者的总有效率90.00%，高于对照1组的45.00%，差异有统计学意义(P<0.05)；对照2组患者的总有效率为37.50%，与观察组比较，差异有统计学意义(P<0.05)。观察组患者出现不良反应2例，对照2组出现3 例，对照1组未出现不良反应。结论：布地奈德与蒙脱石散联合治疗放射性肠炎疗效明显优于单用布地奈德或单用蒙脱石散，且无明显不良反应，值得临床推广。

关键词放射性肠炎； 布地奈德； 蒙脱石散； 灌肠

Observation on Efficacy of Budesonide Combined with Montmorillonite Powder in Treatment of Radiation Enteritis

GAN Yuan, HUANG Fanghua, WANG Ruiyun, HUANG Xuda(Dept.of Gastroenterology, the Second People’s Hospital of Guigang, Guangxi Guigang 537132, China)

ABSTRACTOBJECTIVE：To investigate the clinical efficacy of budesonide combined with montmorillonite powder in treatment of radiation enteritis. METHODS: 120 cases with radiation enteritis admitted into the Second People’s Hospital of Guigang from Jan. 2012 to Dec. 2014 were selected to be divided into 3 groups via the random number table, with 40 cases in each. The observation group were given the treatment of enema of budesonide combined with montmorillonite powder, the control group one were given the treatment of enema of budesonide, while the control group two received montmorillonite powder; the treatment course was 2 weeks. The clinical efficacy were compared among three groups after the end of the treatment. RESULTS: The total effective rate of observation group was 90.00%, significantly higher than that of control group one 45.00%, the difference was statistically significant(P<0.05); the total effective rate of control group two was 37.50%, the difference was statistically significant compared with the observation group(P<0.05). There were 2 cases of adverse reactions in observation group, 3 cases in control group two, and no adverse reactions in control group one. CONCLUSIONS: The curative effect of budesonide combined with montmorillonite powder on radioactive enteritis is superior to single budesonide or montmorillonite powder, with few adverse reactions, it is worthy of worthy of clinical popularization and application.

KEYWORDSRadioactive enteritis; Budesonide; Montmorillonite powder; Enema

放射性肠炎是患者因接受放射治疗时所引起的肠道并发症，主要见于盆腔、腹腔或腹膜后肿瘤，以妇科肿瘤和前列腺肿瘤为多见，可累及小肠、结肠和直肠。放射性肠炎分为急性和慢性两种类型，二者无明显的区分界限，以放射治疗结束后出现肠道并发症的起病缓急作为大概判断标准[1]。以多因素交杂影响的复杂过程形成放射性肠炎，其中因肠黏膜隐窝的有丝分裂细胞死亡及肠道黏膜屏障遭受破坏引起急性炎症结果，从而形成急性放射性肠炎；而因肠壁血管的硬化和肠壁进行性纤维化形成慢性放射性肠炎[2-3]。放射性肠炎主要发病机制是电离辐射照……