李华英 朱宇敏 杨上望

[摘要] 目的 观察铝镁加混悬液联合康复新液保留灌肠在慢性放射性直肠炎中的治疗效果。 方法 选取2018年7月至2020年7月福建中医药大学附属康复医院收治的58例慢性放射性直肠炎患者作为研究对象。根据随机分组法分为研究组与对照组，每组各29例。研究组采用铝镁加混悬液联合康复新液保留灌肠，对照组采用铝镁加混悬液联合表皮生长因子保留灌肠，比较治疗2周后两组的临床症状疗效、C-反应蛋白（CRP）指标和生活质量评分。 结果 研究组临床症状疗效总有效率为89.66%，对照组为72.41%，研究组总有效率高于对照组（P<0.05）。两组治疗后CRP均显著下降，研究组CRP下降值为（11.21±5.30）mg/L，高于对照组的（6.31±4.80）mg/L。研究组情绪功能、社会功能评分高于对照组，差异均有统计学意义（P<0.05）。 结论 铝镁加混悬液联合康复新液治疗慢性放射性直肠炎疗效高于使用铝镁加混悬液联合表皮生长因子保留灌肠，且改善患者临床症状的同时可提高患者生活质量，值得临床推广应用。

[关键词] 铝镁加混悬液;康复新液;放射性直肠炎;灌肠

[中图分类号] R737.3          [文献标识码] A          [文章编号] 1673-9701（2021）34-0012-04

[Abstract] Objective To observe the effect of almagate suspension combined with kangfuxin retention enema in the treatment of chronic radiation proctitis. Methods A total of 58 patients with chronic radiation proctitis admitted to the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from July 2018 to July 2020 were selected. They were randomly divided into the study group and the control group， with 29 patients in each group. The study group were given almagate suspension combined with kangfuxin retention enema， and the control group were given almagate suspension combined with epidermal growth factor retention enema. The clinical symptoms， C-reactive protein（CRP） indicator and quality of life score were compared between the two groups after 2 weeks of treatment. Results The total effective rate of clinical symptoms in the study group was 89.66%， which was higher than that in the control group as 72.41%（P<0.05）. The CRP decreased significantly in both groups after treatment， but the decrease of CRP in the study group （11.21±5.30）mg/L was higher than that in the control group （6.31±4.80）mg/L. The emotional function and social function scores in the study group were higher than those in the control group（P<0.05）. The above differences were statistically significant（P<0.05）. Conclusion The effect of almagate suspension combined with kangfuxin retention enema is better that of almagate suspension combined with epidermal growth factor retention enema in the treatment of chronic radiation proctitis. It can improve clinical symptoms and quality of life in patients. It is worthy of clinical application and promotion.

[Key words] Almagate suspension; Kangfuxin retention; Radiation proctitis; Enema

放射性直肠炎（Radiation proctitis，RP）是指因盆腔恶性肿瘤，如前列腺癌、直肠癌、宫颈癌、子宫内膜癌、卵巢癌、膀胱癌而接受放射治疗后引起的直肠放射性损伤，通常病程以3个月为界，分为急性放射性直肠炎（Acute radiation proctitis，ARP）和慢性放射性直肠炎（Chronic radiation proctitis，CRP）[1]。急性放射性直肠炎大部分具有自限性，通常表现为轻微腹瀉、里急后重、痉挛疼痛、轻度直肠出血等。但有5%～10%的患者可因急性放射性肠炎进展或完成3个月的放疗后转变为慢性放射性直肠炎[2]。疾病迁延不愈，严重者可表现为下消化道大出血、直肠狭窄、直肠瘘、直肠穿孔等，对患者的生活质量造成严重的影响。对于慢性放射性直肠炎，目前推举的治疗手段包括药物治疗、灌肠治疗、内镜治疗、手术治疗等[1]。但国内外对此治疗仍缺乏标准策略，整体治疗效果欠佳。……