自拟中药煎剂灌肠治疗宫颈癌放疗致放射性直肠炎的临床观察

目的:探讨自拟中药煎剂灌肠治疗宫颈癌放疗致放射性直肠炎的临床疗效。方法:将2017年9月至2020年3月重庆大学附属肿瘤医院收治的120例宫颈癌放疗致放射性直肠炎患者采用随机数字表法分为中药治疗组和对照组,每组60例。中药治疗组患者给予自拟中药煎剂(葛根30 g,黄芩30 g,黄连30 g,白头翁30 g,地榆15 g,槐花15 g,体外培育牛黄300 mg,紫花地丁15 g)保留灌肠,对照组患者给予西药(庆大霉素16万U,地塞米松5 mg,2%利多卡因4 ml,0.9%氯化钠注射液100 ml)混合后保留灌肠。两组患者均以10 d为1个疗程,共治疗2个疗程。观察两组患者治疗前后的症状评分、直肠放射损伤分级、卡氏评分及不良反应发生情况。结果:中药治疗组患者治疗后的症状评分(腹痛/不适评分(0.39±0.19)分,腹泻评分(0.57±0.13)分,大便性状评分(0.47±0.26)分,黏液血便评分(0.89±0.14)分]明显低于对照组腹痛/不适评分(1.23±0.22)分,腹泻评分(1.03±0.41)分,大便性状评分(1.33±0.18)分,黏液血便评分(2.01±0.31)分],差异均有统计学意义(P<0.05)。中药治疗组患者治疗后直肠放射损伤分级(0级24例,Ⅰ级26例,Ⅱ级10例,Ⅲ级0例),较对照组(0级12例,Ⅰ级22例,Ⅱ级20例,Ⅲ级6例)明显改善,差异均有统计学意义(P<0.05)。中药治疗组患者治疗后的卡氏评分为(85.98±7.02)分,明显优于对照组治疗后的(65.01±3.22)分,差异均有统计学意义(P<0.05)。中药治疗组和对照组患者治疗过程中均未出现不良反应。结论:自拟中药煎剂灌肠治疗宫颈癌放疗致放射性直肠炎的疗效显著。

Clinical Observation of Self-Made Traditional Chinese medicine Decoction in the Treatment of Radiation Proctitis Induced by Radiotherapy of Cervical Cancer

OBJECTIVE:To probe into the clinical efficacy of self-made traditional Chinese medicine decoction in the treatment of radiation proctitis induced by radiotherapy of cervical cancer.METHODS:A total of 120 patients admitted to Chongqing University Cancer Hospital from Sept.2017 to Mar.2020 were randomly divided into the the traditional Chinese medicine treatment group and the control group,with 60 cases in each group.The traditional Chinese medicine treatment group was given self-made traditional Chinese medicine decoction(pueraria lobata 30 g,scutellaria baicalensis 30 g,coptis chinensis 30 g,pulsatillae radix 30 g,sanguisorbae radix 15 g,flos sophorae 15 g,calculus bovis sativus 300 mg,herba violae 15 g),while the control group received western medicine(160000 U of gentamicin,5 mg of dexamethasone,4 ml of 2%lidocaine,100 ml of 0.9%sodium chloride injection).Patients in both groups took 10 d as a course of treatment,with a total of 2 courses of treatment.Symptom score,rectal radiation injury grade,Karnofsky score and the incidence of adverse reactions before and after treatment were observed in two groups.RESULTS:The symptom scores of the traditional Chinese medicine treatment groupabdominal pain/discomfort:(0.39±0.19)scores;diarrhea:(0.57±0.13)scores,;stool characteristics:(0.47±0.26)scores;mucinous bloody stools:(0.89±0.14)scores]were significantly lower than those of the control groupabdominal pain/discomfort:(1.23±0.22)scores;diarrhea:(1.03±0.41)scores;stool characteristics:(1.33±0.18)scores;mucinous bloody stools:(2.01±0.31)scores],the differences were statistically significant(P<0.05).Compared with the control group(12 cases of grade 0,22 cases of gradeⅠ,20 cases of gradeⅡand 6 cases of gradeⅢ),rectal radiation injury classification of patients in the traditional Chinese medicine treatment group after treatment(24 cases of grade 0,26 cases of gradeⅠ,10 cases of gradeⅡ,0 cases of gradeⅢ)was significantly improved,and the differences were statistically significant(P<0.05).Karnofsky score after treatment in the traditional Chinese medicine treatment group was(85.98±7.02)scores,significantly better than(65.01±3.22)scores after treatment in the control group,and the differences were statistically significant(P<0.05).There were no adverse drug reactions during the treatment in the traditional Chinese medicine treatment group and the control group.CONCLUSIONS:The efficacy of self-made traditional Chinese medicine decoction in the treatment of radiation proctitis induced by radiotherapy of cervical cancer is significant.