思密达混合液保留灌肠治疗急性放射性肠炎的临床观察

目的 观察思密达混合液保留灌肠治疗直肠癌术后放疗急性放射性肠炎的临床疗效。方法 将65例直肠癌根治术后患者随机分为对照组（n=31）和思密达混合液保留灌肠治疗组（n=34），均采用三维适形调强放射治疗联合卡培他滨同步化疗。放疗总量为50Gy，2Gy／次，5次／周。卡培他滨1600mg／m2分两次口服，间隔12h，d1～d14，3周为1周期，共化疗2个周期。在出现1级急性放射性肠炎后，对照组给予对症处理，治疗组在对症处理的基础上采用思密达混合液保留灌肠（37℃ 09％氯化钠溶液100ml溶解思密达3g，复方谷氨酰胺颗粒670mg，地塞米松10mg）。观察两组放疗期间及放疗后1个月急性放射性肠炎损伤程度和放疗前后患者的生存质量。结果 放疗第1周治疗组和对照组发生急性放射性肠炎的程度无统计学差异（P＞0.05）；放疗第3周、第5周和放疗后1个月治疗组急性放射性肠炎的发生率明显低于对照组（P＜0.05）。放疗前及放疗第1周治疗组和对照组患者生存质量的差异无统计学意义（P＞0.05）；放疗第3周、第5周及放疗后1个月治疗组患者的生存质量明显改善，两组差异有统计学意义（P＜0.05）。结论 思密达混合液保留灌肠可降低急性放射性肠炎的损伤程度，并能够提高患者的生存质量。

Clinical observation of retention enema with smecta mixture in the treatment of acute radiation-induced enteritis

Objective To evaluate the efficacy of retention enema with smecta mixture on acute radiation-induced enteritis （RIE） due to radiotherapy for patients post-operation with rectal cancer. Methods A total of 65 patients with rectal cancer after radi- cal surgery were randomized into control group （n= 31 ） and treatment group with smeeta mixture（ n= 34）. All the patients were treated with three-dimensional and intensity modulated radiotherapy （50Gy/2Gy/25f） in combination with capeeitabine （ 1600mg/m2 daily, ql2h, d1 -d14, 3 weeks for a cycle with a total of 2 cycles）. After the onset of grade 1 PalE, control group was carried on symptomatic treatment, while treatment group was applied with symptomatic treatment and smecta mixture retention enema （smecta 3g, compound glutamine granules 670mg and dexamethasone 10mg were resolved in 37℃ 0. 9% NaC1 injection 100ml）. RIE during radiation and one month after radiation, as well as life quality pre- and post-radiation were compared between the two groups. Results The incidence of RIE at the 1st week of radiation between treatment group and control group had no statistical difference （P〉0. 05）, but the incidence of RIE at the 3~d, 5＇h, and 1month after radiation was significantly lower in treatment group compared with the control group （P〈0. 05）. Life quality pre-radiation and at the 1s＇ week of radiation between the two groups had no statistical difference （P〉0. 05） , while it was improved in treatment group at the 3rd, 5th and 1 month after radiation compared with control group （P〈0. 05）. Conclusion Retention emena with smecta mixture is able to relieve acute RIE and improve life quality of patients.