中药内服加灌肠防治放射性直肠炎47例临床观察

目的 观察中药内服加灌肠防治放射性直肠炎的临床疗效. 方法 将89例局部晚期癌症患者随机分为中药组47例和西药组42例,中药组每日放疗结束后采用葛根芩连汤和白头翁汤保留灌肠30min,每日1次,同时辨证给予中药口服；西药组每日放疗结束后采用生理盐水加思密达、地塞米松保留灌肠30min,每日1次,自腹泻出现时口服思密达、左氧氟沙星.放疗结束后比较两组患者的肠道急性放射性损伤程度及生存质量. 结果 中药组急性放射性肠炎Ⅱ级以上的发生率明显少于西药组,差异有统计学意义(P＜0.05)；放疗后中药组卡氏评分(KPS)80分以上者明显高于西药组,差异有统计学意义(P＜0.05).结论 中药内服加灌肠可明显减少急性放射性肠炎的发生率,有效地提高患者的生存质量.

Clinical Observation on Radiotherapy Combined with Chinese Medicine Enema for 47 Cases of Radiation Enteritis

Objective To observe the therapeutic effect of radiotherapy combined with Chinese medicine enema on radiation enteritis.Methods Eighty-nine patients with locally advanced cancer were randomized into the Chinese medication ( radiother- apy+oral Chinese medicine+ Chinese medicine enema ) group of 47cases and western medication ( radiotherapy+oral west- ern medicine+ western medicine enema ) group of 42cases.For the Chinese medication group , Gegen Qinlian Decoction and Baitouwong Decoction were used for enema after radiotherapy each day , meanwhile , oral medication based on syndrome differ- entiation was given.Normal saline added with smecta and Dexamethasone was given to the Western medication group for ene- ma , once everyday after radiotherapy , and smecta and levofloxacin were given orally when diarrhea appeared.The intestinal a- cute radiation injury degree and quality of life in both groups were observed after treatment.Results The incidence of acute ra- diation enteritis above gradeⅡin the Chinese medication group was significantly less than that in the western medicine group ( P<0.05 ) .Patients with KPS score above 80points was significantly more in the Chinese medication group than in the west- ern medication group ( P<0.05 ) .Conclusion Chinese medicine oral medication and enema for radiation enteritis could obvi- ously reduce the incidence of acute radiation enteritis and effectively improve the quality of life of patients.