摘要：
Objective To evaluate the efficacy of Bupi-Qingchang recipe combined with traditional Chinese medicine enema on the patients with radiation proctitis.Methods Eighty patients with radioactive proctitis who met the inclusion criteria were randomly divided into two groups,40 in each group.The control group was treated with western medicine combined with enema,and the observation group was treated with oral spleen and clearing spleen combined with traditional Chinese medicine enema.Symptoms were scored before and after treatment from abnormal sensation of bowel movement,blood in stool,stool traits and frequency,abdominal pain;TNF-α,IL-8,IL-6,IL-10 levels were detected by ELISA.The intestinal mucosal healing and recurrence were observed by microscopy.Results After treatment,the serum TNF-α (1.18 ± 0.61 ng/ml vs.1.78 ± 0.66 ng/ml,t=4.860),IL-6 (2.52 ± 0.75 ng/ml vs.3.02 ± 0.81 ng/ml,t=3.297),IL-8 (2.51 ± 0.68 ng/ml vs.3.01 ± 0.82 ng/ml,t=3.417),IL-10 (0.56 ± 0.25 ng/ml vs.0.89 ± 0.29 ng/ml,t=6.275) in the observation group were significantly lower than those in the control group (P＜0.01).The total scores of abdominal pain,blood in the stool,stool characteristics and frequency,abnormal feeling of defecation and symptoms were significantly lower in the observation group than in the control group (t values were 8.108,2.085,4.965,7.865,9.586,P＜0.01 or P＜0.05).The total effective rate was 92.5％ (37/40) in the observation group and 67.5％ (27/40) in the control group.The difference between the two groups was statistically significant (x2=7.813,P＜0.01).The intestinal mucosa of the observation group was treated.The healing rate was significantly better than that of the control group (x2=15.535,P＜0.01),and the recurrence rate was significantly lower than that of the control group (x2=10.912,P＜0.01).Conclusions The Bupi-Qingchang recipe combined with traditional Chinese medicine enema can improve the clinical symptoms of patients with radiation proctitis,reduce inflammation,reduce recurrence and improve curative effect.%目的 评价补脾清肠方结合中药灌肠治疗放射性直肠炎的疗效.方法 将符合入选标准的80例放射性直肠炎患者采用随机数字表法分为2组,每组40例.对照组口服西药结合灌肠治疗,观察组口服补脾清肠方结合中药灌肠治疗.分别于治疗前后从排便异常感觉、便血、大便性状及频率、腹痛方面进行症状评分;采用ELISA法检测TNF-α、IL-8、IL-6、IL-10水平;2组治疗后均行肠镜检查,观察肠道黏膜愈合情况及复发情况,评价临床疗效.结果 治疗后,观察组血清TNF-α[(1.18±0.61)ng/ml比(1.78±0.66) ng/ml,t=4.860]、IL-6[(2.52±0.75) ng/ml比(3.02±0.81) ng/ml,t=3.297]、IL-8[(2.51±0.68) ng/ml比(3.01±0.82) ng/ml,t=3.417]、IL-10[(0.56±0.25) ng/ml比(0.89±0.29) ng/ml,t=6.275]水平均低于对照组(P＜0.01).观察组治疗后腹痛、便血、大便性状及频率、排便异常感觉及症状总积分均低于对照组(t值分别为8.108、2.085、4.965、7.865、9.586,P＜0.01或P＜0.05).观察组总有效率为92.5％ (37/40)、对照组为67.5％(27/40),2组比较差异有统计学意义(x2=7.813,P＜0.01);观察组治疗后肠道黏膜愈合情况优于对照组(x2=15.535,P＜0.01),复发率低于对照组(x2=10.912,P＜0.01).结论 补脾清肠方结合中药灌肠可改善放射性直肠炎患者的临床症状,降低炎症反应,减少复发,提高疗效.
