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摘 要:目的:观察复方谷氨酰胺胶囊治疗直肠癌放疗后急性放射性直肠炎的疗效。方法:将80例直肠癌放疗后急性放射性直肠炎患者分为两组,治疗组45例给予口服复方谷氨酰胺胶囊治疗,对照组35例给予口服硫糖铝治疗,比较两组的疗效。结果:治疗组治愈12例,有效31例,无效2例,总有效率95.6%;对照组治愈3例,有效17例,无效15例,总有效率57.2%。两组疗效比较有显著性差异(P0.05)。
1.2 放射治疗方法
放疗采用俯卧位,真空垫固定,直线加速器6MV-X线等中心照射。设盆腔后野及水平两侧野,上界在骶1上缘水平,下界在闭孔下缘,左右界在真骨盆外缘1.5cm,侧野前界第5腰椎前2cm,后界包括骶、尾骨后缘。照射剂量DT 50Gy/25次,每次2Gy,每周照射5次。
1.3 药物治疗方法
治疗组:给予复方谷氨酰胺胶囊(由人参、茯苓、白术、甘草、谷氨酰胺等组成,曾用名谷参肠安胶囊)口服,每次3片,3次/d。对照组:给予硫糖铝混悬液口服,每次10mL,3次/d。均于患者出现II级或II级以上放射性直肠炎时开始治疗,于放疗终止或症状缓解时结束治疗。
1.4 急性放射性直肠炎分级
按RTOG/EORTC急性放射损伤分级标准。0级:无变化;I级:大便次数增多或大便习惯改变,无需用药,直肠不适,无需止痛治疗;II级:腹泻,需用抗副交感神经药(如止吐宁),黏液分泌增多,无需卫生垫,直肠或腹部疼痛,需服用止痛药;III级: 腹泻,需肠胃外支持,重度黏液或血性分泌物增多,需卫生垫,腹部膨胀(X线平片示肠管扩张);IV级:急性或亚急性肠梗阻,瘘或穿孔,胃肠道出血需要输血,腹痛或里急后重,需置管减压,或肠扭转。
1.5 疗效标准及统计学方法
治愈:分级下降至0级;有效:分级下降但未达到0级;无效:分级无下降甚至上升。统计学处理采用χ2检验,当P [6] CANDELLI M, CARLONI E, ARMUZZI A, et al. Role of sucralfate in gastrointestinal diseases [J]. Panminerva Med, 2000, 42(1):55-591.
[7] SASAI T, HIRAISHI H, SUZUKI Y, et al. Treatment of chronic post-radiation proctitis with oral administration of sucralfate[J]. Am J Gastroenterol, 1998, 93(9):1593-1595.
[8] MELKO GP, TURCO TF, PHELAN TF, et al. Treatment of radiation-induced proctitis with sucralfate enemas[J]. Ann Pharmacother, 1999, 33(12): 1274-1276.
(责任编辑:曾楚华)
Treatment of Acute Radiation-induced Rectitis with
CompoundGlutaminEntresolubleCapsules
Rao Jian
(department of oncology, Jiangmen central hospital, Jiangmen City, Guangdong province, 529070)
Abstract:Objective:To investigate the clinical efficacy of compound glutamine entresoluble capsules in the treatment of acute radiation-induced rectitis. Methods:80 cases of rectal carcinoma patients with acute radiation-induced rectitis were divided into two groups. 45 cases were treated with compound glutamine entresoluble capsules and 35 cases were treated with sucralfate. To analyze the clinical efficacy and the adverse reaction. Results:Efficacy in trial group and control group were 96% and 57%. Total efficacy of trial group was significantly higher than control group(P
