复方黄藤合剂防治急性放射性肠炎疗效及对血清炎性因子的影响

姚诗清; 何斌; 孙蕊; 柳雯; 孙涛; 周兰

doi:10.13422/j.cnki.syfjx.20200135

您当前的位置：

首页 >

文章列表页 >

复方黄藤合剂防治急性放射性肠炎疗效及对血清炎性因子的影响

临床 | 更新时间：2021-02-09

- 复方黄藤合剂防治急性放射性肠炎疗效及对血清炎性因子的影响
- Efficacy of Compound Huangteng Mixture for Acute Radiation Enteritis and Effect on Serum Inflammatory Factors
- 中国实验方剂学杂志 2020年26卷第9期页码：69-74
- 作者机构：
  
  蚌埠医学院　第一附属医院，安徽蚌埠　 233004
- 作者简介：
  
  [第一作者]　姚诗清，硕士，副主任中医师，从事中西医结合内科学的临床、科研、教学工作，E-mail：ysqdww@163.com
  *周兰，主任中医师，从事中医内科学的临床、科研及教学工作，E-mail：zhoulan3092845@163.com
- 基金信息：
  
  安徽省卫生厅中医药管理局项目(2014zy25);2018年度蚌埠医学院科技发展基金项目(BYKF1860)
- DOI：10.13422/j.cnki.syfjx.20200135
  中图分类号： R25; R256; R256.3; R516
- 纸质出版日期：2020-05-05，
  
  网络出版日期：2019-10-21，
  
  收稿日期：2019-09-04，
- 稿件说明：
扫描看全文
姚诗清, 何斌, 孙蕊, 等. 复方黄藤合剂防治急性放射性肠炎疗效及对血清炎性因子的影响[J]. 中国实验方剂学杂志, 2020,26(9):69-74.

Shi-qing YAO, Bin HE, Rui SUN, et al. Efficacy of Compound Huangteng Mixture for Acute Radiation Enteritis and Effect on Serum Inflammatory Factors[J]. Chinese Journal of Experimental Traditional Medical Formulae, 2020,26(9):69-74.
姚诗清, 何斌, 孙蕊, 等. 复方黄藤合剂防治急性放射性肠炎疗效及对血清炎性因子的影响[J]. 中国实验方剂学杂志, 2020,26(9):69-74. DOI： 10.13422/j.cnki.syfjx.20200135.

Shi-qing YAO, Bin HE, Rui SUN, et al. Efficacy of Compound Huangteng Mixture for Acute Radiation Enteritis and Effect on Serum Inflammatory Factors[J]. Chinese Journal of Experimental Traditional Medical Formulae, 2020,26(9):69-74. DOI： 10.13422/j.cnki.syfjx.20200135.

摘要

目的：

探讨复方黄藤合剂对急性放射性肠炎(ARE)的防治效果及对血清炎症因子的调节作用。

方法：

将140例患者随机分为对照组和观察组各70例。对照组采用精确放射治疗，并口服蒙脱石散，3 g/次，3次/d。观察组放疗同期口服复方黄藤合剂，1剂/d。两组疗程均至放疗结束后2周。记录ARE(1级和2级)出现的时间和照射剂量，记录重度ARE(3级和4级)发生率；放疗结束后2周进行内镜评估，ARE症状评分和生活质量KPS评分；检测治疗前后血清白细胞介素-1(IL-1)，IL-4，IL-6，肿瘤坏死因子-

(TNF-

)和C反应蛋白(CRP)水平。

结果：

观察组患者1级和2级ARE出现时间均短于对照组(

0.01)，出现1级和2级ARE时的照射剂量均多于对照组(

0.01)；在放疗4，5周和放疗结束后2周，观察组2级及以上ARE发生率分别为42.86%(30/70)，50.00%(35/70)和54.29%(38/70)，均低于同期对照组的61.43%(43/70)，68.57%(48/70)和74.29%(52/70)(

＝4.837，

0.05;

＝5.001，

0.05;

＝6.097，

0.05)；观察组患者放疗后ARE发生率为62.86%(44/70)，低于对照组的78.57%(55/70)(

＝4.173，

0.05)；观察组患者重度ARE发生率13.64%(6/44)，低于对照组的32.73%(18/55) (

＝4.851，

0.05)；观察组患者放疗后内镜评分和ARE症状评分均低于对照组，KPS评分高于对照组(

0.01)；放疗后观察组患者血清IL-1，IL-6，TNF-

和CRP水平低于对照组(

0.01)，IL-4水平高于对照组(

0.01)。

结论：

采用复方黄藤合剂同期用于放疗患者能降低ARE发生率，推迟了ARE出现，减轻了ARE发生程度，并能调节炎症因子表达，减轻了临床症状，提高了患者生活质量，从而有利于放疗的顺序开展。

Abstract

Objective:

To discuss the efficacy of compound Huangteng mixture for acute radiation enteritis (ARE) and to investigate its regulatory effect on serum inflammatory factors.

Method:

One hundred and forty patients were randomly divided into control group (70 cases) and observation group (70 cases) by random number table. Patients in control group got precise radiotherapy. And take montmorillorillonite powder orally based on the treatment in control group

patients in observation group additionally received compound Huangteng mixture

1 dose/day. The treatment was continued to the second week after the ending of radiotherapy in both groups. Time of appearance of ARE (1 and 2 levels)

irradiation dose and incidence of severe ARE (3 and 4 levels) were recorded. Endoscope examination was conducted at the second week after the ending of radiotherapy. ARE symptom scores and KPS scores of quality of life were graded. Levels of serum interleukin-1 (IL-1)

IL-4

IL-6

tumor necrosis factor-

(TNF-

) and C-reactive protein (CRP) were detected both before and after treatment.

Result:

Time of appearance of ARE (1 and 2 levels) in observation group was shorter than those in control group (

0.01)

and irradiation dose was more than that in control group (

0.01). At the fourth and fifth week of radiotherapy and at the second week after the ending of radiotherapy

incidence rate of ARE (levels 2 and above) was 42.86%(30/70)

50.00%(35/70) and 54.29%(38/70)

all lower than 61.43%(43/70)

68.57%(48/70) and 74.29%(52/70) in control group (

=4.837

0.05

=5.001

0.05

=6.097

0.05). After radiotherapy

incidence of ARE was 62.86%(44/70) in observation group

lower than 78.57%(55/70) in control group (

=4.173

0.05)

and the incidence of severeARE was 13.64%(6/44) in observation group

lower than 32.73%(18/55) in control group (

=4.851

0.05). Scores of endoscope and ARE symptoms in observation group were lower than those in control group

while score of KPS was higher than that in control group (

0.01). After radiotherapy

levels of IL-1

IL-6

TNF-

and CRP in observation group were lower than those in control group (

0.01)

while level of IL-4 was higher than that in control group (

0.01).

Conclusion:

Compound Huangteng mixture combined with radiotherapy can reduce the incidence of ARE

postpone the occurrence of ARE

relieve the severity of ARE

regulate the expression of inflammatory factors

alleviate clinical symptoms

and improve the quality of life in patients withradiotherapy

thus it is conducive to the sequential development of radiotherapy.

关键词

急性放射性肠炎复方黄藤合剂放射治疗预防炎症因子

Keywords

acute radiation enteritiscompound Huangteng mixtureradiotherapypreventioninflammatory factors

references

中国医师协会外科医师分会，中华医学会外科学分会结直肠外科学组．中国放射性直肠炎诊治专家共识(2018版)[J]．中华炎性肠病杂志，2019，3(1)：5-20.

李萌，宋冀，张文博，等．加味肠风饮保留灌肠对急性放射性直肠炎患者Th1/Th2的调节作用[J]．中国实验方剂学杂志，2019，25(1)：119-123.

朱潇雨，高晋生，王晞星．放射性肠炎诱发及加重因素探究[J]．癌症进展，2019，17(13)：1501-1502，1568.

陈宇杰，石志敏．肠风饮灌肠治疗肠风伤络型宫颈癌放疗所致急性放射性直肠炎临床观察[J]．中国实验方剂学杂志，2018，24(3)：197-201.

姚诗清，周兰，陈莉，等．复方黄藤合剂治疗湿热蕴结证急性放射性肠炎[J]．中成药，2015，37(6)：1201-1204.

陈莉，周兰，姚诗清，等．黄藤合剂治疗急性放射性肠炎湿热蕴结证临床观察[J]．中成药，2016，38(12)：2556-2560.

汪超，周兰，姚诗清，等．复方黄藤合剂治疗放射性肠炎效果及对血清超氧化物歧化酶含量的影响[J]．中国老年学杂志，2017，37(1)：134-136.

柳雯，周兰，崔珍，等．复方黄藤合剂对急性放射性肠炎的预防作用[J]．中成药，2016，38(1)：226-228.

中国抗癌协会. 新编常见恶性肿瘤诊治规范[M]．北京：中国协和医科大学出版社，1999.

中华人民共和国卫生部．GBZ111-2002放射性直肠炎诊断标准[S]．北京：中国标准出版社，2002.

B GAMI, K HARRINGTON, P BLAKE, et al. Howpatients managegastmintestinal symptomsafter pelvic radiotherapy [J]．Aliment Pha Hnacol Ther，2003，18(10)：987-994.

闫鼎鼎，楼寒梅．放射性肠炎的内科防治新进展[J]．中国现代医生，2016，54(10)：164-168.

袁庆延，丁曙晴．中医药防治放射性肠炎研究进展[J]．世界中医药，2016，11(11)：2490-2494，2499.

Ö DANDIN, M L AKIN, A Z BALTA, et al. The efficacy of probiotic (lactobacillus rhamnosus GG) and 5-ASA (aminosalicylic acid) in the treatment of experimental radiation proctitis in rats[J].Indian J Surgery, 2015, 77(Suppl 2)：563-569.

谢梓沄，苏旭春，孔嘉欣，等．肠和煎液对大鼠放射性肠炎NF-κB信号通路的干预机制[J]．中药材，2018，41(7)：1731-1734.

王毓国，秦丽，窦永起．黛黄芍药散对放射性直肠炎大鼠NF-κB，TNF-α及IL-6的影响[J]．中医药导报，2016，22(15)：17-20.

曹阳，高玉华，于明新．吴茱萸碱对急性放射性肠炎疗效及相关机制实验研究[J]．辽宁中医药大学学报，2017，19(2)：29-31.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

基于血清代谢组学和流式细胞术探讨百药煎不同炮制品及其复方治疗溃疡性结肠炎作用机制

岩黄连总碱在抑郁模型大鼠体内的药代动力学分析

桃红四物汤上调Nrf2/HO-1信号通路减轻去势小鼠心肌缺血再灌注损伤

通督活血汤对腰椎间盘突出症急性期患者腰椎功能及血清炎症因子水平的影响

基于电阻抗断层成像（EIT）技术监测加味厚朴大黄汤治疗中重度ARDS患者的疗效评价