| 引用本文:吴昊1，耿碧竹1，杨振宇2，吴易超1，丁井永1，谢燕东3.清热解毒方治疗宫颈癌放疗后急性放射性肠炎热毒伤络证的疗效及作用机制[J].世界中医药,2024,(05):. |
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| 清热解毒方治疗宫颈癌放疗后急性放射性肠炎热毒伤络证的疗效及作用机制 |
| Effect and Mechanism of Qingre Jiedu Formula in Treating Acute Radiation Enteritis(Syndrome of Heat Toxin Damaging Collaterals) after Radiotherapy for Cervical Cancer |
| 投稿时间：2022-10-06 |
| DOI：10.3969/j.issn.1673-7202.2024.05.013 |
| 中文关键词: 放射性肠炎 急性期 热毒伤络证 复方谷氨酰胺肠溶胶囊 氧化机制 清热解毒方 临床疗效 维也纳肠镜 宫颈癌 放疗 |
| English Keywords:Radiation enteritis Acute phase Syndrome of heat toxin damaging collaterals Compound glutamine enteric-coated capsules Oxidation mechanism Qingre Jiedu Formula Clinical efficacy Vienna rectoscopy Cervical cancer Radiotherapy |
| 基金项目:国家自然科学基金项目（81572916）；空军军医大学第二附属医院社会人才基金项目（2021SHRC006；2021SHRC068）；空军军医大学临床研究资助计划项目（2022LC2230）；空军军医大学第二附属医院临床创新救治能力提升项目（2022TDLCTS05） |
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| 中文摘要: |
| 目的：探讨清热解毒方治疗宫颈癌放疗后急性放射性肠炎热毒伤络证的应用价值及对相关氧化因子的影响。方法：选取2021年3月至2022年3月空军军医大学第二附属医院收治的宫颈癌放疗后急性放射性肠炎患者74例作为研究对象，采用随机数字表法随机分为观察组和对照组，每组37例。对照组给予复方谷氨酰胺肠溶胶囊口服治疗联合地塞米松灌肠，观察组在对照组基础上口服清热解毒方，连续治疗15 d，观察2组患者治疗前后症状改善有效率、放射性肠炎（ARE中文不是放射性肠炎给出中文）分级、维也纳肠镜分级、中医证候评分（里急后重、腹痛、腹泻、食欲不振等）、血清炎症介质超氧化物歧化酶（SOD）、丙二醛（MDA）水平。结果：观察组总有效率为91.67%（33/36），高于对照组的82.86%（29/35）（P<0.05）。2组患者治疗后放射性肠炎分级、维也纳肠镜分级、中医证候评分均有改善（P<0.05），MDA较治疗前降低（P<0.01），SOD较前升高（P<0.01）。用药15 d后，观察组ARE分级、维也纳肠镜分级、中医证候评分、MDA、SOD均优于对照组（P<0.05）。结论：清热解毒方口服联合复方谷氨酰胺肠溶胶囊治疗宫颈癌所致放射性肠炎急性期比单纯复方谷氨酰胺肠溶胶囊具有良好效果，其作用机制可能与抑制氧化因子相关。 |
| English Summary: |
| To explore the clinical value of Qingre Jiedu Formula in treating acute radiation enteritis(heat toxin damaging collaterals) after radiotherapy for cervical cancer and the effects of this formula on oxidative stress indicators.Methods:A total of 74 patients with acute radiation enteritis after radiotherapy for cervical cancer treated in the Second Affiliated Hospital of Air Force Military Medical University from March 2021 to March 2022 were selected and assigned by the random number table method into an observation group and a control group，with 37 patients in each group.The control group received oral administration with compound glutamine enteric-coated capsules combined with dexamethasone enema，and the observation group received Qingre Jiedu Formula on the basis of the therapy in the control group.Both groups were treated for 15 consecutive days.The symptom response rate，Radiation Therapy Oncology Group(RTOG) grade of radiation enteritis，Vienna rectoscopy score，scores of TCM symptoms(tenesmus，abdominal pain，diarrhea，loss of appetite，etc.)，and serum levels of inflammatory mediators [superoxide dismutase(SOD) and malondialdehyde(MDA)] were determined before and after treatment.Results:The total response rate in the observation group was 91.67%(33/36)，which was higher than that(82.86%，29/35) in the control group(P<0.05).The treatment in both groups was effective in terms of RTOG grade，Vienna rectoscopy score，and TCM syndrome scores(P<0.05)，lowered the MDA level(P<0.01)，and elevated the SOD level(P<0.01).After 15 days of medication，the observation group outperformed the control group in terms of RTOG grade，Vienna rectoscopy grade，TCM syndrome scores，and MDA and SOD levels(P<0.05).Conclusion:Qingre Jiedu Formula combined with compound glutamine enteric-coated capsules has a better effect on treating acute radiation enteritis caused by radiotherapy for cervical cancer than the capsules alone，and this formula may exert the therapeutic effect by inhibiting oxidative stress. |
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