葛根芩连汤保留灌肠联合参苓白术散加味对宫颈癌放射性肠炎的疗效观察<sup>★</sup>

doi:10.3969/j.issn.2095-1264.2025.05.12

首页 > 过刊浏览>2025年第15卷第5期 >664-670. DOI:10.3969/j.issn.2095-1264.2025.05.12

葛根芩连汤保留灌肠联合参苓白术散加味对宫颈癌放射性肠炎的疗效观察★
DOI:
                        10.3969/j.issn.2095-1264.2025.05.12
                    
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作者单位:四川省中西医结合医院 肛肠科，四川 成都，610041
作者简介:张宁，男，硕士，副主任医师，研究方向为中医肛肠病学。
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中图分类号:R737.3;R285.6;R574
基金项目:四川省中医药管理局科学技术研究专项课题（2020LC0188）。

Curative effect of modified Gegen Qinlian decoction for retention enema combined with Shenling Baizhu powder in radiation enteritis of cervical cancer^★

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Proctology Department, Sichuan Integrative Medicine Hospital, Chengdu, 610041, Sichuan, China

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摘要:

目的探讨葛根芩连汤加味保留灌肠联合参苓白术散加味治疗对宫颈癌放射性肠炎的防治效果。方法将四川省中西医结合医院2020年10月至2022年10月收治的280例宫颈癌放射性肠炎患者按随机数字表法分为中医药治疗组（140例）和西医治疗组（140例）。西医治疗组采用西药口服和西药保留灌肠方案治疗，中医药治疗组接受西药口服+葛根芩连汤加味保留灌肠联合参苓白术散加味治疗。比较两组患者在RTOG放射性损伤分级、Sherman分级、肠道菌群（乳酸杆菌、双歧杆菌、大肠埃希菌）、免疫指标（NK+、CD4+、CD8+细胞水平及CD4+/CD8+）、miR-122-5p和miR-21-3p表达、QLQ-CR38与ECOG评分、灌肠相关不良事件发生率及放射性肠炎症状复发率方面的差异。结果中医药治疗组患者RTOG放射性损伤分级、Sherman分级均低于西医治疗组（P<0.05）。治疗后，两组患者乳酸杆菌、双歧杆菌数量，NK+、CD4+细胞水平及CD4+/CD8+，QLQ-CR38评分均较治疗前升高，且中医药治疗组患者高于西医治疗组，差异均有统计学意义（P<0.05）。治疗后，两组患者大肠埃希菌数量、CD8+细胞水平、miR-122-5p相对表达量、miR-21-3p相对表达量及ECOG评分均较治疗前降低，且中医药治疗组低于西医治疗组，差异均有统计学意义（P<0.05）。两组患者灌肠相关不良事件发生率比较，差异无统计学意义（P>0.05）。中医药治疗组疗程结束后3个月放射性肠炎症状复发率低于西医治疗组（P<0.05）。结论在西药治疗基础上加用葛根芩连汤加味保留灌肠联合参苓白术散加味治疗，可有效防治宫颈癌放射性肠炎，改善患者肠道菌群与免疫功能，提高患者生活质量。

Abstract:

Objective To explore the prevention effect of modified Gegen Qinlian decoction for retention enema combined with Shenling Baizhu powder on radiation enteritis of cervical cancer.Methods According to random number table method, 280 patients with radiation enteritis of cervical cancer admitted to Sichuan Integrative Medicine Hospital were divided into Chinese medicine treatment group (140 cases, oral western medicine + modified Gegen Qinlian decoction for retention enema combined with Shenling Baizhu powder) and western medicine treatment group (140 cases, oral Western medicine + western medicine for retention enema) between October 2020 and October 2022. The differences in grading of RTOG radiation injury and Sherman, intestinal floras (Lactobacillus, Bifidobacteria, Escherichia coli), immune indexes (NK+, CD4+, CD8+, CD4+/CD8+), expressions of miR-122-5p and miR-21-3p, scores of QLQ-CR38 and ECOG, incidence of adverse events and recurrence rate between the two groups were compared.Results The grading of RTOG radiation injury and Sherman grading were lower in Chinese medicine treatment group than in western medicine treatment group (P<0.05). After treatment, counts of Lactobacillus and Bifidobacteria, levels of NK+ and CD4+, CD4+/CD8+, and QLQ-CR38 score were increased in both groups, which were higher in Chinese medicine treatment group than in western medicine treatment group (P<0.05), while count of Escherichia coli, CD8+ level, relative expression levels of miR-122-5p and miR-21-3p, and ECOG score were decreased, which were lower in Chinese medicine treatment group than in western medicine treatment group (P<0.05). There was no significant difference in the incidence of enema-related adverse eavents between the two groups (P>0.05), but recurrence rate of radiation enteritis was lower in Chinese medicine treatment group than in western medicine treatment group (P<0.05).Conclusion Modified Gegen Qinlian decoction for retention enema combined with Shenling Baizhu powder on basis of western medicine can effectively prevent radiation enteritis of cervical cancer, improve intestinal floras, immune function and quality of life.