摘要
目的观察重组人粒细胞巨噬细胞集落刺激因子(rhGM-CSF)联合传统药物保留灌肠治疗慢性放射性直肠炎的临床疗效及安全性。方法选取2017年10月至2019年10月襄阳市中心医院肿瘤科收治的128例经病理证实为子宫颈癌、子宫内膜癌的1、2级慢性放射性直肠炎患者,进行随机、单盲、对照试验。患者按随机数字表法分为对照组、试验组;对照组给予庆大霉素+地塞米松+云南白药保留灌肠,试验组给予rhGM-CSF+庆大霉素+地塞米松+云南白药保留灌肠,均2次/d,连续治疗3周。根据主观客观管理分析(SOMA)量表对灌肠前后临床症状评分,结合粪常规及直肠镜检查评价疗效。结果根据SOMA量表评分,两组患者灌肠后便血、腹泻、里急后重、腹痛症状评分均较同组灌肠前降低,差异均有统计学意义(均P<0.05);治疗前两组间各症状评分差异均无统计学意义(均P>0.05);灌肠后试验组便血评分比对照组低[(0.33±0.15)分比(0.48±0.32)分,t=2.045,P=0.022],两组其他症状评分差异均无统计学意义(均P>0.05)。对照组总有效率为79.69%(51/64),试验组为90.63%(58/64),差异有统计学意义(χ^(2)=6.485,P=0.026)。全组患者均未出现明显不良反应。结论rhGM-CSF联合传统药物保留灌肠治疗子宫颈癌、子宫内膜癌患者放射性直肠炎有效率高,操作简便,患者耐受性良好,值得临床推广。
Objective To observe the clinical efficacy and safety of recombinant human granulocyte-macrophage colony stimulating factor(rhGM-CSF)combined with traditional medicine retention enema for treatment of chronic radiation proctitis.Methods A total of 128 patients pathologically diagnosed as cervical cancer and endometrial cancer with grade 1-2 chronic radiation proctitis at Xiangyang Central Hospital from October 2017 to October 2019 were enrolled in a random,single-blind,control trial.The patients were divided into the control group and the experiment group according to the random number table,and the control group was given the treatment regimen of gentamicin+dexamethasone+Yunnan Baiyao retention enema,and the experimental group was given the treatment regimen of rhGM-CSF+gentamicin+dexamethasone+Yunnan Baiyao retention enema;both regimens treated twice daily for three weeks.The clinical symptom before and after enema treatment based on the subjective,objective,management and analytic(SOMA)scale was scored and the efficacy was evaluated by combining with stool routine and rectoscopy.Results According to the SOMA scale,the scores of hematochezia,diarrhea,tenesmus,abdominal pain after enema were lower than those before enema,and the differences were statistically significant(all P<0.05);however,the scores of all symptoms before treatment of both groups were not statistically significant different(all P>0.05).The score of hematochezia in the experimental group after enema was lower than that in the control group[(0.33±0.15)scores vs.(0.48±0.32)scores,t=2.045,P=0.022],and the scores of other symptoms in both groups were not statistically significant different(all P>0.05).The overall effective rate was 79.69%(51/64)in the control group and 90.63%(58/64)in the experimental group,and difference was statistically significant(χ^(2)=6.485,P=0.026).All patients had no obvious adverse reactions.Conclusions rhGM-CSF combined with traditional medicine retention enema for treatment of chronic radiation proctitis in patients w
作者
刘媛
方珊珊
李泉
Liu Yuan;Fang Shanshan;Li Quan(Department of Oncology,Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Science,Xiangyang 441000,China)
出处
《肿瘤研究与临床》
CAS
2021年第5期349-352,共4页
Cancer Research and Clinic
基金
北京市希思科临床肿瘤学研究基金会项目(Y-HS2019/2-071)。
关键词
宫颈肿瘤
子宫内膜肿瘤
辐射损伤
直肠炎
粒细胞巨噬细胞集落刺激因子
灌肠
Uterine cervical neoplasms
Endometrial neoplasms
Radiation injuries
Proctitis
Granulocyte-macrophage colony stimulating factor
Enema
