| 李滨冉,王禛,苏曼华,等.凉血地黄汤加味联合西药口服治疗热毒伤络型急性放射性直肠炎 26例[J].安徽医药,2026,30(2):393-398. |
| 凉血地黄汤加味联合西药口服治疗热毒伤络型急性放射性直肠炎 26例 |
| Modified Liangxue Dihuang decoction combined with oral western medicine in treating acute radioactive inflammation of heat toxin injury collateral type:26 cases |
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| DOI：10.3969/j.issn.1009-6469.2026.02.034 |
| 中文关键词: 急性放射性直肠炎 凉血地黄汤加味 肠黏膜损伤 炎症反应 |
| 英文关键词: Acute radiation inflammation Modified Liangxue Dihuang decoction Intestinal mucosal injury Inflammatory reac-tion |
| 基金项目:河北省中医药管理局中医药类科研计划课题( 2015017) |
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| 中文摘要: |
| 目的观察凉血地黄汤加味联合西药口服治疗热毒伤络型急性放射性直肠炎( ARP)的临床疗效。方法选取 2017年 8月至 2022年 11月河北省中医院 ARP病人 52例，采用 SPSS软件及随机数字表法分为对照组和治疗组。对照组 26例接受了双歧杆菌四联活菌片、复方谷氨酰胺胶囊以及美沙拉嗪肠溶片治疗，治疗组 26例则在此基础上采用凉血地黄汤加味口服治疗。两组均治疗 2个疗程。对比两组临床疗效，治疗前后中医症候评分、炎症指数以及直肠黏膜损伤分级，并监测两组的安全指标。结果经过两个疗程治疗后，治疗组中医证候评分明显低于对照组(P<0.05)。肠黏膜损伤分级比较，治疗组 0级 7例； 1级 10例； 2级 8例； 3级 1例；对照组 0级 4例； 1级 4例； 2级 6例； 3级 12例。经过比较，治疗组较对照组改善更为明显( P<0.05)。炎症指数比较，治疗组治疗后白细胞介素( IL)-6为( 6.41±0.72)pg/L，C反应蛋白( CRP)为( 8.88±1.78)mg/L，肿瘤坏死因子 α(TNF-α)为( 1.80±0.45)pg/L；对照组治疗后 IL-6为( 8.17±0.53)pg/L，CRP为( 12.50±2.23)mg/L，TNF-α为( 1.85±0.42)pg/L。两组血清 IL-6、CRP比较差异有统计学意义( P<0.05)；两组 TNF-α比较差异无统计学意义( P>0.05)。临床疗效比较，治疗组总有效率 84.6％，对照组总有效率 69.0％，治疗组的总有效率高于对照组，差异有统计学意义( P<0.05)。结论凉血地黄汤加味联合口服西药可以有效缓解 ARP临床症状，并能够有效地恢复肠黏膜损伤，减少机体炎症反应，而且没有出现明显的不良反应。 |
| 英文摘要: |
| Objective To observe the clinical efficacy of modified Liangxue Dihuang decoction combined with oral western medicine in the treatment of acute radiation-induced proctitis (ARP) of heat toxicity and collateral damage type.Methods Fifty-two ARP pa-tients in Hebei Provincial Hospital of Traditional Chinese Medicine from August 2017 to November 2022 were selected and randomlydivided into 2 groups using SPSS software. In the control group, 26 patients received treatment with Bifidobacterium quadruple viabletablets, compound glutamine capsules, and mesalazine enteric coated tablets, while the treatment group of 26 patients received oraltreatment with modified Liangxue Dihuang decoction on this basis. Both groups were treated for two courses of treatment. The clinicalefficacy, TCM symptom score, inflammation index, and grading of rectal mucosal injury between two groups of patients before and aftertreatment were compared, and the safety indicators of the two groups were monitored.Results After two courses of treatment, the TCM syndrome score of the treatment group was significantly lower than that of the control group (P<0.05). Comparison of grading of intesti-nal mucosal injury: 7 cases in the treatment group with grade 0; 10 cases at level 1; 8 cases at level 2; 1 case at level 3; Control group: 4cases at level 0; 4 cases at level 1; 6 cases at level 2; 12 cases at level 3. After comparison, the treatment group showed more significantimprovement compared to the control group (P<0.05). Comparison of inflammatory indices: after treatment, the Interleukin (IL)-6, C-re-active protein (CRP), and tumor necrosis factor (TNF) -α levels in the treatment group were (6.41±0.72) pg/L, (8.88±1.78) mg/L, and (1.80 ± 0.45) pg/L, respectively; after treatment, the IL-6 level in the control group was (8.17±0.53) pg/L, CRP level was (12.50±2.23) mg/L, and TNF -α level was (1.85±0.42) pg/L. There was a significant statistical difference in the levels of IL-6 and CRP between the two groups of serum (P<0.05); there was no significant difference observed in TNF-α levels (P>0.05). Clinical efficacy comparison: thetotal effective rate of the treatment group was 84.6%, while that of the control group was 69.0%. The total effective rate of the treatmentgroup was higher than that of the control group, and the difference between the two groups was statistically significant (P<0.05).Conclu. sion After analysis, the modified version of Liangxue Dihuang Decoction combined with oral western medicine can effectively allevi-ate the clinical symptoms of ARP, restore intestinal mucosal damage, reduce the body's inflammatory response, and there are no signifi-cant side effects. |
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