实用医学杂志 ›› 2022, Vol. 38 ›› Issue (17): 2221-2225.doi: 10.3969/j.issn.1006⁃5725.2022.17.019

• 药物与临床 • 上一篇    下一篇

重组人表皮生长因子外用溶液联合蒙脱石散保留灌肠预防宫颈癌患者放射性直肠炎的临床观察 

李洲宇 杨兴龙 蔡展拓 朱艳仪 覃青华 李铭仪    

  1. 广州医科大学附属肿瘤医院放疗科(广州510095)

  • 出版日期:2022-09-10 发布日期:2022-09-10
  • 通讯作者: 李铭仪 E⁃mail:tangxi94@126.com 李洲宇、杨兴龙为共同第一作者
  • 基金资助:
    广州市科技局项目(编号:202102010093)

Effectiveness of recombinant human epidermal growth factor derivative for external use combined with smectite powder administrated by retention enema for prevention of radiation proctitis in cervical cancer patients

LI Zhouyu,YANG Xinglong,CAI Zhantuo,ZHU Yanyi,QIN Qinghua,LI Mingyi.    

  1. Department of Radi⁃ ation Oncology,Affiliated Cancer Hospital & Institute of Guangzhou Medical University,Guangzhou 510095,China 

  • Online:2022-09-10 Published:2022-09-10
  • Contact: LI Mingyi E⁃mail:tangxi94@126.com

摘要:

目的 本研究拟探讨重组人表皮生长因子外用溶液联合蒙脱石散保留灌肠预防宫颈癌患 者急慢性放射性直肠炎的疗效,为防治放射性直肠炎提供有效方案。方法 收集 59 例根治性放疗的宫颈 癌患者,随机分成对照组 28 例,灌肠组 31 例;灌肠组给重组人表皮生长因子外用溶液联合蒙脱石散保 留灌肠,对照组无灌肠处理。结果 在急性放射性直肠炎方面,两组患者消化道反应分级分布相似,主 要以 0 ~ 2 级为主,比较差异无统计学意义(U = 429.5,P = 0.939)。在慢性直肠炎方面,灌肠组维也纳直肠 镜(vienna rectoscopy score,VRS)分项评分及总评分的轻度反应(0 ~ 1 级)患者明显高于对照组,而对照 组中度反应(2 ~ 3 级)的患者明显增多;两组毛细血管扩张(U = 262.5,P = 0.003)、黏膜充血(U = 256, P = 0.002)及总 VRS 评分(U = 256,P = 0.002)差异有统计学意义。结论 重组人表皮生长因子外用溶液 联合蒙脱石散保留灌肠可减低宫颈癌根治性放疗患者慢性直肠炎的发生率及严重程度。

关键词:

表皮生长因子, 蒙脱石散, 保留灌肠, 宫颈癌, 放射性直肠炎

Abstract:

Objective Retention enema is a simple and effective method for preventing and treating radia⁃ tion proctitis(RP),while there is no standard regimen. This study aims to investigate the effectiveness of recombi⁃ nant human epidermal growth factor derivative for external use combined with smectite powder administrated by retention enema for the prevention of RP in cervical cancer patients. Method Fifty⁃nine patients with cervical cancer treated with radical radiotherapy were collected and randomly divided into control group(n = 28)and enema group(n = 31). The enema group was given recombinant human epidermal growth factor derivative for external use combined with smectite powder by retention enema,while the control group did not receive enema administration. Results Gastrointestinal adverse reaction of the two groups was similar with grade 0⁃2,and there was no statistical difference between two groups(U = 429.5,P = 0.939)in acute PR. In terms of chronic PR,the sub⁃item score and total score of Vienna Rectoscopy Score(VRS)showed that there were more patients with mainly mild adverse events(grade 0 ~ 1)in enema group,while there were significantly more patients with moderate adverse events (grade 2 ~ 3)in the control group. Capillary telangiectasia(U = 262.5,P = 0.003),mucosal hyperemia(U = 256 P = 0.002)and VRS total score(U = 256,P = 0.002)were statistically different in the two groups. Conclusion Recombinant human epidermal growth factor derivative for external use combined with smectite powder administrat⁃ ing by retention enema could reduce the incidence and severity of chronic PR in patients with radical radiotherapy for cervical cancer.

Key words:

human epidermal growth factor, smectite powder, retention enema, cervical cancer, radiation proctitis