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[目的]探讨复方谷氨酰胺对重度放射性直肠炎的治疗效果及对患者炎性细胞因子水平的影响。[方法]78例重度放射性直肠炎患者随机分为观察组(41例)和对照组(37例)。对照组采用5mg地塞米松加100mg利多卡因配100ml的0.9%氯化钠溶液每晚灌肠1次;观察组在对照组基础上加用复方谷氨酰胺口服,3次/d,每次3粒。治疗3周后评价2组疗效及血液中炎性细胞因子(TNF-α及IL-8)的变化。[结果]观察组临床有效率为78.0%(32/41),结肠镜检查缓解率为82.9%(34/41);对照组临床有效率为48.6%(18/37),结肠镜检查缓解率为56.8%(21/37);2组在临床有效率及结肠镜检查缓解率上比较均差异有统计学意义(P<0.05)。治疗后2组血液中TNF-α及IL-8均下降,但观察组较对照组下降更明显(P<0.05)。[结论]在用地塞米松加利多卡因灌肠治疗重度放射性直肠炎的基础上加用复方谷氨酰胺口服,可以显著提高临床有效率及结肠镜检查缓解率,并能显著降低血液中炎性细胞因子的水平。
[Objective] To investigate the therapeutic effect of compound glutamine on severe radiation proctitis and its effect on inflammatory cytokines in patients. [Method] 78 patients with severe radiation proctitis were randomly divided into observation group (41 cases) and control group (37 cases). The control group was treated with 5mg dexamethasone plus 100mg lidocaine with 100ml 0.9% sodium chloride solution once a day for enema. The observation group was given compound glutamine on the basis of the control group orally 3 times / d grain. Three weeks after treatment, the curative effect and the changes of inflammatory cytokines (TNF-α and IL-8) in blood were evaluated. [Results] The clinical effective rate was 78.0% (32/41) in the observation group and 82.9% (34/41) in the colonoscopy group. The clinical effective rate in the control group was 48.6% (18/37), and the colonoscopy remission rate 56.8% (21/37) respectively. There was significant difference between the two groups in the clinical efficiency and the rate of colonoscopy remission (P <0.05). The levels of TNF-α and IL-8 in the two groups decreased after treatment, but the decrease in the observation group was more significant than that in the control group (P <0.05). [Conclusion] Adding dexamethasone plus lidocaine orally on the basis of dexamethasone plus lidocaine enema in the treatment of severe radiation proctitis can significantly improve clinical efficiency and colonoscopy remission rate, and can significantly reduce the blood inflammatory cells Factor level.