| Through retrospective analysis on the clinical data of 99 radiat ion proctitis patients(acute and chronic), the paper will analyze the clinica l features of radiation proctitis patients and compare the curative effect o f retention enema in different medicine solutions imposed on radiation pr octitis patients to offer examples and references for further enhancing its clinical diagnosis and treatment. At the same time, provide the reference for the future development of the experiment.Methods : The paper conducts retrospective analysis through looking up the medical record and calling patients who suffer from radiation proctitis in the course of radiotherapy for pelvic cavity cancer in the First Hospi tal Affiliated to Sichuan Medical University from January 2011 to Januar y 2016. Analytical contents contain: gender, age, underlying disease, degr ee and type of radiation enteritis, radiotherapy dose, morbidity time, clini cal symptoms, endoscopy, therapeutic schedule, prognosis of disease, time of therapy, toxic and adverse effects, and so forth. Enema treatment pla n is divided into three kinds of compound.There are: A group: symptom atic treatment medicines(anti-inflammatory + hemostasis analgesic);B gr oup: intestinal mucosa protective agent + symptomatic treatment medicine s(anti-inflammatory + hemostasis analgesic); C group: Chinese medicinal formulae + symptomatic treatment medicines(anti-inflammatory + hemos tasis analgesic). the effective rate?Onset time and treatment time in acut e and chronic patients were compared between the three groups respectiv ely. conduct statistic analysis by SPSS 20.0; show measurement data with Mean ± Standard Deviation(X±S); set ?as 0.05, P<0.05 has statistic al significance. Variance analysis(one-way ANOVA) is adopted to condu ct comparative analysis among groups; chi-square test is adopted to cond uct comparative analysis on qualitative data. In case one of the theoretica l values in the table is less than 5, Fisher precise probability chi-square test will be adopted to conduct the analysis.Results: 1?This experiment were reviewed 1326 pelvic radiotherapy patients. Radi ation proctitis patients were seen in 9.7%(128 cases); acute radiation pro ctitis occurred in the proportion of 5.9%(79 cases), chronic radiation pro ctitis occurrence ratio of 5.4%(71 cases); 2?99 patients included in the retrospective analysis, all of them have a history of pelvic radiotherapy in The Affiliated Hospital of Southwest Me dical University. Gender distribution, 22 males(22.2%), 77 females(77.8%), Among which, the quantity of patients with carcinoma of uterine ce rvix are 63(63.6%), carcinoma of the rectum 25(25.2%), carcinoma of endometrium(3.0%), prostatic cancer(4.0%),vagina cancer 2(4.0%). Th e age ranks from 37 to 75 with average age 55.04±10.39. There are 44 patients with acute radiation enteritis(44.4%), among which, I degree pat ients are 34(77.37%), and II degree patients are 10(22.7%). There are 55 patients with chronic radiation enteritis(55.6%),among which, I degre e patients are 35(63.6%), and II degree patientsare 20(36.4%). 9 cases experience the both course of disease(9.1%).Foracute patients, radiation en teritis raises as quick as 6 days, or as slow as 5months. It normally rais es within 1-2 week after radiotherapy. For chronic patients, radiation ent eritis raises in the period from 3 months to 2 years after radiotherapy. It usually raises around 1 year after radiotherapy. 3?The difference on age, sex distribution, underlying disease, radiotherapy dose and disease degree in these three groups is not obvious of the pa tients with acute radiation proctitis. After analyzing, Total effective rate is86.36%(38/44 cases). A group, the effective rate is 71.4%(10 / 14 case s),In group B, the effective rate is 90%(18 / 20 cases); and group C with efficiency is 100%(10/10 cases). Among the three groups effective rate by X2 test, P=0.403>0.05, no statistical difference. 4?The acute patients were compared according to the severity of radiatio n enteritis. The results are as follows: the effective rate of grade I patien ts with group A is 80%(8/10 cases), meanwhile is 50% in grade II(2/4 cases);the effective rate of grade I patients with group B is 92.8%(13/14 cases), meanwhile is 83.3% in in grade II(5/6 cases); the effecti ve rate of grade I patients with group C is 100%(10/10 cases),howeve r no grade II patients founded in group C.after statistical analysis,wo fi nd that effective rate in three groups of grade I patients has no statistica l significance(P>0.05)Because there were no grade II patients founded with group C,we just compared the effective rate between group A and B,but found no effective rate among them(P>0.05). 5?Average treatment time in acute patients : group A is 7.86±2.627 days,group B is 9.50±4.989 days, group C is 9.0±3.127 days.the onset time in group A is 4.6±1.075 days, in group B is 3.89±0.901 days, in group C is 4.31±1.059 days. The onset time of drugs in three groups have no significan t difference(p>0.05). 6?The onset time was compared according to the severity of radiation e nteritis in acute patients. In grade I,the onset time of group A is 4.63±0.916 days,group B is 3.54±0.660 days, group C is 4.3±1.059 days. after statistical analysis,wo find obvious difference in three groups in onset ti me(P<0.05),further compared each two,we find the difference exist bet ween the group A and group B,also in group B and group C. The resultshows intestinal mucosa repair agent can quicken the onset time.In grad e II,the onset time of group A is 4.5±1.197 days,group B is 4.8±0.387 days. after statistical analysis,we find no obvious difference. 7?The difference on age, sex distribution, underlying disease, radiotherap y dose and disease degree in these three groups is not obvious of the pa tients with chronic radiation proctitis. After analyzing, Total effective rate was 69.1%(38/55 cases). A group, the effective rate is 41.6%(5/12cases;In group B, the effective rate was 66.6%(12/18 cases); and group C wit h efficiency is 84%(21/25 cases). The effective rates of the three groups were compared by X2 square, P=0.032<0.05, it means there is obvious di fference among the three group. Further comparison between each two,no s ignificant difference between A group and B group, B group and C grou p(P>0.05).however A group and C group were statistically significant(P=0.008<0.05). The result means that treatment effect of C compound dr ug is better than the A,but have no obvious diference with B compound drug. 8?The chronic patients were compared according to the severity of radiat ion enteritis. The results are as follows: the effective rate of grade I pati ents with group A is 50%(5/10 cases), meanwhile only two patients co ntained in grade II, both of them are ineffective(0/2 cases); the effecti ve rate of grade I patients with group B is 70%(7/10 cases), meanwhi le is 37.5% in grade II(3/8 cases); the effective rate of grade I patient s with group C is 93.3%(13/15 cases), meanwhile is 70%(7/10)in grade II. after statistical analysis,wo find that effective rate in three gro ups of grade II patients has no statistical significance(P>0.05). The eff ective rates of the three groups in grade I were compared by X2 square, P<0.05,means there is obvious difference among them. Further compariso n between each two. We find no significant difference between A group and B group, B group and C group(P>0.05). however A group and C gr oup were statistically significant(P<0.05). The result shows that treatment effect among three groupas in grade I patients is similar.but treatment eff ect of C compound drug is better than the A,but have no obvious difere nce with B compound drug in patients with grade I radiation proctitis. 9?Average treatment time in chronic patients: group A is 13.83±4.366 da ys, group B is 13.61±4.629 days, group C is 12.92±4.153 days.the onset t ime in group A is 8.2±1.095 days,in group B is 6.54±1.506 days, in group C is 7.76±2.587 days. The onset time of drugs in three groups have no sign ificant difference( P>0.05). 10?The onset time was compared according to the severity of radiation enteritis in chronic patients. In grade I,the onset time of group A is 8.2±1.095 days,group B is 6.13±1.126 days, group C is 7.57±2.209 days. In grade II,the onset time of group B is 7.2±1.924 days,group B is 8.14±3.388 days. after statistical analysis,we find no obvious difference.Conclusion: 1?Clysis treatment schedules for clinical radiation enteritis mainly contai n three types, there are(anti-inflammatory + hemostasis analgesic),intesti nal mucosa repair agent + suited treatmentsand medicines(anti-inflammat ory + hemostasis analgesic), and Chinese medicinal formulae + suited tre atments and medicines(anti-inflammatory + hemostasis analgesic). Most c ommon of intestinal mucosa protective agent is kangfuxin,at the same ti me Xileisan is the most common in Chinese medicinal formulae. 2?on the base of symptomatic treatment, Join the Chinese medicinal for mulae or intestinal mucosa repair agent donot enhance the curing rater in acute radiation proctitis. 3?Chinese medicinal formulae can enhance the curing rater in treatment of the chronic radiation proctitis,especially in grade I patients.4?Joint intestinal mucosa repair agent can quicken the onset time in the treatment of grade I acute radiation proctitis patients. |
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