CAJ | 학술논문

目的：观察中药鸦胆子油乳配合调强放疗（IMRT）及192 Ir 腔内后装治疗宫颈癌的近期有效率及毒副反应。方法：68例宫颈癌患者随机分为2组，对照组34例，全程IMRT 配合腔内后装治疗。研究组34例，全程鸦胆子油乳配合 IMRT 及腔内后装治疗。对照组采用6MV X 线调强放疗给予平均剂量54.5Gy，1.8-2.2Gy/次，每周5次，放疗30Gy 后开始作腔内后装治疗，后装照射共给5次，每周1次，每次6Gy，治疗当日不进行外照射。研究组在对照组治疗基础上另加用鸦胆子油乳注射液30ml 加入0.9%氯化钠注射液250ml中静脉滴注，每天1次，连续使用21d。结果：2组近期有效率分别为85.29%和88.24%，无统计学差异（P ﹥0.05）；研究组治疗后 CD3+、CD4+水平较治疗前明显升高（P ﹤0.05），对照组 CD3+、CD8+水平较治疗前下降（P ﹤0.05）；两组治疗前 CD3+、CD4+、CD8+和 CD56+水平比较均无差异（P ﹥0.05），研究组治疗后上述各指标均明显高于对照组治疗后水平（P ﹤0.05）；两组毒副反应比较，研究组急性放射性肠炎及血液学毒性程度均明显低于对照组（P ﹤0.05）。结论：鸦胆子油乳可通过提高患者机体免疫功能等途径有效避免或降低放疗毒副反应的发生，增强 IMRT 和腔内后装对宫颈癌患者的放疗疗效。
목적：관찰중약아담자유유배합조강방료（IMRT）급192 Ir 강내후장치료궁경암적근기유효솔급독부반응。방법：68례궁경암환자수궤분위2조，대조조34례，전정IMRT 배합강내후장치료。연구조34례，전정아담자유유배합 IMRT 급강내후장치료。대조조채용6MV X 선조강방료급여평균제량54.5Gy，1.8-2.2Gy/차，매주5차，방료30Gy 후개시작강내후장치료，후장조사공급5차，매주1차，매차6Gy，치료당일불진행외조사。연구조재대조조치료기출상령가용아담자유유주사액30ml 가입0.9%록화납주사액250ml중정맥적주，매천1차，련속사용21d。결과：2조근기유효솔분별위85.29%화88.24%，무통계학차이（P ﹥0.05）；연구조치료후 CD3+、CD4+수평교치료전명현승고（P ﹤0.05），대조조 CD3+、CD8+수평교치료전하강（P ﹤0.05）；량조치료전 CD3+、CD4+、CD8+화 CD56+수평비교균무차이（P ﹥0.05），연구조치료후상술각지표균명현고우대조조치료후수평（P ﹤0.05）；량조독부반응비교，연구조급성방사성장염급혈액학독성정도균명현저우대조조（P ﹤0.05）。결론：아담자유유가통과제고환자궤체면역공능등도경유효피면혹강저방료독부반응적발생，증강 IMRT 화강내후장대궁경암환자적방료료효。
To investigate the effect,local control rate,life quality and complications of bruceae oil e-mulsion combined with intensity modulated radiation therapy(IMRT)and 192 Ir after loading intracavitary brach thera-py in patients with cervical cancer. Methods:Sixty - eight cervical cancer patients were divided randomly into two groups,the control group(34 cases)and the observation group(34 cases). Both groups received IMRT plus intracav-itary brachytherapy(1. 8 - 2. 2Gy per fraction,5 fractions per week,with an average dose of 54. 5Gy). Intracavitary brach therapy was to a total dose of 24 - 30Gy at 6Gy per fraction once a week after the dose of IMRT reached 30Gy. The observation group received 30ml of bruceae oil emulsion once a day for 21 days. Results:The effective rates of two groups were 85. 29% and 88. 24% and there was no difference in the two groups(P ﹥ 0. 05). After treatment,the level of CD3 + ,CD4 + was obviously increased in the observation group(P ﹤ 0. 05),while in the control group,the lev-el of CD3 + ,CD8 + was obviously decreased after treatment( P ﹤ 0. 05). The level of CD3 + ,CD4 + ,CD8 + and CD56 + before treatment in two groups were not significantly different(P ﹥ 0. 05),after treatment,the level of CD3 + , CD4 + ,CD8 + and CD56 + in the observation group were higher than those in the control group(P ﹤ 0. 05). The toxic effects were compared in two groups,the acute radiation enteritis and hematology toxic in the observation group were obviously lower than those in the control group(P ﹤ 0. 05). Conclusion:Bruceae oil emulsion could enhance the sen-sitivity of cervical cancer cells to IMRT and intracavitary brachytherapy through improving the cell immunologic func-tion and avoiding or decreasing side effect,improve the time and quality.