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目的:探讨思密达和康复新混合液保留灌肠联合高压氧(HBO)预防宫颈癌放疗后放射性直肠炎(RP)的临床疗效及其作用机制。方法:选择2016年1月至2019年12月上海交通大学医学院附属新华医院崇明分院收治的宫颈癌放疗后患者92例作为研究对象,按治疗方法分为观察组(n n=46)和对照组(n n=46)。对照组予以思密达和康复新混合液保留灌肠治疗,观察组采用思密达和康复新混合液保留灌肠联合HBO治疗。记录2组患者急性RP的发生率、发生时间及急慢性RP分级发生情况。观察结直肠镜检查结果并采用维也纳直肠镜评分。采用免疫比浊法检测2组患者治疗后免疫球蛋白IgG、IgM、IgA水平。使用酶联免疫法检测治疗后白细胞介素-6(IL-6) 、肿瘤坏死因子-α(TNF-α)的水平;采用荧光法检测治疗后C反应蛋白(CRP)的水平。n 结果:观察组患者放疗后急性RP的发生率显著低于对照组,RP的平均发生时间明显延后于对照组,差异均有统计学意义(n P<0.05)。观察组1~2级、3~4级RP发生率及急慢性RP总发生率均明显低于对照组,差异均有统计学意义(n P<0.05)。观察组维也纳直肠镜评分0~2分患者明显多于对照组,3~5分少于对照组,差异均有统计学意义(n P<0.05)。观察组治疗后IgG、IgM、IgA水平显著高于对照组,而TNF-α、IL-6、CRP水平显著低于对照组,差异均有统计学意义(n P<0.05)。n 结论:思密达和康复新混合液保留灌肠联合HBO治疗可延缓和减少宫颈癌放疗后放射性直肠炎的发生,并能缓解临床症状,其作用机制可能是通过提高机体免疫功能和降低炎性因子水平实现的。“,”Objective:To investigate the clinical effect and action mechanism of Smecta and Kangfuxin mixture retention enema combined with hyperbaric oxygen (HBO) in the prevention of radiation proctitis (RP) after radiotherapy for cervical cancer.Methods:A total of 92 patients with RP after radiotherapy for cervical cancer admitted to Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2016 to December 2019 were selected and divided into observation group and control group according to their treatments, with 46 cases each. The control group was treated with Smecta and Kangfuxin mixture retention enema, and the observation group was treated with HBO on the basis of the treatment of the control group. The incidence, time of occurrence, and classification of acute and chronic RP of both groups were recorded. The results of colonoscopy were observed and evaluated by the Viennese colonoscopy score. The levels of immunoglobulin IgG, IgM, and IgA in the two groups before and after treatment were detected by immunoturbidimetric method. The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA), and the levels of C-reactive protein (CRP) was detected by fluorescence method.Results:The incidence of acute RP after radiotherapy in the observation group was significantly lower than that in the control group, and the average occurrence time of RP in the observation group was significantly delayed than that in the control group (n P<0.05). The incidences of grade 1-2, grade 3-4 RP, and the total incidence of acute and chronic RP in the observation group were significantly lower than those in the control group (n P<0.05). The patients with 0-2 points of Viennese colonoscopy scores in the observation group were significantly more than those in the control group, and the patients with 3-5 points were less than those in the control group, the differences were statistically significant (n P<0.05). After treatment, the levels of IgG, IgM, and IgA in the observation group were significantly higher than those in the control group, while the levels of TNF-α, IL-6, and CRP in the observation group were significantly lower than those in the control group (n P<0.05).n Conclusion:Smecta and Kangfuxin mixture retention enema combined with Hyperbaric oxygen (HBO) can delay and reduce the occurrence of radiation proctitis and relieve the clinical symptoms of cervical cancer patients after radiotherapy. The mechanism may be achieved by improving the immune function and reducing the level of inflammatory factors.