摘要
目的:观察养阴益肺汤同期辅助用于胸肺部放疗患者对急性放射性肺炎(RIP)的预防作用及对患者血清白细胞介数-1(IL-1),血清白细胞介数-6(IL-6),肿瘤坏死因子-α(TNF-α)的影响。方法:将183例胸肺部肿瘤放疗患者随机按数字表法分成对照组90例和观察组93例。两组采用放射治疗,对照组同期给予相应的对症支持处理,但不使用中药相关制剂。观察组同期采用养阴益肺汤,1剂/d,内服。连续服用3个月。记录两组放射性肺炎发生率、放射性肺损害程度及发生时间;采用Watters评分法评估治疗前后呼吸困难程度,采用卡氏行为状态评分(KPS)评价治疗前后生活质量;检测治疗前后肺活量(VC),用力肺活量(FVC),第1秒用力呼气容积(FEV1)等肺功能指标;检测治疗前后血清IL-1,IL-6,TNF-α水平。结果:对照组RIP发生率为41.11%,高于观察组的19.35%(P<0.05);对照组发生RIP时间短于观察组(P<0.01),发生RIP时放射剂量低于观察组(P<0.01);治疗后观察组RIP患者放射性肺损害程度和Watters评分均低于对照组(P<0.01);治疗后观察组VC,FVC和FEV1高于对照组(P<0.05);治疗后观察组KPS评分高于对照组(P<0.01);治疗后观察组IL-1,IL-6,TNF-α水平低于对照组(P<0.01)。结论:养阴益肺汤同期辅助放疗治疗胸肺部肿瘤患者,能减少RIP的发生率,减轻RIP发生的程度,改善患者呼吸困难,稳定患者肺功能,其作用机制可能是通过减轻炎症反应来实现的。
Objective： To observe the preventive effect of Yangyin Yifei decoction for assistance of radiotherapy in treating patients with acute radiation-induced pneumonia （RIP） , and to investigate its influence on serous interleukin-1 （IL-1）, interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α）. Method： One hundred and twenty-five patients were randomly divided into the control group （90 cases） and the observation group （93 cases）. Patients in both groups received radiosurgery, and patients in the control group received symptomatic therapy without any traditional Chinese medicine treatment. Patients in the observation group received 1 dose Yangyin Yifei decoction. All patients in both two groups received 3 months of treatment. Incidence rate of RIP, injury degree and the occurrence time were recorded. Before and after the treatment, degree of dyspnea was evaluated by Watters method of point rating, and quality of life was evaluated by Karnofsky performance status score （KPS）. Vital capacity （VC） , forced vital capacity （FVC） and forced expiratory volume in one second （FEV1） were detected. Levels of IL-1, IL-6 and TNF-α were also detected. Result： Incidence rate of RIP in the observation group was 41.11% , which was higher than that of 19.35% in the control group （P 〈0.05 ）. Duration of RIP in the observation group was shorter than that in the control group （P 〈 0. 01 ）. Radiation dose in the observation group was less than that in the control group （P 〈 0.01 ）. After treatment, patients＇ radioactive injury degree and Watters scores in the observation group were both lower than those in the control group （P 〈 0.01 ）.Levels of VC, FVC and FEV1 were higher than those in the control group （P 〈 0.05）. KPS score was higher than that in the control group （P 〈0.01 ）. Levels of IL-1, IL-6 and TNF-o~ were lower than those in the control group （P 〈0.01）. Conclusion： Assistance of Yangyin Yifei decoction could reduce the incidence rate of RIP and the injury degree caused by RIP, ameliorate dyspnea and stabilize patients＇ lung function, and its mechanism of action may be related to relieving inflammatory response.
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2015年第12期186-189,共4页
Chinese Journal of Experimental Traditional Medical Formulae
关键词
放射性肺炎
养阴益肺汤
预防
radiation induced pneumonia
Yangyin Yifei decoction
prevention
作者简介
[第一作者]占明，硕士，主治医师，从事呼吸内科临床工作，Tel：13997739351，E-mail：doczm@sina．com
[通讯作者]鱼江，副教授，从事药学教学与科研工作，Tel：13628183507，E-mail：495299669@qq．com
