CAJ | 학술논문

目的观察清燥救肺汤加黄芪对局部中晚期胸部肿瘤放射治疗的肺保护作用及对肿瘤坏死因子-α(TNF-α)、内皮素(ET)表达水平的影响.方法将局部中晚期胸部肿瘤放射治疗者随机分为治疗组和对照组.治疗组在放射治疗开始起服用清燥救肺汤200 ml,黄芪口服液10 ml,2次/d,连续6个月.放射治疗前后测定血浆TNF-α和ET,放射治疗开始15 d起观测临床症状、高分辨率CT和肺弥散功能.结果治疗组放射治疗前血浆TNF-α为(1.92±0.49)ng/ml,放射治疗后为(2.51±0.73)ng/ml;对照组放射治疗前为(1.90±0.51)ng/ml,放射治疗后为(5.12±1.01)ng/ml,较治疗组明显升高(P<0.001).治疗组放射治疗前血浆ET为(56.73±18.35)pg/ml,放射治疗后为(68.97±21.76)pg/ml;对照组放射治疗前为(58.93±16.98)pg/ml,放射治疗后为(97.87±37.83)pg/ml,明显升高(P<0.001).放射治疗开始后5个月和10个月治疗组CO弥散量下降情况较对照组差异有统计学意义(P<0.05).治疗组和对照组急性放射性肺炎和肺纤维化的发生率比较差异有统计学意义(P<0.05).结论清燥救肺汤加黄芪能抑制放射治疗后血浆TNF-α、ET的过度表达,降低放射治疗后弥散功能的恶化,可以用于放射性肺损伤的治疗和预防.
목적 관찰청조구폐탕가황기대국부중만기흉부종류방사치료적폐보호작용급대종류배사인자-α(TNF-α)、내피소(ET)표체수평적영향.방법 장국부중만기흉부종류방사치료자수궤분위치료조화대조조.치료조재방사치료개시기복용청조구폐탕200 ml,황기구복액10 ml,2차/d,련속6개월.방사치료전후측정혈장TNF-α화ET,방사치료개시15 d기관측림상증상、고분변솔CT화폐미산공능.결과 치료조방사치료전혈장TNF-α위(1.92±0.49)ng/ml,방사치료후위(2.51±0.73)ng/ml;대조조방사치료전위(1.90±0.51)ng/ml,방사치료후위(5.12±1.01)ng/ml,교치료조명현승고(P<0.001).치료조방사치료전혈장ET위(56.73±18.35)pg/ml,방사치료후위(68.97±21.76)pg/ml;대조조방사치료전위(58.93±16.98)pg/ml,방사치료후위(97.87±37.83)pg/ml,명현승고(P<0.001).방사치료개시후5개월화10개월치료조CO미산량하강정황교대조조차이유통계학의의(P<0.05).치료조화대조조급성방사성폐염화폐섬유화적발생솔비교차이유통계학의의(P<0.05).결론 청조구폐탕가황기능억제방사치료후혈장TNF-α、ET적과도표체,강저방사치료후미산공능적악화,가이용우방사성폐손상적치료화예방.
Objective To observe the effect of "Qin Zao Jiu Fei Recipe" and Astragalus membranaceus on radiation-induced lung injury and levels of plasma tumor necrosis factor-α(TNF-α)and endothelin (ET) in partial mid and late stage chest tumor patients with lung radiotherapy. Methods The partial mid and late stage chest tumor patients were randomly divided into control group and therapy group, therapy group was treated with "Qin Zao Jiu Fei Recipe" 200 ml ,po,bid and Astragalus membranaceus10 ml,po,bid before radiotherapy and continued for 6 months.Plasma TNF-α and ET were examined before and at the end of radiotherapy,Clinicalsymptoms,lung function and high-resolution computed tomography of thorax were evaluated after 15 days of radiotherapy.Results Before radiotherapy, plasma TNF-α for(1.92±0.49)ng/ml in therapy group and (1.90±0.51)ng/m in control group,at the end of radiotherapy,the level of plasma TNF-α in control group was much higher than in therapy group(5.12±1.01ng/ml vs2.51±0.73ng/ml,P<0.001).Before radiotherapy, plasma ET was(56.73±18.35)pg/ml in therapy group and (58.93±16.98)pg/ml in control group,at the end of radiotherapy,the level of plasma ET in control group was much higher than that of therapy group(97.87±37.83 pg/ml vs 68.97±21.76 pg/ml,P<0.001).Five months and ten months after radiotherapy,reduced CO diffusion capacity of lung (DLCO) in therapy group were less than that of the control group(P<0.05), and there was significant difference between the two groups.Occurrence rate of radioactive pneumonia and pulmonary fibrosis was significant difference between the two groups(P<0.05).Conclusion "Qin Zao Jiu Fei Recipe" and Astragalus membranaceus can inhibit overexpression of plasma TNF-α and ET after radiotherapy,and may reduce the severity of dysfunction lung injury. "Qin Zao Jiu Fei Recipe" and Astragalus membranaceus can prevent and treat raduation-induced lung injury.