痰热清注射液治疗放射性肺炎的效果

Tanreqing injection for radiation pneumonitis

目的:观察痰热清注射液治疗放射性肺炎的疗效,并与单纯西药治疗效果比较。方法:①选择2002-02/2006-02三门峡市中心医院肿瘤内科住院的恶性肿瘤患者169例,男98例,女71例,年龄32～78岁。均为经病理或细胞学检查确诊的恶性肿瘤患者,放疗后胸片或CT发现肺部受照部位出现与放射野一致的肺部纤维化和(或)肺部炎症;均对治疗方案知情同意。按随机数字表法将其分为2组:治疗组89例和对照组80例。②治疗方法:治疗组采用痰热清注射液(由上海凯宝药业公司生产,主要成分为黄芩、熊胆粉、山羊角、金银花、连翘,批号021101,10mL/支)20mL加入50g/L葡萄糖注射液500mL中静脉点滴,1次/d。对照组用头孢噻肟钠2.0g加入生理盐水250mL静脉点滴,2次/d,同时口服强的松片10mg,4次/d,两组均以15d为1个疗程,观察1个疗程。③疗效评定标准:恢复正常、显效、有效、无效均为临床症状消失,X射线平片表现分别为絮状阴影消失、阴影减少80%以上、阴影减少50%以上、无明显变化或片絮状阴影增加。观察患者临床症状和体征发热、咳嗽、咯痰、憋喘、胸痛、肺罗音消失和胸部X射线平片表现阴影吸收所需时间。④组间率比较用χ2检验,组间均数比较采用t检验。结果:恶性肿瘤患者169例均进入结果分析。①总体疗效比较:治疗组总有效率高于对照组(分别为83%和49%,χ2=20.97,P<0.01)。②治疗后症状、体症改变所需时间:治疗组退热、止喘、痰色质变化、胸痛消失、肺罗音消失、X射线平片阴影消失天数均短于对照组(t=2.097～6.360,P<0.05～0.01)。结论:痰热清注射液对于放射性肺炎具有较好的治疗作用,优于单纯西药治疗。

AIM： To observe the therapeutic effect of Tanreqing injection for treating radiation pneumonitis, and compare with that of simple western medicine. METHODS： （1）From February 2002 to February 2006, 169 inpatients with malignant tumor were enrolled from the Department of Oncology, the Central Hospital of Sanmenxia, and there were 98 cases of male and 71 cases of female, who aged from 32 to 78 years. All patients were diagnosed per pathological or cytological examination, and radiation pulmonary fibrosis and （or） radiation pneumonitis coherent to radiation field were detected from CT or X-ray sternum. All patients who knew the therapeutic regimen were divided into two groups according to the method of random digits table： the treatment group （n=89） and control group （n=80）.（2） Treatment： The treatment group were treated intravenously with 500 mL glucose parental solution （50 g/L） containing 20 mL Tanreqing injection, which was produced by Shanghai Kaibao Pharmaceutical Co.Ltd （The major constituents were baical skullcap root, bear gall power, comu capra hircus, flos lonicerae and forsythia suspense. The batch number was 021101, 10 mL/ramus）, once per day. While the control group were treated with 2.0 g cefotaxime sodium and 250mL saline, twice per day. Additionally, 10 mg Dexamethasone was administrated orally four times per day. Both groups were treated for 15 days as one course of treatment.（3）The standard of therapeutic effect was adopted as follows： recovery, excellence, efficiency and inefficacy were taken as the disappearance of clinical symptom, and X-ray plain film was assessed by patchy shadow disappearance, over 80% or 50% decrease of shadow, no marked change and shadow increase. The physical sign and clinical symptom such as febris, cough, expectoration, thoracalgia, wheeze, the disappearance of pulmonary rale and the time of patchy shadow disappearance in X-ray plain film were all observed. （4）The x^2 test was used in the comparison of intergroup rates while the t test was used in the comparison of interblock mean. RESULTS： Totally 169 cases of patients with malignant tumor were analyzed. （1）The overall response rate of treatment group was higher than that of control group （83%, 49%,x^2=20.97, P 〈 0.01）. （2）The time of physical sign and clinical symptom changed was shorter in treatment group than in control group （t=2.097-6.360, P 〈 0.05-0.01）. CONCLUSION： Compared with western medicine, the Tanreqing injection has better curative effect in treatment of radiation pneumonitis.