痰热清注射液预防放射性肺损伤的疗效观察

Clinical observation of Tanreqing injection on prevention of radiation-induced pulmonary injure

目的观察痰热清注射液预防放射性肺损伤的临床疗效及对血浆转化生长因子β1(TGF-β1)的影响。方法将68例需要放射治疗的肺癌患者随机分为2组,观察组32例放射治疗同时予痰热清注射液静脉滴注;对照组36例只予常规放射治疗。于放射治疗开始后1h、24h、72h、1周(潜伏期)、2周、4周、8周、16周(肺炎期)、24周(肺纤维化期)抽空腹静脉血,用ELISA法测定血浆TGF-β1含量。结果急性放射性肺炎总发生率观察组25.00%,对照组33.33%;3、4级肺炎发生率观察组6.25%,对照组25.00%;3、4级肺炎平均发病剂量分别60Gy和53Gy;放射性肺炎平均发病时间分别为38日和31日;肺纤维化发生率观察组为28.13%,对照组为55.56%。观察组血浆TGF-β1的含量较对照组低。结论痰热清注射液能降低血清TGF-β1的表达,有效预防和推迟严重性急性放射性肺炎及肺纤维化的发生;对减轻放射性肺损伤、提高生存质量、保证放射治疗的顺利进行具有积极意义。

Objective To observe the clinical effect of Tanreqing injection on prevention of radiation - induced pulmonary injure and changes of TGF - β1 in plasma. Methods 68 cases with lung carcinoma were randomly divided into two groups. 32 cases in the treatment group were treated by intravenous drip of Tanreqing injection combined with radiotherapy. Other 36 cases in control group were treated by conventional radiotherapy. Blood specimens were taken from veins, at 1 h, 24 h,72 h, 1 week, 2 weeks, 4 weeks, 8 weeks, 16 weeks and 24 weeks after radiotherapy for determination of the level of TGFβ- 1 in plasma by ELISA. Results The total incidence rates of acute radiation pneumonitis in the treatment group and the control group were 25 % and 33.3% respectively. Grade 3 or 4 acute radiation pneumonitis occurred in 6.25 % of patients treated with Tanreqing injection, and 25% in the control group .The mean dose of radiation in the treatment group and the control group was 60 Gy and 53 Gy ~spectively. The average onset time of acute radiation pneumonitis occurred was 38 days and 31 days respectively. The incidence rates of radiation pulmonary fibrosis in the treatment group and the control group were 28.13% and 55.56% respectively. The plasma level of TGF - β1 was obviously higher in control group than that in treatment group. Conclusion TGF -β expression was down regulated by Tanreqing injection. Tanreqing injection is effective in preventing the occurrence of Grade 3 or 4 acute radiation pneumonitis and radiation pulmonary, fibrosis. It is proved that Tanreqing injection may elevate the life quality and ensure successful radiotherapy.