痰热清注射液对血浆内皮素-1的影响及防治放射性肺损伤的疗效观察

CLINICAL OBSERVATION OF TANREQING INJECTION ON PREVENTION OF RADIATION-INDUCED PULMONARY INJURE AND CHANGES OF ENDOTHELIN-1(ET-1)

目的观察痰热清注射液对血浆内皮素-1(ET-1)的影响及防治放射性肺损伤的临床疗效。方法将100例需要进行放射治疗的肺癌患者随机分为二组,观察组52例放射治疗同时予痰热清注射液静滴;对照组48例只予常规放射治疗。二组均于放射治疗开始后1h、24h和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,用酶联免疫吸附法(ELISA法)测定血清中ET-1的含量。结果急性放射性肺炎总发生率观察组为17.31%,对照组为33.33%;3、4级肺炎发生率观察组为3.85%,对照组为27.08%;3、4级肺炎平均发病剂量分别61Gy和52Gy;放射性肺炎平均发病时间分别为39d和28d;肺纤维化发生率观察组为15.38%,对照组为52.38%。观察组血浆中ET-1的含量较对照组低。结论痰热清注射液能降低血浆中ET-1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 ET- 1 in plasma. Methods 100 cases were divided into two group randomly. 52 cases in the observation group treated by intravenous drip of Tanreqing Injection combine with radiotherapy. Other 48 control cases were treated with conventional radiotherapy. Blood specimens were taken from veins, at lh, 24h, 72h, 1 week, 2 weeks, 4weeks, 8 weeks, 16 weeks and 24weeks after radiotherapy for determination of the level of ET-1 in plasma by ELISA. Results The total rates of acute radiation pneumonitis, in the observation group and the control group were 17.31% and 33.33 % respectively. Grade 3 or 4 acute radiation pneumonitis occurred in 3.85% of patients treated with Tanreqing Injection ,and 27. 08% in the other group . The mean dose of radiation was 61 Gy and 52 Gy respectively. The average time of that acute radiation pneumonitis occured was 39 days and 28 days respectively. The rates of radia- tion pulmonary fibrosis, in the observation group and the control group were ：15. 38% and 52.38% respectively. Moreover, the plasma levels of ET- 1 was obviously higher in control group than that in observation group. Conclusion ET - 1 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.