中药治疗放射性肺损伤的中医证候评价

Lntervention Effect of the Blood-cooling and Blood Flow-promoting Drugs on Rat Radiation-induced Lung Injury

目的:评价凉血活血中药早期干预防治放射性肺损伤的效果,研究放射性肺损伤的中医微观证候依据。方法:160只wistar种雌性大鼠随机分为模型组、治疗组、单纯中药组和对照组,通过右肺分次照射(30Gy/10次,共5周)造模,分批取材,对动物活体、肺脏大体及组织病理进行观察和评分。结果:模型组大鼠在照射期间出现典型的"热毒内盛"证表现;其肺组织第5周至第8周急性炎症表现最重,镜下呈明显的"热伤肺络"和"瘀阻肺络"证;后期照射区呈明显局灶性肺纤维化,符合"瘀阻肺络"证的表现。而中药干预组大鼠急性放射性肺组织损伤评分明显低于模型组(P<0.01),后期纤维化评分明显低于模型组(P<0.01)。结论:凉血活血中药早期干预减轻了早期放射性肺炎的炎症反应,减轻了放射性肺纤维化的程度;凉血活血早期干预的防治手段不仅符合中医学理论,而且也具有充分的实验依据。

Objective： To evaluate the prevention effect of blood-cooling and blood flow-promoting drugs used earlier on radiation-induced lung injury of rat and research the experiment evidence for the therapy in the Traditional Chinese Medi- cine. Methods ：160 Wistar rats were randomly allocated into irradiation group, treatment group, herb-fracture group and control group. The first three groups were irradiated right hemithorax with a dose of 30Gy/10 fraction for 5 weeks. We observed the living animal and the macro-changes of lung in detail, and investigated histological changes and lung fibrosis score. Results：During the radiation period the irradiation group presented a symptom-group of＂ pyretic toxicity accumulate inside＂. The acute radiation-induced pneumonia was most serious at the fifth week. After 26 weeks the lung showed focal interstitial fibrosis which consistent with the symptom of＂ heat impairing pulmonary collateral＂ and especially the＂ stagnant blood hinder pulmonary collateral＂. The acute radiation-reduced lung injury and the fibrosis score was significantly lower than the irradiation group（ P 〈 0. 01 ）. Conclusion ： Using blood-cooling and blood flow-promoting drugs early ean prevent and reduced the radiation-reduced lung injury effectively;this treatment method is not only according with the theory of traditional chinese medicine but also supported by the experiment.