中肺合剂防治放射性肺炎的临床研究

Preventive Effect of ZhongFei Decoction on Radiation-induced Pneumonia

[目的]评价中肺合剂防治放射性肺炎的临床疗效。[方法]2009年12月至2011年2月入组的83例肺癌患者随机分为两组,观察组42例给予三维适形或调强放射治疗同时口服中肺合剂,对照组41例仅行三维适形或调强放射治疗。根据RTOG放射性肺损伤标准进行评价,观察两组放射性肺炎出现时间、程度。[结果]观察组放射性肺炎发生率为21.42%(9/42),对照组26.82%(11/41),从放疗开始到出现放射性肺炎中位时间分别为80d和51d;其中观察组3、4级肺炎发生率为4.76%(2/42),而对照组为21.95%(9/41)(P<0.05)。观察组放射性肺纤维化发生率为7.14%(3/42),对照组为24.39%(10/41),统计学有显著性差异(P<0.05)。[结论]中肺合剂能有效预防和推迟放射性肺炎的发生、降低3、4级放射性肺炎的发生率、减少放射性肺纤维化的发生,提高了患者的生活质量。

[Purpose] To investigate the protective effect of ZhongFei Decoction on radiation-induced pneumonia. [Methods] Eighty-three cases with lung cancer from Dec. 2009 to Feb. 2011 were randomized into two groups： 42 cases were treated with ZhongFei Decoction combined with 3DCRT or MRT radiotherapy（ZFD group）, 41 cases in control group treated with 3DCRT or MRT radiotherapy only. The Severity of pneumonia and the time of occurrence were observed, the degree of radiation-induced pneumonia was evaluated according to the protocol proposed by RTOG. [Results ] Acute radiation pneumonitis was 21.42%（9/42） in ZFD group and 26.82%（11/41） in control group （P〈0.05）. The median time from onset of radiation to pneumonitis occurred was 80 days in ZFD group and 51 days in control group （P〈0.05）. The grade 3~4 acute radiation pneumonitis occurred in 4.76%（2/42） of patients in ZFD group, and 21.95%（9/41） in control group , with a significant difference （P〈0.05）. The rate of radiation fibrosis was 7.14%（3/42） in ZFD group and 24.39%（10/41） in control group（P〈0.05）.[Conclusion] ZhongFei Decoction can postpone the deve-lopment of acute radiation pneumonitis, prevent the occurrence of grades 3～4 acute radiation pneumonitis and improve the quality of life for the patients.