滋阴活血颗粒联合糖皮质激素、抗生素治疗放射性肺炎的临床观察

Treating Radiation Peumonitis by Ziyin Huoxue Granule Combined Glucocorticoids and Antibiotics:a Clinical Observation

目的观察滋阴活血颗粒联合糖皮质激素、抗生素治疗放射性肺炎患者的临床疗效。方法将放射性肺炎患者70例按照随机数字表法分为治疗组和对照组,每组35例。两组均给予激素乖抗生素治疗,治疗组加用滋阴活血颗粒,每日1剂,连续用药4周。观察治疗前后两组患者Watters临床-影像-生理(clinical radiographic physiologic,CRP)评分、卡氏评分和美国肿瘤放射治疗协作组(Radiation Therapy Oncology Group,RTOG)急性放射性损伤分级,比较两组抗生素及激素应用时间。结果所有患者均完成了观察,无脱落和死亡病例。治疗前两组Watters-CRP评分、卡氏评分及RTOG分级比较,差异无统计学意义(P>0.05);与本组治疗前比较,两组治疗后RTOG分级明显改善(P<0.05);与对照组比较,治疗后治疗组Watters-CRP评分降低,卡氏评分升高,抗生素和激素使用时间减少(P<0.05),治疗后RTOG分级治疗组虽优于对照组,但差异无统计学意义(P>0.05)。结论滋阴活血颗粒联合激素、抗生素治疗放射性肺炎,在改善Watters-CRP评分、缩短抗生素和激素用药时间、提高患者身体机能状态方面,优于单纯应用激素和抗生素治疗。

Objective To observe the clinical effect of Ziyin Huoxue Granule（ZHG） combined glucocorticoids and antibiotics in treatment of radiation pneumonitis.Methods Totally 70 radiation pneumonitis patients were assigned to the treatment group and the control group according to random digit table,35 in each group.All patients received glucocorticoids and antibiotics.Patients in the treatment group additionally took ZHG,one dose per day for 4 successive weeks.Watters clinical-radiologic-physiologic（CRP）score,Karnofsky Performance Status Scale（KPS）,and acute radiation injury classification[set by Radiation Therapy Oncology Group（RTOG）]were observed in the two groups before and after treatment.The application time for antibiotics and glucocorticoids was compared between the two groups.Results All patients completed this trial,and nobody dropped out or died.There was no statistical difference in WattersCRP scores,KPS,or RTOG between the two groups before treatment（P〈0.05）.Compared with before treatment in the same group,RTOG classification was obviously improved in the two groups（P〉0.05）.Compared with the control group,Watters-CRP scores decreased,KPS increased,the application time for antibiotics and glucocorticoids was reduced（P〈0.05）.The efficacy of RTOG classification was better in the treatment group than in the control group,but with no statistical difference between the two groups（P〉0.05）.Conclusion ZHG combined glucocorticoids and antibiotics was superior in treating radiation pneumonitis to using glucocorticoids or antibiotics alone in elevating Watters-CRP scores,shortening the application time for glucocorticoids and antibiotics,and improving patients＇ physical conditions.