复方溃疡油对放射性皮肤炎患者血液细胞因子的影响

Effect of Compound Ulcer Oil on Blood Cytokines in Patients with Radiation Dermatitis

目的:探讨细胞因子与放射性皮炎发生发展及预后的相关性,并以此探讨复方溃疡油防治放射性皮炎的作用机制。方法:选择符合入组条件、接受头颈胸部位放射治疗的患者80例,随机分为试验组(溃疡油组)和对照组(西医治疗组),观察临床疗效,并通过检测患者外周血中表皮生长因子(EGF),肿瘤坏死因子-α(TNF-α),白细胞介素(IL)-6,IL-1,IL-8,IL-10的变化,探寻溃疡油防治放射性皮炎的作用机制。结果:复方溃疡油能显著地延缓患者放射性皮炎发生时间,降低患者放射性皮炎级别,加速放射性皮炎的愈合(P<0.05)。在30 GY时,两组EGF水平较放疗前均显著下降(P<0.01)。60 Gy时,两组EGF水平均较30 Gy时有所回升,试验组上升水平明显高于对照组(P<0.01)。30 Gy时两组的IL-6,TNF-α,IL-1,IL-8水平均在放疗后显著上升(P<0.01),60 Gy时两组的IL-6,TNF-α,IL-1,IL-8水平有所下降;30 Gy时试验组IL-6,TNF-α,IL-1,IL-8上升水平明显低于对照组(P<0.05),60 Gy时下降水平又高于对照组。30 Gy时两组IL-10均较放疗前明显下降,而60Gy时IL-10均上升,试验组下降水平明显低于对照组(P<0.01),60 Gy时试验组IL-10高于对照组(P<0.05)。结论:复方溃疡油可能通过早期抑制促炎因子IL-6,TNF-α,IL-1,IL-8的产生和释放,同时降低抑炎因子IL-10的下降速度,后期促进EGF的产生,从而达到延缓皮肤炎发生,并提高皮肤炎痊愈速度的目的。

Objective： To discuss the correlation between cytokines,occurrence,development and prognosis of radioactive dermatitis,and investigate the effect and mechanism of Chinese herbal compound ulcer oil in prevention and treatment of radiation dermatitis. Method： The 80 eligible patients who received radiotherapy in head,neck and chest were prospectively enrolled in this study and randomly divided into observation group（ ulcer oil group） and control group（ western medicine group）. Efficacy was observed,then changes in epidermal growth factor（ EGF）,tumor necrosis factor（ TNF）-α,interleukin（ IL）-6,IL-1,IL-8 and IL-10 in peripheral blood of the patients were detected to investigate action mechanism of ulcer oil in prevention and treatment of radiation dermatitis. Result： Ulcer oil can significantly delay occurrence of radiation dermatitis,reduce grade of radiation dermatitis,and accelerate healing rate of radiation dermatitis（ P〈0. 05）. At 30 Gy, EGF levels were significantly lower than those before radiotherapy in both groups（ P〈0. 01）. At 60 Gy,EGF levels of two groups were increased compared with 30 Gy,but the increase degree in observation group was significantly higher than that of control group（ P〈0. 01）. At 30 Gy,both groups showed significant increases in IL-6,TNF-α,IL-1 and IL-8 levels of peripheral blood（ P〈0. 01）. At 60 Gy,IL-6,TNF-α,IL-1 and IL-8 levels were decreased in both groups. In comparison between two groups,increase degree in IL-6,TNF-α,IL-1 and IL-8 levels in observation group was lower than that of control group at 30 Gy（ P〈0. 05）. At 60 Gy,IL-10 levels were increased in both groups,decrease degree in observation group was significantly lower than that of the control group（ P〈0. 01）. At60 Gy,IL-10 level of the observation group was higher than that of the control group（ P〈0. 05）. Conclusion：Compound ulcer oil may delay occurrence of skin inflammation, and increase its recovery speed by inhibiting production and release of IL-6, TNF-α, IL-1 and IL-8, reducing decline speed of IL-10 at early stage, and promoting production of EGF at advanced stage.