经方麦门冬汤预防放射性肺损伤及其对血浆TGF-β1的影响

Maimendong Decoction in the Prevention of Radiation-induced Lung Injury and Its Effect on Plasma TGF-β1

目的探讨经方麦门冬汤能否预防放射性肺损伤的发生及其对血浆TGF-β1水平的影响。方法采用前瞻性随机对照设计,将符合入选标准接受根治性放疗的食管癌及Ⅲ期以上的肺癌患者随机分为治疗组和对照组。对照组行单纯放化疗,治疗组在进行放化疗的同时口服麦门冬汤,比较两组患者放射性肺损伤的发生率。在放疗前、放疗完成40 Gy及放疗后1个月测定两组患者血浆TGF-β1的水平。结果治疗组2级以上(≥2级)放射性肺损伤的发生率为16.67%(5/30),明显低于对照组40.00%(12/30),差异具有统计学意义(P<0.05)。放疗前,两组血浆TGF-β1水平比较无统计学差异(P<0.05);放疗完成40 Gy时,治疗组血浆TGF-β1水平为(25.23±5.11)ng/ml,对照组为(27.85±5.57)ng/ml,两组比较有统计学差异(t=1.90,P<0.05);放疗后1个月治疗组TGF-β1水平为(5.74±2.64)ng/ml,对照组为(7.36±3.11)ng/ml,两组间比较有统计学差异(t=2.18,P<0.05)。结论麦门冬汤可以预防放射性肺损伤的发生;其机制可能与TGF-β1通路有关。

Objective To investigate classical maimendong deeoetion in the prevention of radiation-induced lung injury, and its impaet on the level of plasma TGF beta 1. Methods A prospeetive, randomized, eontrolled trial was designed to treat esophageal cancer patients and stage m lung cancer patients treated with radical radiotherapy, and the patients were randomly divided into 2 groups. The eontrol group received ehemotherapy, the treatment group received radiotherapy and chemotherapy oral maimendong decoction, ineidenee of radiation-induced lung injury of the 2 groups were compared. The plasma level of TGF-[31 were measured in the 2 groups of patients before radiotherapy, after 40 Gy of radiotherapy, and 1 month after radiotherapy. Results In the treatment group,ineidenee rate of level 2 and above（≥2） radiation-induced lung injury was 16.67% （5/30） ,which were significantly lower than the eontrol group,40.00 % （ 12/30）, the difference has statistieal significance （ P 〈 0.05 ）. Before the start of radiotherapy,plasma TGF-1 level of the 2 groups had no statistical difference （P 〈0. 05 ） ; 40gy of radiotherapy, he level of TGF-beta 1 in the treatment group was（25.23±5.11 ） ng/ml and of the eontrol group was（27.85 ＋5.57） ng/ml,the difference between the 2 groups has statistical signifieanee（t = 1.90,P 〈 0.05） ; 1 month after radiotherapy,TGF-β1 level in the treatment group was （5.74± 2.64 ） ng/ml, and of the control group was （ 7.36± 3.11 ） ng/ml, there had signifieant differenee between the 2 groups （ t = 2.18, P 〈 0.05 ）. Conclusion Maimendong deeoetion can prevent the oeeurrenee of radiation-indueed lung injury ; the mechanism may be related to TGF beta I pathway.