清肺八味汤对化疗后肿瘤患者血清TGF-β1及TNF-α的影响及其在预防放射性肺炎中的作用

The clinical effect of Qingfei Decoction on the serum level of TGF-β1 and TNF-α in patients with malignant tumor after radiotherapy and in the prevention of radiation pneumonitis

目的研究清肺八味汤对经过化疗后的肿瘤患者血清转化生长因子-β1(TGF-β1)及肿瘤坏死因子-α(TNF-α)的影响,并探讨其在预防放射性肺炎中的作用。方法选取确诊为恶性肿瘤的62例患者进行研究,按随机数字表法将患者分为观察组(n=31)与对照组(n=31)。对照组患者采用常规化疗,观察组在对照组的基础上于化疗结束后1个月服用清肺八味汤,连续服用一个疗程(10 d,每日1剂)。治疗前及治疗后检测两组患者血清中TNF-α及TGF-β1的水平。采用影像学检查方法观察并记录患者放疗后放射性肺炎的发生情况。结果观察组放射性肺炎总发生率为54.84%,对照组放射性肺炎总发生率为87.10%,观察组放射性肺炎发生率及整体分级均低于对照组,差异有统计学意义(P﹤0.05)。治疗前,两组患者血清中TGF-β1及TNF-α水平比较,差异无统计学意义(P﹥0.05);治疗后,两组患者血清TGF-β1和TNF-α水平均较本组放疗前下降,差异有统计学意义(P﹤0.05);治疗后,对照组患者TGF-β1血清水平明显高于观察组,差异有统计学意义(t=7.130,P﹤0.01);治疗后,两组患者TNF-α水平比较,差异无统计学意义(t=0.237,P﹥0.05)。结论肿瘤患者采取放射性治疗后,配合服用清肺八味汤可有效降低血清TGF-β1含量,且可有效降低放射性肺炎的发生率。

Objective To study the clinical effect of Qingfei Decoction on the serum level of TGF-β1 and TNF-α in patients with malignant tumor after radiotherapy and in the prevention of radiation pneumonitis. Method A total of 62 patients with malignant tumor were included in the research, and were randomized as study group（n=31） and control group（n=31）, respectively. The control group was treated with conventional chemotherapy, and the study group was additionally administered with Qingfei Decoction for 10 days starting in one month after the chemotherapy. The serum level of TGF-β1 and TNF-α in the two groups were compared before and after the treatment. The incidence of radiation pneumonia was recorded and evaluated. Result The overall incidence of radiation pneumonia in study group was 54.84%,and was 87.10% in control group, the overall incidence and classifications were lower in study group than control group（P〈0.05）; before the treatment, both groups had similar serum level of TGF-β1 and TNF-α（P〈0.05）, while after treatment, the serum levels of TGF-β1 and TNF-α were decreased in both groups, and were of significant difference when compared with that before treatment（P〈0.05）; higher TGF-β1 level was observed in control group compared with study group, though TNF-α was similar between the two groups（P〈0.05）. Conclusion Qingfei Decoction can effectively reduce the TGF-β1 in patients with malignant tumor after radiotherapy, and it has a positive influence on lowering the incidence of radiation pneumonitis.