复方麻杏石甘汤对非小细胞肺癌放化疗致肺损伤的保护作用及对TGF-β1的影响

Effect of compound Maxing Shigan decoction on lung injury induced by radiotherapy and chemotherapy in non-small cell lung cancer and its effect on TGF-β1

目的探讨复方麻杏石甘汤对Ⅲ期非小细胞肺癌放化疗致肺损伤的保护作用及对血清转化生长因子-β1(TGF-β1)的影响。方法选择2014年2月—2016年10月间在舟山市中医院和舟山医院接受治疗的Ⅲ期非小细胞肺癌患者120例,采用随机数字法将患者随机分为2组,每组60例。对照组给予同步放化疗方案,观察组在同步放化疗期间加用复方麻杏石甘汤治疗。比较2组放射性肺损伤发生率及分级情况、肿瘤近期疗效、同步放化疗前1周、同步放化疗结束、同步放化疗结束后5周KPS评分与血清TGF-β1水平的变化。结果同步放化疗结束后,观察组放射性肺损伤发生率为11.67%,明显低于对照的35.00%(P<0.05);观察组≥2级放射性肺损伤发生率为6.67%,明显低于对照组28.33%(P<0.05)。观察组总有效率为70.00%,对照组总有效率为63.33%,2组比较差异无统计学意义(P>0.05)。同步放化疗结束、同步放化疗结束后5周KPS评分观察组均显著高于对照组(P<0.05)。同步放化疗结束后,2组血清TGF-β1水平均明显升高(P<0.05),且对照组高于观察组(P<0.05)。结论复方麻杏石甘汤对放射性肺损伤具有较好的保护作用,可显著降低Ⅲ期非小细胞肺癌同步放化疗所致的放射性肺损伤的发生率与严重程度,提高患者的生活质量,其作用机制与其能更好的改善患者血清TGF-β1有关。

Objective To investigate the protective effect of compound Maxing Shigan decoction on lung injury induced by radiotherapy and chemotherapy in non-small cell lung cancer and its effect on TGF-β1. Methods A total of 120 patients with stage Ⅲ non-small cell lung cancer were randomly divided into two groups by random number method, with 60 cases in each group. Patients in control group were treated with concurrent chemoradiotherapy and patients in observation group were treated with compound Maxing Shigan decoction during concurrent chemoradiotherapy. The incidence and classification of radiation-induced lung injury, the tumor curative effect, KPS scores at 1 week before concurrent chemoradiotherapy, end of the concurrent chemoradiotherapy, and 5 weeks after concurrent chemoradiotherapy, and the serum TGF-β1 levels of two groups were compared. Results After concurrent ehemoradiotherapy, the radiation-induced lung injury rate of observation group was 11.67% , which was significantly lower than that of control group （35.00% , P 〈 0.05）. The radiation-induced lung injury rate ≥2 levels of observation group was 6.67% , which was significantly lower than that of control group （28.33% , P 〈0.05）. The short-term effect of observation group was 70.00% , and short-term effect of control group was 63.33%, without significant difference between two groups （P 〉 0.05 ）. The KPS scores at end of concurrent chemoradiation and 5 weeks after concurrent chemoradiotherapy of observation group were significantly higher than those of control group （P 〈 0.05 ）. After concurrent chemoradiotherapy, serum TGF-β1 levels of two groups were significantly increased （ P 〈 0.05 ） , and TGF-β1 level of control group was higher than that of observation group （P 〈 0.05）. Conclusion Compound Maxing Shigan decoction could protect the radiation-induced lung injury, reduce the incidence and severity of radiation-induced lung injury caused by concurrent chemoradiotherapy, and improve the life quality of patients. Its mechanism might be related to its improvement of serum TGF-β1 production.