活血化瘀中药对鼻咽癌放疗后患者白质微观结构改变的DTI-TBSS研究

The Effect of Blood-Activating and Stasis-Removing Chinese Medicine on the Changes of White Matter Microstructure of Patients with Nasopharyngeal Carcinoma After Radiation Therapy:An DTI-TBSS Study

目的探讨规律服用活血化瘀中药时间>6个月的鼻咽癌放疗后患者,其放射性脑损伤的全脑白质微观结构的变化。方法搜集17例鼻咽癌放疗后规律服用(1剂/日,早晚煎服)活血化瘀中药>6个月的患者作为治疗组,20例同时期门诊常规随访的鼻咽癌放疗后患者作为对照。所有患者行全脑DTI及常规MRI扫描,采用基于纤维束示踪的空间统计分析方法对两组的DTI数据做统计分析。结果与对照组相比,治疗组在左侧颞叶、桥脑右侧局部各向异性分数值显著升高;双侧颞叶、左侧额叶、右侧顶叶、左侧枕叶及左侧半卵圆中心多个脑区的平均扩散率值显著性减低;左侧额叶、双侧顶叶、右侧颞叶多个脑区的径向弥散度值有显著减低。结论长期规律服用活血化瘀中药,有利于鼻咽癌放疗后放射性脑损伤的修复,从而可能减少放射性脑病的发生。

Objective Evaluation the microstructure changes of white matter in radiation-induced necrosis for patients with nasopharyngeal carcinoma(NPC)after radiotherapy,who regularly took activating blood circulation herbs(ABCH),a widely used Chinese medicine,for more than 6 months.Methods Analyzed 17 PNPC patients who regularly took ABCH for more than 6 months,and 20 PNPC patients who did not take ABCH and who underwent outpatient follow-up during the same period as control group.A magnetic resonance diffusion tensor imaging(DTI)scan and routine MRI sequences were performed in all the patient.Tract-based spatial statistics(TBSS)was used to find the region where the FA differed between the case and control groups.Results In the experimental group,the local fractional anisotropy(FA)significantly increased in the left temporal lobe and right pontine,and the average diffusion rate(MD)in the bilateral temporal lobe,left frontal lobe,right parietal lobe,left occipital lobe and the left centrum semiovale were significantly reduced,and the radial dispersion(RD)in the left frontal lobe,bilateral parietal lobe and right temporal lobe was significantly reduced.Conclusion Long-term regular administration of Chinese medicine like,ABCH can repair the radiation-induced brain injury,and may reduce the incidence of radiation encephalopathy.