养阴清肺活血法对气阴两虚型非小细胞肺癌放疗后放射性肺损伤的影响

Effect of Yangyin Qingfei Huoxue Method on Radiation-Induced Lung Injury After Radiotherapy for Non-Small Cell Lung Cancer with Deficiency of Qi and Yin

目的:观察养阴清肺活血法对气阴两虚型非小细胞肺癌(NSCLC)放疗后放射性肺损伤的防治效果及作用机制。方法:选取100例气阴两虚型NSCLC患者,按照随机数字表法分为对照组与观察组,每组50例。对照组采用常规放射治疗,观察组在对照组基础上应用养阴清肺活血法治疗,2组均治疗12周。比较2组治疗前后症状评分、炎症因子水平;比较2组放疗效果及放射性肺炎、放射性肺纤维化发生率。结果:观察组有效缓解率68.00%,对照组有效缓解率72.00%,2组比较,差异无统计学意义(P>0.05)。治疗后,2组咳嗽、发热、胸痛、胸闷评分均较治疗前降低(P<0.05),观察组咳嗽、发热、胸痛、胸闷评分均低于对照组(P<0.05)。治疗4周、8周、12周,观察组肿瘤坏死因子-α(TNF-α)、转化生长因子-β(TGF-β)、白细胞介素-6(IL-6)水平均低于同期对照组(P<0.05)。观察组放射性肺炎发生率34.00%,放射性肺纤维化发生率14.00%,低于对照组54.00%、32.00%(P<0.05)。结论:养阴清肺活血法能有效改善气阴两虚型NSCLC患者放疗后的临床症状,降低放疗后放射性肺损伤发生率,其作用机制可能与降低炎症因子水平有关。

Objective:To observe the prevention and control effect and mechanism of Yangyin Qingfei Huoxue method on radiation-induced lung injury after radiotherapy for non-small cell lung cancer(NSCLC)with deficiency of qi and yin.Methods:A total of 100 cases of NSCLC patients with deficiency of qi and yin were selected and divided into the control group and the observation group according to the random number table method,with 50 cases in each group.The control group was treated with conventional radiation,and the observation group was additionally treated with Yangyin Qingfei Huoxue method based on the treatment of the control group.Both groups were treated for 12 weeks.Before and after treatment,symptom scores and inflammatory factors levels in the two groups were compared.The radiation-induced effects,incidences of radiation pneumonitis and radiation-induced pulmonary fibrosis in the two groups were compared.Results:After treatment,the scores of cough,fever,chest pain and dyspnea in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of cough,fever,chest pain and dyspnea in the observation group were lower than those in the control group(P<0.05).The radiation-induced effect in the observation group was 68.00%and 72.00%in the control group,there was no significant difference being found in the comparison in the two groups(P>0.05).After treatment for 4,8,12 weeks,the levels of tumor necrosis factor-α(TNF-α),transforming growth factor-β(TGF-β)and interleukin-6(IL-6)in the observation group were lower than those in the control group at the same period(P<0.05).The incidences of radiation pneumonitis and radiation-induced pulmonary fibrosis were 34.00%and 14.00%in the observation group,lower than those of 54.00%and 32.00%in the control group(P<0.05).Conclusion:Yangyin Qingfei Huoxue method can effectively improve the clinical symptoms of NSCLC patients with deficiency of qi and yin,reduce the incidence of radiation-induced lung injury after radiotherapy,whose mechanism may be related to the reduction of levels of inflammatory factors.