清热解毒方治疗非急性期热毒伤肺型放射性肺炎临床研究

Clinical Study on Heat-Clearing and Detoxicating Decoction in the Treatment of Non-acute Radiation Pneumonia with Syndrome of Heat Toxin Injuring Lung

目的:观察清热解毒方治疗非急性期热毒伤肺型放射性肺炎的临床疗效。方法:将60例非急性期放射性肺炎患者按照随机数字表法分为对照组和观察组,每组各30例。对照组给予常规西医治疗,观察组在对照组治疗的基础上加用清热解毒方治疗。比较两组患者的临床疗效、不良反应发生情况及治疗前后中医证候积分、病情分级、肺功能、细胞炎症因子[白细胞介素-6(interleukin-6,IL-6)、转化生长因子-β(transforming growth factor-β1,TGF-β1)以及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]水平变化情况。结果:两组患者治疗后各项中医证候积分低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。观察组有效率为83.33%,对照组有效率为73.33%,观察组有效率高于对照组(P<0.05)。两组患者治疗后0级、1级、2级占比高于本组治疗前,3级、4级占比低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后肺总量及肺弥散功能高于本组治疗前,且治疗后观察组高于对照组(P<0.05)。两组患者治疗后IL-6、TGF-β1及TNF-α水低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:清热解毒方可有效缓解非急性期热毒伤肺型放射性肺炎患者的临床症状,改善其肺功能,其作用机制可能与抑制IL-6、TGF-β1及TNF-α等细胞炎症因子水平有关。

Objective:To observe the clinical efficacy of Heat-Clearing and Detoxicating Decoction on non-acute radiation pneumonia with syndrome of heat toxin injuring lung.Methods:A total of 60 patients with non-acute radiation pneumonia were divided into the control group and the observation group according to the random number table,with 30 cases in each group.The control group was given con-ventional Western medicine treatment,while the observation group was treated with Heat-Clearing and Detoxicating Decoction on the ba-sis of the control group.The clinical efficacy,incidence of adverse reactions,and the changes in TCM syndrome scores,disease grades,pulmonary function,cell inflammatory factors[including interleukin-6(IL-6),transforming growth factor-β1(TGF-β1)and tumor nec-rosis factor-α(TNF-α)] before and after treatment were compared between the two groups.Results:The TCM syndrome scores of the two groups after treatment were lower than those before treatment,and the observation group's above scores were lower than those of the control group after treatment(P<0.05).The effective rate of the observation group was 83.33%,while that of the control group was 73.33%,and the effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the pro-portion of grade O,1,2 in the two groups was higher than that before treatment,while the proportion of grade 3,4 was lower than that be-fore treatment,and all the differences were statistically significant(P<0.05);the total lung volume and lung diffusion function in the two groups were higher than those before treatment,and the observation group's above indexes were higher than those of the control group(P<0.05);the levels of IL-6,TCF-β1 and TNF-αin the two groups were lower than those before treatment,and the observation group's above indexes were lower than those of the control group(P<0.05).There was no significant diference in the incidence of ad-verse reactions between the two groups(P>0.05).Conclusion:Heat-Clearing and Detoxicating Decoction can effectively relieve the clinical symptoms of non-acute radiation pneumonia patients with syndrome of heat toxin injuring lung,and improve their lung function,and its mechanism may be related to inhibiting the levels of IL-6,TGF-β1 and TNF-αand other inflammatory factors.