不同时相服用清燥救肺汤加减方对防治放射性肺损伤的影响

Effect of taking modified Qingzao Jiufei Decoction at different times in the prevention and treatment of radiation induced lung injury

目的探讨不同时相服用清燥救肺汤加减方对防治放射性肺损伤(RILI)的影响。方法将111例放射性肺损伤患者按就诊顺序随机分为治疗1组、治疗2组、治疗3组,各37例,3组均进行常规药物治疗,并给予清燥救肺汤加减方,治疗1组给药时间为放疗前1 h,治疗2组给药时间为放疗结束后1 h,治疗3组给药时间为放疗开始与结束后1 h内,比较3组中医证候评分、卡氏功能评分(KPS)、放射性肺损伤程度、肺功能、相关生化指标水平。结果3组放疗后中医证候评分均高于放疗前(P<0.05),且与治疗2组、治疗3组比较,治疗1组升高幅度较小(P<0.05);3组KPS评分均低于放疗前,且与对治疗2组、治疗3组比较,治疗1组升降低幅度较小(P<0.05);3组放射性肺损伤程度比较,治疗1组与治疗3组的总发生率较低,与治疗2组比较,差异有统计学意义(P<0.05);3组放疗后用力肺活量(FVC)、第1秒用力呼吸容积(FEVl)、第1秒用力呼吸容积/用力肺活量(FEVl/VC)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、转化生长因子-β1(TGF-β1)水平均低于放疗前,且与对治疗2组、治疗3组比较,治疗1组降低幅度较小(P<0.05)。结论运用清燥救肺汤加减方防治放射性肺损伤疗效显著,但需在放疗前1 h给药。

Objective To explore the clinical efficacy of taking modified Qingzao Jiufei Decoction at different times in the prevention and treatment of radiation induced lung injury(RILI).Methods A total of 111 RILI patients who met the corresponding criteria were randomly divided into treatment group 1,treatment group 2,and treatment group 3,with 37 patients in each group.All the three groups received a routine drug treatment and were given modified Qingzao Jiufei Decoction additionally.The administration time of treatment group 1 was one hour before radiotherapy,while the administration time of treatment group 2 was one hour after radiotherapy,and the administration time of treatment group 3 was within one hour after radiotherapy.The TCM syndrome scores,KPS scores,degree of radiation-induced lung injury,lung function,and levels of related biochemical indicators were compared among the three groups.Results After radiotherapy,the TCM syndrome scores were higher in the three groups than before radiotherapy,and compared with treatment groups 2 or 3,the increase in treatment group 1 was moderate(P<0.05).After radiotherapy,the KPS scores were lower in the three groups than before radiotherapy,and compared with treatment groups 2 or 3,the decrease in treatment group 1 was relatively moderate(P<0.05).After radiotherapy,the total incidence rate of radiation-induced lung injury was significantly lower in treatment group 1 and treatment group 3 than that in treatment group 2(P<0.05).After radiotherapy,the levels of FVC,FEVl,FEVl/VC,and TNF-α,CRP and TGF-β1 were lower in the three groups than before radiotherapy,and compared with treatment group 2 or treatment group 3,the decrease in treatment group 1 was moderate(P<0.05).Conclusion Modified Qingzao Jiufei Decoction is effective in the prevention and treatment of radiation-induced lung injury,but it needs to be administered one hour before radiotherapy.