百合固金汤加减治疗肺癌急性放射性肺炎临床观察

Effect of Modified Baihe Gujin Decoction on Patients with Acute Radiation Pneumonia of Lung Cancer

目的观察肺癌急性放射性肺炎采用百合固金汤加减方治疗的临床疗效并探寻其作用机制。方法采用随机分配方法将90例急性放射性肺炎患者分为对照组和观察组各45例。对照组采用西医常规治疗,观察组在对照组治疗的基础上给予百合固金汤加减治疗。两组疗程均为2周。比较临床疗效和治疗后急性放射性肺炎病情分级,评估治疗前后气阴两虚证候评分和生活质量KPS评分;检测治疗前后氧分压(PO_(2))、一氧化碳弥散量(DLCO)和肺活量(VC)等肺功能指标;检测治疗前后肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)、白细胞介素-1α(IL-1α)、白细胞介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)和血清淀粉样蛋白A(SAA)等炎症因子和相关细胞因子水平。结果治疗后,观察组总有效率为91.11%,高于对照组的64.44%(P<0.05);观察组急性放射性肺炎病情分级轻于对照组(P<0.05);两组气阴两虚证主症评分及总积分均降低(P<0.05),且观察组低于对照组(P<0.05);两组PO_(2)、DLCO和VC升高(P<0.05),观察组高于对照组(P<0.05);两组MMP-9、SAA、TNF-α、TGF-β1、IL-1α和IL-6水平均明显下降(P<0.05),且观察组低于对照组(P<0.05)。结论百合固金汤加减方配合西医常规治疗肺癌急性放射性肺炎可减轻症状,改善肺功能,提高生活质量,减轻急性放射性肺炎病情程度,并能抑制炎症因子及相关细胞炎子的表达,临床疗效优于单纯的西医治疗。

Objective:To observe the clinical efficacy of Modified Baihe Gujin Decoction in the treatment of acute radiation pneumonitis of lung cancer and explore its mechanism.Methods:A total of 90 patients with acute radiation pneumonitis were randomly divided into western medicine group and traditional Chinese medicine group,45 cases in each group.The control group received comprehensive conventional western medicine treatment;the observation group received Modified Baihe Gujin Decoction on the basis of the control group.The course of treatment in both groups was 2 weeks.The clinical efficacy and the severity of acute radiation pneumonitis after treatment were compared,the syndrome score of deficiency of both qi and yin and the KPS score of quality of life before and after treatment were evaluated;the pulmonary function parameters such as PO_(2),diffusing capacity of carbon monoxide(DLCO)and vital capacity(VC)before and after treatment were detected;the levels of inflammatory factors and related cytokines such as tumor necrosis factor-α(TNF-α),transforming growth factor-β1(TGF-β1),interleukin-1α(IL-1α),interleukin-6(IL-6),matrix metalloproteinase-9(MMP-9)and serum amyloid A(SAA)before and after treatment were detected.Results:After treatment,the total effective rate of the observation group(91.11%)was higher than that of the control group(64.44%)(P<0.05);the disease grade of acute radiation pneumonitis in the observation group was lighter than that of the control group(P<0.05);the main symptom score and total score of qi and yin deficiency syndrome in the two groups decreased(P<0.05),and the observation group was lower than the control group(P<0.05);PO_(2),DLCO and VC increased in the two groups(P<0.05),and the observation group was higher than the control group(P<0.05);the MMP-9,SAA,TNF-α,TGF-β1,IL-1αand IL-6 levels decreased significantly in the two groups(P<0.05),and the observation group was lower than the control group(P<0.05).Conclusion:Modified Baihe Gujin Decoction combined with western medicine routine in treatment of acute radiation pneumonitis of lung cancer can reduce symptoms,improve pulmonary function,improve quality of life,reduce the severity of acute radiation pneumonitis,and inhibit the expression of inflammatory factors and related cytokines,demonstrating better clinical efficacy than western medicine alone.