沙参麦冬汤干预小细胞肺癌患者放射性肺损伤的作用与机制

Effect and mechanism of Shashen Maidong Decoction on radioactive lung injury in small cell lung cancer patients

目的探讨小细胞肺癌(small cell lung cancer,SCLC)合并放射性肺损伤患者应用沙参麦冬汤疗法对其血清转化生长因子-β(transforming growth factor-β,TGF-β)/Smad信号通路相关因子的影响及作用机制。方法选取接受放射治疗的104例SCLC合并放射性肺损伤患者,采用随机数字表法分为沙参麦冬汤干预组及常规治疗组,每组52例。常规治疗组予以常规西药治疗,沙参麦冬汤干预组在常规治疗组治疗的基础上加用沙参麦冬汤剂。观察2组的临床疗效,对比2组患者治疗前后的TGF-β、肿瘤坏死因子-α(tumor necrosis factor,TNF-α)和白细胞介素-6(interleukin-6,IL-6)水平,对比2组治疗前后身体机能状态量表(karnofsky performance scale,KPS)评分和临床-影像-生理(clinical-radiologicand physiological scale,CRP)评分,分析SCLC合并放射性肺损伤患者CRP评分与KPS评分的相关性。结果沙参麦冬汤干预组的临床治疗总有效率较常规治疗组明显升高(P<0.05);治疗后,2组血清TGF-β、TNF-α和IL-6水平均明显降低,且沙参麦冬汤干预组各指标较常规治疗组均明显降低(均P<0.05);2组KPS评分均明显升高,且沙参麦冬汤干预组高于常规治疗组(P<0.05);2组CRP评分均明显降低,且沙参麦冬汤干预组较常规治疗组明显降低(P<0.05);Pearson相关系数分析结果显示,SCLC合并放射性肺损伤患者CRP评分与KPS评分呈明显负相关(P<0.05)。结论沙参麦冬汤干预疗法对改善SCLC患者放射性肺损伤疗效显著,有助于降低患者血清TGF-β、TNF-α和IL-6水平,对抑制机体炎性反应、改善患者生活质量等具有积极作用。

Objective To explore the effects and mechanisms of Shashen Maidong Decoction on plasma transforming growth factor-β(TGF-β)/Smad signaling pathway related factors in patients with small cell lung cancer(SCLC)complicated by radiation-induced lung injury.Methods A total of 104 patients with SCLC complicated with radiation-induced lung injury who received radiotherapy were selected.According to the random number table method,Shashen Maidong Decoction intervention group and conventional treatment group were established,with 52 cases in each group.The conventional treatment group was treated with conventional western medicine,while the Shashen Maidong Decoction intervention group was treated with Shashen Maidong Decoction on the basis of the conventional treatment group.The clinical efficacy of the 2 groups was observed.The levels of TGF-β,tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were compared between the 2 groups before and after treatment.The karnofsky performance scale(KPS)score and clinical-radiological-physiological scale(CRP)score before and after treatment were compared between the 2 groups.The correlation between CRP score and KPS score in SCLC patients with radiation-induced lung injury was analyzed.Results The total effective rate of Shashen Maidong Decoction intervention group was significantly higher than that of the conventional treatment group(P<0.05).After treatment,the plasma levels of TGF-β,TNF-αand IL-6 in the 2 groups were significantly decreased,and the indices in the Shashen Maidong Decoction intervention group were significantly lower than those in the conventional treatment group(all P<0.05).The KPS scores of the 2 groups were significantly increased,and the Shashen Maidong Decoction intervention group was higher than the conventional treatment group(P<0.05).The CRP scores of the 2 groups were significantly decreased,and the Shashen Maidong Decoction intervention group was significantly lower than the conventional treatment group(P<0.05).Pearson correlation coefficient analysis showed that CRP score was negatively correlated with KPS score in SCLC patients with radiation-induced lung injury(P<0.05).Conclusion Shashen Maidong Decoction intervention therapy has obvious effect on improving radiation-induced lung injury in patients with SCLC,which helps to reduce the plasma levels of TGF-β,TNF-αand IL-6,inhibit the inflammatory response of the body,and improve the quality of life of patients.