Objective:To observe the curative effect of Qingre Shengji Ointment(清热生肌膏)on acute radiation dermatitis caused by radiotherapy after modified radical mastectomy.Methods:100 patients with radiotherapy after modifi...Objective:To observe the curative effect of Qingre Shengji Ointment(清热生肌膏)on acute radiation dermatitis caused by radiotherapy after modified radical mastectomy.Methods:100 patients with radiotherapy after modified radical mastectomy in our hospital from June 2019 to December 2020 were randomly divided into treatment group and control group,with 50 cases in each group.The treatment group was given Qingre Shengji Ointment(清热生肌膏)on the basis of routine nursing,and the intervention began until one week after radiotherapy,while the control group was given routine nursing.Observe and record the occurrence time of acute radiation dermatitis,the degree of acute radiation dermatitis,changes of skin erythema,pruritus,pain,changes of interleukin-6(IL-6)and curative effect were evaluated.The degree of dermatitis was evaluated by RTOG grading standard,the erythema was evaluated by TCM symptom score,and pruritus and pain were evaluated by visual analogue scale(VAS).Blood routine,liver and kidney function,electrocardiogram and other safety indicators and adverse reactions were recorded before and after the study.Results:The time of acute radiation dermatitis was 6-11 days(median 8 days)in the treatment group and 8-14 days(median 10 days)in the control group(P<0.01).The degree and probability of acute radiation dermatitis in the treatment group were 82%(41/50)in grade I,16%(8/50)in grade II and 2%(1/50)in grade III.The degree and probability of acute radiation dermatitis in the control group were 54%(27/50)in grade I,40%(20/50)in grade II and 6%(3/50)in grade III(P<0.05).The highest TCM symptom score of skin erythema in the treatment group was lower than that in the control group(P<0.01).The results of generalized estimation equation show that,The VAS scores of pruritus and pain were(1.34±0.01)and(2.08±0.02)(Waldχ^(2)=1198.123,P<0.01)in the treatment group and(2.08±1.74)(Wald^(2)=1547.804,P<0.01)in the control group,respectively.Compared with the control group,the VAS scores of pruritus and pain were(1.14±0.01)and(2.08±1.74)(Wald^(2)=1547.804,P<0.01)in the treatment group.After observation,the curative effect of the treatment group was better than that of the control group(P<0.05),and the subjective symptoms of patients were obviously improved.After treatment,the level of IL-6 in the treatment group was significantly lower than that before treatment,and was lower than that in the control group(P<0.01).Conclusion:Qingre Shengji Ointment(清热生肌膏)can prevent and treat acute radiation dermatitis to some extent,and its mechanism may be to inhibit the release of inflammatory cytokines,reduce the degree of dermatitis,improve the quality of life of patients,and its safety is good.VAS score can subjectively evaluate the changes of itching and pain,and it is easy to use,so it is worthy of clinical application.展开更多
基金Traditional Chinese Medicine Research Program of Hebei Provincial Administration of Traditional Chinese Medicine(NO.2020512)。
文摘Objective:To observe the curative effect of Qingre Shengji Ointment(清热生肌膏)on acute radiation dermatitis caused by radiotherapy after modified radical mastectomy.Methods:100 patients with radiotherapy after modified radical mastectomy in our hospital from June 2019 to December 2020 were randomly divided into treatment group and control group,with 50 cases in each group.The treatment group was given Qingre Shengji Ointment(清热生肌膏)on the basis of routine nursing,and the intervention began until one week after radiotherapy,while the control group was given routine nursing.Observe and record the occurrence time of acute radiation dermatitis,the degree of acute radiation dermatitis,changes of skin erythema,pruritus,pain,changes of interleukin-6(IL-6)and curative effect were evaluated.The degree of dermatitis was evaluated by RTOG grading standard,the erythema was evaluated by TCM symptom score,and pruritus and pain were evaluated by visual analogue scale(VAS).Blood routine,liver and kidney function,electrocardiogram and other safety indicators and adverse reactions were recorded before and after the study.Results:The time of acute radiation dermatitis was 6-11 days(median 8 days)in the treatment group and 8-14 days(median 10 days)in the control group(P<0.01).The degree and probability of acute radiation dermatitis in the treatment group were 82%(41/50)in grade I,16%(8/50)in grade II and 2%(1/50)in grade III.The degree and probability of acute radiation dermatitis in the control group were 54%(27/50)in grade I,40%(20/50)in grade II and 6%(3/50)in grade III(P<0.05).The highest TCM symptom score of skin erythema in the treatment group was lower than that in the control group(P<0.01).The results of generalized estimation equation show that,The VAS scores of pruritus and pain were(1.34±0.01)and(2.08±0.02)(Waldχ^(2)=1198.123,P<0.01)in the treatment group and(2.08±1.74)(Wald^(2)=1547.804,P<0.01)in the control group,respectively.Compared with the control group,the VAS scores of pruritus and pain were(1.14±0.01)and(2.08±1.74)(Wald^(2)=1547.804,P<0.01)in the treatment group.After observation,the curative effect of the treatment group was better than that of the control group(P<0.05),and the subjective symptoms of patients were obviously improved.After treatment,the level of IL-6 in the treatment group was significantly lower than that before treatment,and was lower than that in the control group(P<0.01).Conclusion:Qingre Shengji Ointment(清热生肌膏)can prevent and treat acute radiation dermatitis to some extent,and its mechanism may be to inhibit the release of inflammatory cytokines,reduce the degree of dermatitis,improve the quality of life of patients,and its safety is good.VAS score can subjectively evaluate the changes of itching and pain,and it is easy to use,so it is worthy of clinical application.
基金National Natural Science Foundation of China(82074447)Key Research and development Project of Hainan Province(ZDYF2023SHFZ123)Research Project of Traditional Chinese Medicine in Hunan Province(C2023038)。
文摘目的从网络药理学角度探讨温阳生肌膏治疗糖尿病创面的作用机制,并通过动物实验进行验证。方法采用中药系统药理学数据库与分析平台(TCMSP)及相关文献筛选温阳生肌膏(WYSJO)活性成分及对应靶点;通过Gene Cards、Online Mendelian Inheritance in Man(OMIM)、Drug Bank、Pharm Gkb和Therapeutic Target(TTD)等数据库检索糖尿病创面的作用靶点;使用Cytoscape 3.9.0绘制出WYSJO活性成分-糖尿病创面靶标网络;应用检索相互作用基因/蛋白质的搜索工具(STRING)平台搭建蛋白互作网络(PPI);应用京都基因与基因组百科全书(KEGG)与基因本体(GO)富集分析WYSJO与糖尿病创面的信号通路;应用Auto Dock 1.5.6对核心成分与靶点进行分子对接;将18只大鼠随机分为对照组、模型组和WYSJO组(n=6),以模型组和WYSJO组制备糖尿病大鼠难治性创面模型。分别在处理第0、5、9、14天时观察创面愈合,苏木素-伊红(HE)染色观察创面组织形态,实时荧光定量聚合酶链式反应(q PCR)检测核心基因表达情况。结果网络药理学筛选出WYSJO药物有效成分76种,药物靶点206个,糖尿病创面疾病靶点3797个,以及WYSJO治疗糖尿病创面作用靶点167个;通过构建WYSJO活性成分-糖尿病创面作用靶标网络,发现槲皮素、大豆苷元、山奈酚、鼠李素、鼠李柠檬素、异长春花苷内酰胺和邻苯二甲酸二异丁酯(DIBP)7个核心靶点。GO富集分析表明温阳生肌膏治疗糖尿病创面可能涉及细胞对脂多糖、细菌来源分子、金属离子、外来刺激、化学应激、营养水平、缺氧及氧化应激等生物过程。KEGG富集分析表明温阳生肌膏治疗糖尿病创面可能涉及高级糖基化终末产物-受体(AGE-RAGE)信号通路、p53信号通路、白介(IL)-17信号通路、肿瘤坏死因子(TNF)信号通路、缺氧诱导因子-1(HIF-1)信号通路、细胞凋亡、脂质和动脉粥样硬化等相关通路发挥治疗糖尿病创面的作用。动物实验显示WYSJO可显著加快糖尿病创面的愈合速度(P<0.05),减轻炎症反应,促进肉芽组织生长,同时也可下调网络药理学预测的E1A结合蛋白p300(EP300)、Jun激酶(JUN)、骨髓细胞瘤癌基因(MYC)、缺氧诱导因子1A(HIF1A)、丝裂原活化蛋白激酶14(MAPK14)、特异性蛋白1(SP1)、肿瘤蛋白p53(TP53)以及雌激素受体1(ESR1)等8个核心基因表达(P<0.05)。结论WYSJO治疗糖尿病创面的作用机制可能与AGE-RAGE、p53、HIF-1等通路密切相关,通过此研究可为WYSJO的药理学研究提供新思路,并为其进一步转化应用提供基础。
