加味麻杏石甘汤防治放射性肺损伤的临床研究

Preventive and therapeutic effect of modified Ma Xing Shi Gan decoction on radiation-induced lung injury:a clinical research

关键词:  放射性肺损伤  麻杏石甘汤  转化生长因子β1

Key words:  radiation-induced lung injury  Ma Xing Shi Gan decoction  transforming growth factor β1

摘要:

[目的]观察加味麻杏石甘汤对放射性肺损伤的防治作用。[方法]将75例接受放疗的肺肿瘤患者随机分为治疗组和对照组。治疗组于放射治疗开始起服用加味麻杏石甘汤200 mL,每日2次,至放疗结束;对照组单纯放射治疗。观察两组患者症状、体征变化,评价放疗前、放射2周、放疗结束及放疗后6个月时胸部计算机断层扫描(CT)和卡氏评分,并检测各时间点血浆转化生长因子β1(TGF-β1)浓度变化。[结果]治疗组的生存质量优于对照组;其血浆TGF-β1的浓度在放疗中及放疗后均明显低于对照组,且2组急性放射性肺损伤的发生率比较差异有统计学意义(P<0.05)。[结论]加味麻杏石甘汤能抑制放疗中及放疗后血浆TGF-β1的过度表达,降低急性放射性肺损伤的发生,可以用于防治放射性肺损伤。

Abstract:

[Objective] To observe the preventive and therapeutic effect of modified Ma Xing Shi Gan decoction on radiation-induced lung injury.[Methods] Seventy-five cases of lung cancer patients receiving radiotherapy were randomly divided into treatment group and control group.The treatment group took modified Ma Xing Shi Gan decoction,200 mL twice a day beginning from the day of the radiotherapy;The control group received the radiotherapy alone.The symptoms and signs of patients were measured to evaluate the chest CT and Karnofsky score before radiotherapy,2 weeks after radiation,at the end of radiotherapy and 6 months after that.The plasma transforming growth factor β1(TGF-β1) concentration was also determined at all the time points.[Results] Quality of life of the treatment group was better than the control group.In the treatment group,plasma concentrations of TGF-β1 during radiotherapy and after radiotherapy were significantly lower than that in the control group,and the incidence of acute radiation-induced lung injury in two groups was statistically significant(P<0.05).[Conclusion] Modified Ma Xing Shi Gan decoction can inhibit over-expression of plasma TGF-β1 during and after radiotherapy,and reduce the incidence of acute radiation-induced lung injury.This decoction can be used to prevent radiation-induced lung injury.