加味养阴清肺汤防治急性放射性口腔炎的疗效及对细胞因子的影响  

Effect on cytokines and clinical outcomes of treatment of acute radiation-induced stomatitis by Modified Yangyin Qingfei decoction

作　　者：沈红梅[1] 黄杰[1] 贾立群[2] 周映伽[1] 黄菁[1] 

机构地区：[1]昆明医学院第三附属医院,云南省肿瘤研究所中西医结合肿瘤临床研究中心,昆明650118 [2]卫生部中日友好医院,北京100029

出　　处：《重庆医学》2012年第24期2469-2471,共3页Chongqing medicine

基　　金：云南省自然科学基金资助项目(2009CD182);云南省卫生厅科技计划基金资助项目(2010NS086);云南省教育厅科学研究基金资助项目(07Y10626)

摘　　要：目的探讨加味养阴清肺汤防治急性放射性口腔炎的疗效及对炎症细胞因子的影响。方法将80例鼻咽癌行根治性放疗的患者随机分为治疗组和对照组,每组各40例。治疗组每天含服中药加味养阴清肺汤,对照组从放疗剂量达20Gy后每天含漱西药漱口水。观察两组患者放射性口腔炎发生率,同时检测患者唾液中IFN-r、TNF-α、IL-2、IL-4、IL-6、IL-10、IL-1β、IL-8含量水平。结果随着放疗剂量增加,两组患者Ⅲ、Ⅳ度口腔黏膜反应的发生率显著增加(P<0.05)。但治疗组患者Ⅲ、Ⅳ度口腔黏膜反应的发生率始终低于对照组(P<0.05)。放疗前两组细胞因子水平无显著差别(P>0.05)。在放疗剂量达40Gy时:两组细胞因子水平均较放疗前升高,但治疗组升高不明显(P>0.05),治疗组各细胞因子水平均明显低于对照组(P=0.000)。在放疗剂量达70Gy时:治疗组IL-10较放疗前升高不明显(P=0.055),而对照组明显升高(P=0.000),治疗组IL-10水平明显低于对照组(P=0.000);两组IL-4均低于放疗前(P=0.000),治疗组IL-4明显低于对照组(P=0.001);两组IFN-g、TNF-α、IL-2、IL-6均显著低于放疗前(P=0.000),治疗组IL-2、IL-6、IL-1β、IL-8明显低于对照组(P<0.05)。结论加味养阴清肺汤对急性放射性口腔黏膜炎的预防性治疗效果显著,可能通过调节多个炎性细胞因子水平发挥其作用。Objective To investigate the effect on cytokines and clinical outcomes of treatment of acute radiation-induced stomatitis by Modified Yangyin Qingfei decoction.Methods 80 cases with a radical radiotherapy were divided into two groups randomly,40 cases in the treatment group and 40 cases in the controlled group.The treatment group was treated by Modified Yangyin Qingfei decoction after the initiation of radiotherapy.The controlled group was treated by the mouthwash after DT=20 Gy.The incidence rates of stomatitis and the levels of IFN-γ,TNF-α,IL-2,IL-4,IL-6,IL-10,IL-1β and IL-8 in saliva were measured.Results With the increasing dose of radiotherapy,the incidence rates of Ⅲ-degree and Ⅳ-degree stomatitis were significantly increased in the two groups（P0.05）.The levels of cytokines in two groups at DT=40 Gy increased compared with previous radiotherapy,but the increase of cytokines was not obvious in the treatment group（P〉0.05）,and it was remarkably lower than that of the controlled group（P=0.000）.At DT=70 Gy,the increase of IL-10 was not obvious in treatment group compared with previous radiotherapy（P=0.055）,the level of IL-10 increased remarkably in the controlled group（P=0.000）,and the level of IL-10 in treatment group was remarkably lower than that of the controlled group（P=0.000）;The level of IL-4 in the two groups were both lower than the previous radiotherapy（P=0.000）,The level of IL-4 in treatment group was significantly lower than that in the controlled group（P=0.001）;The levels of IFN-g,TNF-α,L-2,IL-6 in two groups were remarkably lower than those of the previous radiotherapy（P=0.000）.The levels of IL-2,IL-6,IL-1β,IL-8 in treatment group were lower than those in controlled group（P〈0.05）.Conclusion The acute radiation-induced stomatitis is significantly improved after prophylactic therapy of Modified Yangyin Qingfei decoction.The mechanism might be that the drug regulated the expression of multiple inflammatory cytokines.

关 键 词：加味养阴清肺汤 放射性口腔炎 炎性细胞因子 

分 类 号：R473.73[医药卫生—护理学]