七叶灵方联合西医常规疗法治疗放射性肺炎的临床观察  

Clinical observation of Qiyeling Decoction combined with routine western medicine therapy in treating radiation pneumonitis

作　　者：郭毅峻[1] 崔清[1] 刘俊[2] 李洪选[2] 顾嘉钦[3] 张铭[1] 董昀[1] GUO Yijun;CUI Qing;LIU Jun;LI Hongxuan;GU Jiaqin;ZHANG Ming;DONG Yun(Department of Integrated Chinese and Western Medicine,Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China;Department of Radiotherapy,Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China;Department of Pharmacy,Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China.)

机构地区：[1]上海交通大学附属胸科医院中西医结合科,上海200030 [2]上海交通大学附属胸科医院放疗科,上海200030 [3]上海交通大学附属胸科医院药剂科,上海200030

出　　处：《上海中医药杂志》2018年第8期33-36,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市科委中医引导项目(15401933400);上海市卫计委中医药临床能力平台建设类项目(ZY3-LCPT-2-1001)

摘　　要：目的观察七叶灵方联合西医常规疗法治疗放射性肺炎的临床疗效。方法将80例放射性肺炎患者随机分为对照组和观察组,每组40例。对照组予西医常规治疗,观察组在对照组基础上加服七叶灵方。两组疗程均为2个月,观察临床疗效,比较中医证候积分、癌症治疗功能评价系统(FACT-G)评分、血清相关细胞因子(TGF-β1、TNF-α、IL-6)水平及肺功能的变化情况。结果 (1)观察组、对照组总有效率分别为80.0%、67.5%;组间临床疗效比较,观察组优于对照组(P<0.05)。(2)治疗前后组内比较,观察组咳嗽、咯痰、腰酸腿软、头晕耳鸣积分较治疗前降低(P<0.05);对照组咳嗽、咯痰积分较治疗前降低(P<0.05);组间治疗后比较,观察组中医证候改善情况优于对照组(P<0.05)。(3)治疗前后组内比较,两组FEV1/FVC%、FEV1%均较治疗前升高(P<0.05),同时观察组FVC较治疗前升高(P<0.05);组间治疗后比较,观察组FVC、FEV1/FVC%、FEV1%均高于对照组(P<0.05)。(4)治疗前后组内比较,仅观察组在生理状况、功能状况评分及FACT-G量表总分方面较治疗前升高(P<0.05);组间治疗后比较,观察组生理状况、社交/家庭状况、功能状况评分及量表总分高于对照组(P<0.05)。(5)治疗前后组内比较,仅观察组血清TGF-β1、TNF-α、IL-6水平较治疗前下降(P<0.05);组间治疗后比较,观察组血清TGF-β1、TNF-α、IL-6水平低于对照组(P<0.05)。结论七叶灵方联合西医常规疗法治疗放射性肺炎疗效满意,可明显改善患者的临床症状及肺功能,控制炎症反应,提高生存质量。Objective To observe the clinical efficacy of Qiyeling Decocotion combined with routine western medicine therapy in treating radiation pneumonitis.Methods 80 patients with radiation pneumonitis were randomly divided into the control group and observation group,40 cases in each group. The control group was treated with routine western medicine therapy and the observation group was orally treated with Qiyeling Decocotion based on the treatment for the control group,with a course of 2 months. The clinical efficacy was observed,the traditional Chinese medicine（TCM） syndrome scores,FACT-G scores,serum inflammatory factors including transforming growth factor-β1（TGF-β1）,tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6）,and pulmonary function indexes were compared. Results（1）The total effective rates were 80. 0% in the observation group and 67. 5% in the control group,the clinical efficacy of the observation group was better than that of the control group（P〈0.05）.（2）Compared with treatment before,the scores of cough,expectoration,soreness of waist and weakness of legs,dizziness and tinnitus were decreased in the observation group after treatment（P〈0.05）,the scores of cough and expectoration were decreased in the control group after treatment（P〈0.05）.After treatment,the improvement on TCM syndrome in the observation group was better than that in the control group（P〈0.05）.（3）Compared with treatment before,the FEV1/FVC% and FEV1% were increased in both groups after treatment（P〈0.05）,the FVC in the observation group was also increased after treatment（P〈0.05）. After treatment,the FVC,FEV1/FVC% and FEV1% in the observation group were higher than those in the control group（P〈0.05）.（4）After treatment,the physiological status score,function status score and the total score of FACT-G scale were increased in the observation group compared with treatment before（P〈0.05）. The physiological status score,social or family status score,function statu

关 键 词：放射性肺炎 七叶灵方 肺功能 生存质量 细胞因子 

分 类 号：R730.55[医药卫生—肿瘤]