黄芪生脉饮联合阿司匹林对胸部肿瘤放疗后放射性心脏损伤的防治作用研究  

Study on the Preventive and Therapeutic Effect of Huangqi Shengmai Decoction Combined with Aspirin on Radiation-Induced Cardiac Injury after Thoracic Tumor Radiotherapy

作　　者：范习刚 吴飞 杨桄权 谢非[1] 何迎盈[1] 张千仕[1] 陈兆红[1] FAN Xi-gang;WU Fei;YANG Guang-quan;XIE Fei;HE Ying-ying;ZHANG Qian-shi;CHEN Zhao-hong(Department of Oncology,People′s Hospital of Deyang City,Sichuan Province,Deyang Sichuan 618000)

机构地区：[1]四川省德阳市人民医院肿瘤科,四川德阳618000

出　　处：《世界中西医结合杂志》2022年第1期111-115,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：德阳市2016年度应用技术研发资金项目(2016SZ026)。

摘　　要：目的探讨黄芪生脉饮联合西药对胸部肿瘤放疗后放射性心脏损伤(Radiation-induced heart disease,RIHD)的防治效果。方法选取2017年1月—2019年12月期间四川省德阳市人民医院肿瘤科收治的行放射治疗的胸部肿瘤患者144例,其中脱落或剔除34例,满足研究条件且顺利完成研究共110例,使用随机数字表法分为西药组和中西医组,每组各55例。西药组在放疗期间应用阿司匹林,中西医组在西药组基础上加用黄芪生脉饮。观察两组患者血清细胞因子[血清转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、内皮素(Endothelin,ET)、肌酸激酶同工酶(Creatine kinase MB,CK-MB)、心肌肌钙蛋白I(Cardiac troponin I,cTnI)],心肌参数[左室后壁心肌背向散射积分(PW-IBS)、室间隔心肌背向散射积分(IVS-IBS)、左室后壁IBS及IBS周期变化幅度(PW-CVIB)、室间隔IBS及IBS周期变化幅度(IVS-CVIB)],心电图情况,比较两组RIHD发生率。结果两组患者放疗后血清TGF-β1、TNF-α、ET、CK-MB、CTnI水平均较放疗前有不同程度的升高,差异有统计学意义(P<0.05);且中西医组放疗后血清TGF-β1、TNF-α、ET、CK-MB、CTnI水平均较西医组明显降低,差异有统计学意义(P<0.05)。放疗结束后1年内,中西医组心电图总异常率低于西医组,差异有统计学意义(P<0.05),心电图变化以ST-T改变最为多见,其次为房性期前收缩。中西医组放疗后RIHD发生率为3.64%,西医组RIHD发生率为12.73%,中西医组RIHD发生率明显低于西医组,差异有统计学意义(χ;=4.998,P<0.05)。两组患者放疗后IVS-IBS、PW-IBS、IVS-CVIB、PW-CVIB值比较,差异无统计学意义(P>0.05)。两组患者放疗后血常规指标比较,差异无统计学意义(P>0.05)。结论胸部肿瘤放疗患者易发生RIHD,联合应用黄芪生脉饮和阿司匹林能够有效减轻放疗引起的早期炎性病理反应,对心肌细胞发挥保护作用,减�Objective To investigate the effect of Huangqi Shengmai Decoction combined with western medicine on radiation-induced heart disease after thoracic tumor radiotherapy.Methods From January 2017 to December 2019,144 patients with thoracic tumors who received radiotherapy in the Department of Oncology,Deyang People′s Hospital of Sichuan Province were selected,of which 34 were dropped or excluded,and a total of 110 patients who met the research conditions and successfully completed the study were selected.were divided into western medicine group and traditional Chinese and western medicine group by random number table method,with 55 cases in each group.The western medicine group was treated with aspirin during radiotherapy,and the traditional Chinese and Western medicine group was treated with Huangqi Shengmai Yin on the basis of Western medicine group.Serum cytokines[serum transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),endothelin(ET),creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)],myocardial parameters[left ventricular posterior wall myocardial backscatter integral(PW-IBS),ventricular septal myocardial backscatter integral(IVS-IBS),left ventricular posterior wall IBS and IBS cycle changes were observed(PW-CVIB),ventricular septal IBS and IBS cycle change amplitude(IVS-CVIB)],ECG,and the incidence ofRIHD were compared between the two groups.Results The levels of serum TGF-β1,TNF-α,ET,CK-MB,and CTnI in the two groups after radiotherapy were increased to varying degrees compared with those before radiotherapy,and the difference was statistically significant(P<0.05).After radiotherapy,the serum levels of TGF-β1,TNF-α,ET,CK-MB and CTnI were significantly lower than those in the western medicine group,and the difference was statistically significant(P<0.05).Within 1 year after radiotherapy,the total abnormal rate of ECG in the traditional Chinese and western medicine group was lower than that in the western medicine group,and the difference was statistically significant(P<0.05).Th

关 键 词：黄芪生脉饮 阿司匹林 放射性心脏损伤 胸部肿瘤 

分 类 号：R815[医药卫生—放射医学]