痰热清注射液联合清燥救肺汤立体时相给药治疗放射性肺炎的临床研究  

Three-dimensional Phase Administration of Tanreqing Injection Combined with Qingzaojiufei Decoction in Treating Radiation Pneumonitis

作　　者：王静[1] 易宣洪 汪萍[1,2] 王志武 WANG Jing;YI Xuanhong;WANG Ping;WANG Zhiwu(Department of Radiology,Tangshan People′s Hospital,Tangshan 063001,China;Health Science Center,North China University of Technology,Tangshan 063210,China)

机构地区：[1]唐山市人民医院放化科,唐山063001 [2]华北理工大学医学部,唐山063210

出　　处：《世界中医药》2024年第5期672-676,共5页World Chinese Medicine

基　　金：国家自然科学基金项目(81603475);河北省中医药管理局科研计划项目(2021409)。

摘　　要：目的:观察痰热清注射液联合清燥救肺汤加减立体时相给药对放射性肺炎(RP)的治疗效果。方法:选择接受胸部三维适形放射治疗,同时中医辨证为痰热阻肺型的肺癌患者100例作为研究对象,随机分为对照组和观察组,每组50例。对照组患者采用单纯放疗,观察组在放疗基础上,给予痰热清静脉注射联合清燥救肺汤加减立体时相给药,于治疗结束后评估2组患者临床疗效及RP发生率,观察2组放疗前、中、后中医证候评分及血清肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)、白细胞介素-6(IL-6)的水平变化,观察患者放疗前后肺功能指标卡诺夫斯凯计分(KPS)评分的变化。结果:观察组RP发生率较对照组明显降低,临床总有效率明显优于对照组(P<0.05);2组中医证候评分及血清TNF-α、TGF-β1、IL-6水平于放疗后不同时期均明显降低(P<0.05),与对照组比较,观察组放疗后2个月、4个月及放疗结束时中医证候评分及血清TNF-α、TGF-β1、IL-6水平明显降低(P<0.05);观察组肺活量(VC)、用力肺活量(FVC)、第一秒用力呼气量(FEV1)、FEV1/FVC肺功能指标及KPS评分较对照组显著提高(P<0.05)。结论:痰热清注射液联合清燥救肺汤立体时相给药可有效减轻放射治疗所致的放射性肺炎,通过降低血清炎症介质水平,改善肺功能起到减毒增效作用,对提升患者生命质量,提高放疗安全性和有效性具有积极意义。Objective:To observe the therapeutic effect of three-dimensional phase administration of Tanreqing Injection combined with Qingzaojiufei Decoction on radiation pneumonitis.Methods:One hundred patients with lung cancer(syndrome of phlegm-heat blocking lung)treated by chest three-dimensional conformal radiotherapy were randomized into a control group(n=50)and an observation group(n=50).The patients in the control group were treated with radiotherapy alone,and those in the observation group were treated with Tanreqing Injection combined with Qingzaojiufei Decoction by three-dimensional phase administration on the basis of radiotherapy.After treatment,the clinical efficacy and incidence of radiation pneumonitis were compared between the two groups.The TCM syndrome score and serum levels of tumor necrosis factor-α(TNF-α),transforming growth factor-β1(TGF-β1),and interleukin-6(IL-6)were determined before,during,and after radiotherapy.The pulmonary function indicators and the Karnofsky Performance Scale(KPS)score were recorded before and after radiotherapy.Results:The observation group had lower incidence of radiation pneumonitis and higher total response rate than the control group(P<0.05).The TCM syndrome score and serum levels of TNF-α,TGF-β1,and IL-6 in the two groups decreased in different periods after radiotherapy(P<0.05).Compared with the control group,the observation group showed decreased TCM syndrome score and lowered levels of TNF-α,TGF-β1,and IL-62 and 4 months after radiotherapy and at the end of radiotherapy(P<0.05).In addition,the observation group had higher vital capacity(VC),forced vital capacity(FVC),forced expiratory volume in the 1st second(FEV 1),FEV 1/FVC,and KPS score than the control group(P<0.05).Conclusion:The three-dimensional phase administration of Tanreqing Injection combined with Qingzaojiufei Decoction can reduce the incidence of radiation pneumonitis caused by radiotherapy,lower the serum levels of inflammatory mediators,and improve lung function.It has positive effects on the

关 键 词：痰热清注射液 清燥救肺汤 立体时相给药 肺肿瘤 放射性肺炎 痰热壅肺 中医证候积分 炎症介质 

分 类 号：R273[医药卫生—中西医结合]