沙参麦冬汤加减治疗肺癌合并放射性肺炎的临床研究  

Clinical Study on Treatment of Lung Cancer and Radiation Pneumonitis with Modified Shashen Maidong Decoction

作　　者：李蕊洁 王立东 田菲[2] LI Ruijie;WANG Lidong;TIAN Fei(Department of Radiotherapy and Chemotherapy,Qian'an People's Hospital of Hebei Province Tangshan 064400,China;Department of Oncology,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China)

机构地区：[1]河北省迁安市人民医院放化疗科,唐山064400 [2]天津中医药大学第一附属医院肿瘤科,天津300381

出　　处：《中国医药指南》2024年第20期152-155,共4页Guide of China Medicine

摘　　要：目的基于沙参麦冬汤的清养肺胃、免疫调节作用,探讨其对肺癌合并放射性肺炎患者的临床疗效。方法选择2022年1月至2023年12月迁安市人民医院放化疗科收治的确诊为肺癌,并完成胸部放疗的80例肺癌合并放射性肺炎患者,采用完全随机法分为观察组及对照组,各40例,观察组在糖皮质激素阶梯减量治疗基础上联合应用沙参麦冬汤加减,对照组单纯予以糖皮质激素阶梯减量治疗,治疗周期均为28 d,观察两组患者C反应蛋白、中性粒细胞数目百分比、T淋巴细胞亚群及临床症状的缓解情况。结果两组中性粒细胞百分比水平组间差异无统计学意义(P>0.05);观察组患者C反应蛋白下降程度,呼吸困难、咳嗽症状缓解情况优于对照组(P<0.05);两组CD3^(+)、CD4^(+)、CD8^(+)阳性细胞变化无统计学差异(P>0.05),观察组CD4^(+)/CD8^(+)比值高于对照组(P<0.05)。结论沙参麦冬汤可提高肺癌合并放射性肺炎患者的临床疗效,其机制可能与沙参麦冬汤对肺癌患者免疫微环境的调节功能相关。Objective Sha shen Mai dong Decoction is to clearing lung nourishing stomach and immunoregulation effect.To explore the effects of modified Sha shen Mai dong Decoction on clinical efficacy of patients undergoing lung cancer and radiation pneumonitis.Methods A total of 80 patients with lung cancer complicated with radiation pneumonia were divided into a combined treatment group and a control group by complete random method,with 40 cases in each group.The combined treatment group was treated with a modified version of Sha shen Mai dong Decoction on the basis of a gradient reduction of glucocorticoids,while the control group was treated with a gradient reduction of glucocorticoids.The treatment cycle was 28 days.Results After treatment,the C-reactive protein levels in the two groups showed a decreasing trend compared to before treatment,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the percentage of neutrophils between the two groups(P>0.05).The degree of decrease in C-reactive protein,relief of breathing difficulties and cough symptoms in the combination treatment group were better than those in the control group.Compared with before treatment,the trend of CD3^(+),CD4^(+)and CD8^(+)positive cells in the combination therapy group showed no significant statistical difference(P>0.05).The CD4^(+)/CD8^(+)ratio showed an upward trend(P<0.05).The overall effective rate of the combination of Sha Shen Mai Dong Tang and glucocorticoid treatment group was better than that of the control group.Conclusions Sha shen Mai dong Decoction can improve the clinical efficacy of lung cancer patients with radiation pneumonia,and its mechanism may be related to the regulatory function of Sha shen Mai dong Decoction on the immune microenvironment of lung cancer patients.

关 键 词：肺癌 放射性肺炎 沙参麦冬汤 免疫微环境 

分 类 号：R734.2[医药卫生—肿瘤] R563.1[医药卫生—临床医学]