清益护肺方加减联合调强放射治疗对气阴两虚型晚期胸部肿瘤患者的疗效及放射性肺炎的防治效果  

Effect of Modified Qingyi Hufei Formula Combined with Intensity Modulated Radiotherapy in the Treatment of Advanced Thoracic Neoplasms Patients with Qi-Yin Deficiency and Their Prevention and Treatment Effect for Radiation Pneumonia

作　　者：李青峰 张洋 于大海 吴艳 杨文娟[5] 李文婷[2,6] 吴勉华 LI Qingfeng;ZHANG Yang;YU Dahai;WU Yan;YANG Wenjuan;LI Wenting;WU Mianhua(School of Acupuncture-Moxibustion and Tuina of Nanjing University of Chinese Medicine,School of Health Preservation and Rehabilitation of Nanjing University of Chinese Medicine,Nanjing 210023,China;The First Clinical Medical College,Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of Radiology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of Oncology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of Oncology,Kunshan Hospital of Traditional Chinese Medicine,Kunshan 215300,China;Collaborative Innovation Center of Jiangsu Province of Cancer Prevention and Treatment of Chinese Medicine,Nanjing 210023,China)

机构地区：[1]南京中医药大学针灸推拿学院·养生康复学院,江苏省南京市210023 [2]南京中医药大学第一临床医学院,江苏省南京市210023 [3]南京中医药大学附属医院放疗科,江苏省南京市210023 [4]南京中医药大学附属医院肿瘤科,江苏省南京市210023 [5]江苏省昆山市中医医院肿瘤科,215300 [6]江苏省中医药防治肿瘤协同创新中心,江苏省南京市210023

出　　处：《实用心脑肺血管病杂志》2025年第3期99-104,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：2022年全国名老中医药专家传承工作室建设项目;第七批全国老中医药专家学术经验继承工作项目;第四批省名老中医药专家传承工作室建设项目;江苏省研究生科研创新计划项目(KYCX22_1929);2023年度省中医药科技发展计划青年人才项目(QN202302);2024年南京市留学人员科技创新项目。

摘　　要：目的探讨清益护肺方加减联合调强放射治疗(IMRT)对气阴两虚型晚期胸部肿瘤患者的疗效及放射性肺炎(RP)的防治效果。方法选取2022年3月—2023年8月于南京中医药大学附属医院及昆山市中医医院接受IMRT的气阴两虚型晚期胸部肿瘤患者110例作为研究对象,采用随机数字表法将患者分为对照组和观察组,各55例。研究期间对照组与观察组均剔除1例患者,最终对照组与观察组均纳入54例患者。对照组患者入院后接受IMRT 5~7周,观察组患者在对照组基础上采用清益护肺方加减治疗至放疗后2周。比较两组近期疗效,放疗前、放疗后2周中医证候积分、KPS评分、炎症指标与凝血功能指标[CRP、中性粒细胞与淋巴细胞比值(NLR)、PT、APTT、TT、D-二聚体(D-D)],并观察两组RP发生情况及严重程度。结果观察组近期疗效优于对照组(P<0.05)。放疗后2周,观察组乏力、发热、口干、自汗盗汗积分及总积分低于对照组(P<0.05)。放疗后2周,观察组KPS评分高于对照组(P<0.05)。放疗后2周,观察组CRP、NLR、D-D低于对照组,PT、APTT、TT长于对照组(P<0.05)。观察组治疗期间RP发生率低于对照组,RP严重程度轻于对照组(P<0.05)。结论清益护肺方加减联合IMRT对气阴两虚型晚期胸部肿瘤患者的疗效确切,可有效减轻患者临床症状严重程度及炎症反应,改善机体凝血功能,且对RP具有一定的防治效果。Objective To discuss the effect of modified Qingyi Hufei formula combined with intensity modulated radiotherapy(IMRT)in the treatment of advanced thoracic neoplasms patients with Qi-Yin deficiency and their prevention and treatment effect for radiation pneumonia(RP).Methods A total of 110 advanced thoracic neoplasms patients with Qi-Yin deficiency in Affiliated Hospital of Nanjing University of Chinese Medicine and Kunshan Hospital of Traditional Chinese Medicine from March 2022 and August 2023 were selected as the study objects,and they were divided into the control group and the observation group by random number table method,with 55 patients in each group.During the study,one case fell off in both the control group and the observation group,and finally 54 cases were included in both the control group and the observation group.The control group received IMRT for 5-7 weeks,while the observation group was treated with modified Qingyi Hufei formula for 2 weeks after radiotherapy based on the control group.Short-term efficacy,Traditional Chinese Medicine(TCM)syndrome scores,KPS score,indexes of inflammatory and coagulation function[CRP,neutrophil to lymphocyte ratio(NLR),PT,APTT,TT,D-dimer(D-D)]before radiotherapy and at 2 weeks after radiotherapy were compared between the two groups,and the occurrence and severity of RP of the two groups were observed.Results The shor-term efficacy t in the observation group was better than that in the control group(P<0.05).At 2 weeks after radiotherapy,scores of fatigue,fever,dry mouth,spontaneous and night sweating and the total score in the observation group were lower than those in the control group(P<0.05).At 2 weeks after radiotherapy,KPS score in the observation group was higher than that in the control group(P<0.05).At 2 weeks after radiotherapy,CRP,NLR,D-D in the observation group were lower than those in the control group,PT,APTT and TT were longer than those in the control group(P<0.05).The occurrence rate of RP in the observation group was lower than that in the contro

关 键 词：胸部肿瘤 晚期 气阴两虚型 放射性肺炎 清益护肺方 调强放射治疗 治疗结果 

分 类 号：R734.4[医药卫生—肿瘤]