高压氧联合清肺化痰汤及糖皮质激素治疗胸部恶性肿瘤放疗后ARP51例疗效观察  

Observation of therapeutic effect of hyperbaric oxygen combined with Qingfei Huatan Decoction and glucocorticoids in 51 cases of ARP after radiotherapy for thoracic malignant tumors

作　　者：刘亮 韩秀庆 杜庆慧 杜源 张跃飞 Liu Liang;Han Xiuqing;Du Qinghui;Du Yuan;Zhang Yuefei(Department of Traditional Chinese Medicine,Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院中医科,临沂276400

出　　处：《中华航海医学与高气压医学杂志》2025年第1期31-35,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧(HBO)联合清肺化痰汤及糖皮质激素治疗急性放射性肺炎(ARP)的临床疗效。方法选取2019年3月至2023年10月临沂市中心医院中医科收治的胸部恶性肿瘤患者予以常规放射治疗后出现ARP患者102例作为研究对象。采用随机数字表法分为研究组(n=51)和对照组(n=51)。对照组患者采用甲基泼尼松龙联合清肺化痰汤治疗,研究组在对照组治疗的基础上联合HBO治疗。评估2组患者治疗后的临床疗效。采用肺功能仪测定2组患者治疗前后第1秒用力呼气容积(FEV1)及肺活量(VC)。采用血气分析仪测定2组患者治疗前后动脉氧分压(PaO_(2))和动脉二氧化碳分压(PaCO_(2))。采用ELISA法检测2组患者治疗前后血清转化生长因子-β1(TGF-β1)、白细胞介素(IL)-6和肿瘤坏死因子-α(TNF-α)水平,采用散射比浊法检测高敏C反应蛋白(hs-CRP)水平。6个月后随访,采用SF-36健康调查量表评估2组患者的生活质量。结果研究组患者治疗总有效率(92.16%)明显高于对照组(80.39%),差异有统计学意义(χ^(2)=4.354,P=0.029)。与治疗前比较,2组治疗后PaO_(2)、FEV1、VC均明显提高,PaCO_(2)明显降低;且治疗后研究组PaO_(2)、FEV1、VC均明显高于对照组,PaCO_(2)明显低于对照组(P<0.05或P<0.01)。与治疗前比较,2组患者治疗后血清TNF-α、hs-CRP、TGF-β1和IL-6水平均明显降低,且治疗后研究组均明显低于对照组(P<0.05或P<0.01)。治疗6个月后随访,研究组患者的生理功能、生理职能、社会功能、活力、精神健康、总体健康评分均明显高于对照组(P<0.05或P<0.01)。结论HBO联合清肺化痰汤及糖皮质激素综合治疗ARP患者临床疗效较好,能明显改善患者肺功能和生活质量。Objective To study the clinical efficacy of hyperbaric oxygen(HBO)combined with Qingfei Huatan Decoction and glucocorticoids in the treatment of acute radiation pneumonia(ARP).Methods A total of 102 patients with chest malignant tumors who developed ARP after routine radiotherapy from March 2019 to October 2023 and admitted to the Department of Traditional Chinese Medicine of Linyi Central Hospital were selected as the study subjects.They were divided into a study group(n=51)and a control group(n=51),according to the random number table method.The control group patients were treated with methylprednisolone combined with Qingfei Huatan Decoction,while the study group patients were treated with HBO on the basis of the treatments for the control group.The clinical efficacies of the treatment for two groups were evaluated.The lung function meter was used to measure forced expiratory volume at 1 second(FEV1)and vital capacity(VC)of the patients before and after treatment.Blood gas analyzer was used to measure PaO_(2)and PaCO_(2).Enzyme-linked immunosorbent assay was used to detect the levels of serum transforming growth factor(TGF-β1),Interleukin-6,and tumor necrosis factor-α(TNF-α);and the scattering turbidimetry was used to detect the level of serum high-sensitivity C-reactive protein(hs-CRP).The quality of life of the patients after 6 months treatment was followed up using the SF-36 Health Survey Scale.Results The total efficacy rate of study group(92.16%)was significantly higher than that of the control group(80.39%),with a statistically significant difference(χ^(2)=4.354,P=0.029).Compared with those before treatment,PaO_(2),FEV1,and VC significantly increased and PaCO_(2)significantly decreased after treatment in both groups;and the PaO_(2),FEV1,and VC in the study group were significantly higher than those of control group,while PaCO_(2)was significantly lower than that of the control group(P<0.05 or P<0.01)after treatment.Compared with those before treatment,TNF-α,hs-CRP,TGF-β,and IL-6 of both groups sign

关 键 词：急性放射性肺炎 高压氧 清肺化痰汤 糖皮质激素 胸部恶性肿瘤 放射治疗 

分 类 号：R73[医药卫生—肿瘤]