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目的:观察清燥救肺汤对局部中晚期胸部肿瘤放射治疗的肺保护作用及对肿瘤坏死因子-α(TNF-α)、内皮素(ET)表达水平的影响。方法:将局部中晚期胸部肿瘤放射治疗者随机分为治疗组和对照组。治疗组在放射治疗开始起服用清燥救肺汤200ml,2次/d,连续6个月。放射治疗前后测定血浆TNF-α和ET,放射治疗开始15天起观察临床症状、高分辨率CT和肺弥散功能。结果:治疗组放射治疗前血浆TNF-α为(1.89±0.54)ng/ml,放射治疗后为(2.52±0.69)ng/ml;对照组放射治疗前为(1.90±0.51)ng/ml,放射治疗后为(5.12±1.01)ng/ml,较治疗组明显升高(P<0.05)。治疗组放射治疗前血浆ET为(59.45±18.43)pg/ml,放射治疗后为(71.43±25.37)pg/ml;对照组放射治疗前为(58.93±16.98)pg/ml,放射治疗后为(97.87±37.83)pg/ml,明显升高(P<0.05)。放射治疗开始后5个月和10个月治疗组CO弥散量下降情况较对照组差异有统计学意义(P<0.05)。治疗组和对照组急性放射性肺炎和肺纤维化的发生率比较差异有统计学意义(P<0.05)。结论:清燥救肺汤能抑制放射治疗后血浆TNF-α和ET的过度表达,降低放射治疗后弥散功能的恶化,可以用于放射性肺损伤的预防。
Objective: To observe the lung protection effect of Qingzao Yifei Decoction on local advanced thoracic tumor radiotherapy and its effect on the expression of tumor necrosis factor-α (TNF-α) and endothelin (ET). Methods: Radiotherapy of locally advanced thoracic tumors were randomly divided into treatment group and control group. Treatment group in the beginning of radiation therapy taking Qingzaojianfei Tang 200ml, 2 times / d, for 6 months. Plasma levels of TNF-α and ET were measured before and after radiotherapy. Clinical symptoms, high-resolution CT and pulmonary diffuse function were observed from the 15th day after radiotherapy. Results: The plasma levels of TNF-α in the treatment group before radiotherapy were (1.89 ± 0.54) ng / ml and (2.52 ± 0.69) ng / ml after radiotherapy, while those in the control group were (1.90 ± 0.51) ng / (5.12 ± 1.01) ng / ml after treatment, which was significantly higher than that of the treatment group (P <0.05). Before treatment, the plasma ET was (59.45 ± 18.43) pg / ml in the treatment group and (71.43 ± 25.37) pg / ml in the control group before radiotherapy (58.93 ± 16.98) pg / ml after radiotherapy 97.87 ± 37.83) pg / ml, significantly higher (P <0.05). Compared with the control group, the decrease of CO diffusion in the treatment group at 5 and 10 months after the start of radiotherapy was statistically significant (P <0.05). The incidence of acute radiation pneumonitis and pulmonary fibrosis in the treatment group and the control group was significantly different (P <0.05). Conclusion: Qingzaojiu Decoction can inhibit the over-expression of plasma TNF-α and ET after radiotherapy and reduce the deterioration of diffusing function after radiotherapy, which can be used for the prevention of radiation-induced lung injury.