痰热清注射液预防放射性肺损伤的疗效观察VIP专享VIP免费

866毫≤羞毒茎一荽l_：j新药j瞻床jl|：蕾兰萋害羞要蔓萋蠹蔓害姜薹河北中医2008年8月第30卷第8期HebeiJTCM，August2008，V0l30，No．8痰热清注射液预防放射性肺损伤的疗效观察张瑞娟王晓红杨俊泉张静王洪娟王翠兰(河北省唐山市人民医院放化疗科，河北唐山063000)【摘要】目的观察痰热清注射液预防放射性肺损伤的临床疗效及对血浆转化生长因子(TGF—B)的影响。方法将68例需要放射治疗的肺癌患者随机分为2组，观察组32例放射治疗同时予痰热清注射液静脉滴注；对照组36例只予常规放射治疗。于放射治疗开始后lh、24h、72h、l周(潜伏期)、2周、4周、8周、l6周(肺炎期)、24周(肺纤维化期)抽空腹静脉血，用ELISA法测定血浆TGF一岛含量。结果急性放射性肺炎总发生率观察组2500％，对照组3333％；3、4级肺炎发生率观察组6，25％，对照组25．00％；3、4级肺炎平均发病剂量分别印Gv和53Gy；放射性肺炎平均发病时间分别为38日和31日；肺纤维化发生率观察组为28．13％，对照组为55．56％。观察组血浆TGF—B的含量较对照组低。结论痰热清注射液能降低血清TGF—B的表达，有效预防和推迟严重性急性放射性肺炎及肺纤维化的发生；对减轻放射性肺损伤、提高生存质量、保证放射治疗的顺利进行具有积极意义。【关键词】肺疾病；辐射损伤；转化生长因子；中医药疗法【中图分类号】R289．5；R563．；R818【文献标识码】A【文章编号】101312—2619(200B)08—0866—03ClinicalobservationofTanreqiaginjectiononpreventionofradia6on～inducedpulmonaryinjureZHANGRuijuan．WANGXiaohong，Y4NGJunquan，eta1D印州，MofRadiotherapyandChemotherapy，TangshanPeople’sHospitalofHebei，Hebei，Tangshan063000【Al~raet】ObjectiveToobservetheclinicalefectofTanreqinginjectiononpreventionofradiation—inducedpul—monaryinjureandchangesofTGF—plinplasma．Methods68caseswithlungcarcinomawererandomlydividedintotwogroups．32easesinthetreatmentgroupweretreatedbyintravenousdripofTanreqinginjectioncombinedwithradiotherapy．Other36easesincontrolgroupweretreatedbyconventionalradiotherapy．Bloodspecimensweretakenfromveins，at1h，24h，72h，1week，2weeks，4weeks，8weeks，16weeksand24weksafterradiotherapyfordeterminationofthelevelofFG一1inplasmabyELISA．ResultsThetotalincidenceratesofacuteradiationpneumonitisinthetreatmentgroupandthecontrolgroupwere25％and33．3％respectively．Grade3or4acuteradiationpneumonitisoccurredin6．25％0fpatientstreatedwithTanreqinginjection，and25％inthecontrolgroup．ThemeandoseofradiationinthetreatmentgroupandthecontrolgroupWas60Gyand53Gyrespectively．Theaverageonsettimeofacuteradiationpneumonitisoccurredwas38daysand31daysrespectively．Theincidenceratesofradiationpulmonaryfibrosisinthetreatmentgroupandthecontrolgroupwere28．13％and55．56％respectively．TheplasmalevelofTGF—Wasobviouslyhigherincontrolgroupthanthatintreatmentgroup．ConclusionTGF—BexpressionWasdownre#atedbyTanr~inginjection．TanreqinginjectioniseLt~etiveinpreventingtheoccurrenceofGrade3or4acuteradiationpneumonitisandradiationpulmonary．fibrosis．ItisprovedthatTanreqinginjectionmayelevatethelifequalityandensuresuccessfulradiotherapy．【Keywords】Radiation—inducedpulmonaryinjure；Tanreqinginjection；Transfonninggrowthfactor—放射性肺损伤是胸部肿瘤放射治疗中最常见、最重要的并发症，直接影响患者的生存质量和放射治疗计划的评定⋯。2005—05-2006—03，我们观察了痰热清注射液在怖癌放疗中对血浆转化生长因子p-(TGF—p。)的影作者简介：张瑞娟(1957一)，女，副主任医师。主要从事肺癌的综合治疗。响及对肺组织的保护作用，现报告如下。1资料与方法1．1一般资料全部68例均为本院放化疗科住院肺癌患者，采用抽签法随机分为2组。观察组32例，男20例，女l2例；年龄35～65岁，平均58岁；鳞癌l5例...