摘要
目的 观察培元抗癌汤对晚期非小细胞肺癌放射性肺损伤的治疗作用.方法 选择2020 年1 月至2022年1 月收治的88 例晚期非小细胞肺癌放射性肺损伤患者为研究对象,按照随机数字表法分为2 组,对照组44 例予西医常规治疗,治疗组44 例在对照组基础上联合培元抗癌汤治疗.比较2 组治疗前后肺损伤相关指标[包括可溶性血管细胞黏附分子-1(sVCAM-1)、白细胞介素 17A(IL-17A)、高迁移率族蛋白(HMGB1)、IL-1β、血管内皮生长因子(VEGF)、CD34、CD105、转化生长因子-β1(TGF-β1)及动脉血氧分压(PaO2)]、氧化应激指标[包括血清超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)及活性氧(ROS)]、免疫功能指标[包括T淋巴细胞亚群CD4+、CD8+及辅助性T淋巴细胞1(Th1)/Th2]及放射性肺损伤程度分级情况.结果 与本组治疗前比较,2 组治疗后sVCAM-1、IL-17A、HMGB1、IL-1β、CD105 及TGF-β1 水平均降低(P<0.05),CD34、VEGF及PaO2 水平均升高(P<0.05),且治疗组治疗后sVCAM-1、IL-17A、HMGB1、IL-1β、CD105 及TGF-β1 水平均低于对照组(P<0.05),CD34、VEGF及PaO2 水平均高于对照组(P<0.05).与本组治疗前比较,2 组治疗后SOD及GSH-Px水平均升高(P<0.05),ROS水平均降低(P<0.05),且治疗组治疗后SOD及GSH-Px水平均高于对照组(P<0.05),ROS水平低于对照组(P<0.05).与本组治疗前比较,2 组治疗后CD4+水平均升高(P<0.05),CD8+及Th1/Th2 水平均降低(P<0.05),且治疗组治疗后CD4+水平高于对照组(P<0.05),CD8+及Th1/Th2 水平低于对照组(P<0.05).与本组治疗前比较,2 组治疗后放射性肺损伤轻度损伤率均升高(P<0.05),且治疗组治疗后轻度损伤率高于对照组(P<0.05).结论 培元抗癌汤治疗晚期非小细胞肺癌放射性肺损伤患者疗效确切,可有效抑制炎症反应,减轻氧化应激损伤,改善免疫状态,减轻肺损伤程度.
Abstract
Objective To observe the improvement effect of Peiyuan Kangai Decoction on radiation-induced lung inju-ry(RILI)in advanced non-small cell lung cancer(NSCLC).Methods A total of 88 advanced NSCLC patients with RILI ad-mitted to our hospital from January 2020 to January 2022 were enrolled as the study control.They were randomized to control group(routine Western medicine(RWM),n =44)and treatment group(Peiyuan Kangai Decoction plus RWM,n =44).The aim was to compare RILI-related indexes(including soluble vascular cell adhesion molecule-1[sVCAM-1],interleukin-17 A[IL-17A],high mobility group protein[HMGB1],IL-1β,vascular endothelial growth factor[VEGF],CD34,CD105,transforming growth factor-β1[TGF-β1]and arterial partial pressure of oxygen[PaO2]),oxidative stress indexes(including superoxide dismutase[SOD],glutathione peroxidase[GSH-Px],and reactive oxygen species[ROS]),immune function indexes(including T lymphocyte subsets CD4+,CD8+ and T helper 1[Th1]/Th2),and the RILI degree between the two groups before and after treatment.Results After treatment,the levels of sVCAM-1,IL-17 A,HMGB1,IL-1β,CD105 and TGF-β1 in the two groups were significantly decreased(P<0.05),and the levels of CD34,VEGF and PaO2 were significantly increased(P<0.05).There were significant differences in sVCAM-1,IL-17A,HMGB1,IL-1β,CD105 and TGF-β1,as well as CD34,VEGF and PaO2 between groups(all P<0.05).After treatment,the levels of SOD and GSH-Px in the two groups elevated significantly(P<0.05),and the levels of ROS reduced significantly(P<0.05).The differences in SOD,GSH-Px,and ROS were significant between groups(all P<0.05).After treatment,significantly increased CD4+,and signifi-cantly decreased CD8+ and Th1/Th2 were detected in the two groups(all P<0.05).The treatment group was superior to the control group for CD4+,CD8+,and Th1/Th2(all P<0.05).The injury rate of mild RILI in the two groups was significantly higher than before treatment(P<0.05),and the improvement was more pronounced in the treatment group compared with the control group(P<0.05).Conclusion For advanced NSCLC patients with RILI,Peiyuan Kangai Decoction has a definite effect,it can effectively inhibit inflammatory response,reduce oxidative stress injury,improve immune status and reduce the de-gree of lung injury.
基金项目
陕西省重点研发计划(2018ZDCXL-SF-01-02-02)
陕西省卫生健康科研项目(2022D028)
国家科技期刊平台
NSTL
万方数据