目的 探讨养阴清肺汤治疗肺癌放疗并发放射性肺损伤患者的疗效及对其转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、白细胞介素-6(Interleukin-6,IL-6)水平的影响.方法 选取 2022年1月—2023年1月期间上海中医药大学附属龙华医院收治的肺癌放疗并发放射性肺损伤患者70例,按随机数字表法分为对照组和观察组,每组各35例.对照组给予醋酸泼尼松片等常规西医治疗,观察组在对照组基础上联合养阴清肺汤治疗.治疗2周后,观察比较两组患者临床疗效、不良反应情况,治疗前后中医证候积分、肺功能指标[最大呼气流速峰值(Peak expiratory flow,PEF)、用力肺活量(Forced vital capacity,FVC)、第1秒用力呼吸容积(Forced expiratory volume in one second,FEV1)、FEV1/FVC]、KPS 评分、生活质量评分(QLQ-C30)、TGF-β1 IL-6水平.结果 治疗后两组患者咳嗽少痰、咯血量多、胸痛、潮热盗汗、口渴口干、气急心烦评分均较治疗前明显降低,差异有统计学意义(P＜0.05);且观察组中医证候积分明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患者PEF、FVC、FEV1、FEV1/FVC水平均较治疗前升高,差异有统计学意义(P＜0.05);且观察组肺功能指标均明显高于对照组,差异有统计学意义(P＜0.05).治疗后两组患者KPS、QLQ-C30评分均较治疗前升高,差异有统计学意义(P＜0.05);且观察组KPS、QLQ-C30评分均明显高于对照组,差异有统计学意义(P＜0.05).治疗后两组患者TGF-β1、IL-6水平均较治疗前降低,差异有统计学意义(P＜0.05);且观察组TGF-β1、IL-6水平均明显低于对照组,差异有统计学意义(P＜0.05).治疗后观察组临床总有效率94.29％(33/35)明显高于对照组74.29％(26/35),差异有统计学意义(P＜0.05).治疗期间,两组患者均未见与用药相关的不良反应发生.结论 养阴清肺汤联合醋酸泼尼松片等西医常规治疗肺癌放疗并发放射性肺损伤疗效确切,能够进一步缓解患者临床症状,降低TGF-β1、IL-6水平,保护肺功能,改善患者生活质量.
Efficacy of Yangyin Qingfei Decoction in Treating Radiation-Induced Lung Injury in Lung Cancer Patients and its Effect on Transforming Growth Factor-β1 and In-terleukin-6 Levels
Objective To explore the efficacy of Yangyin Qingfei decoction in treating patients with radiation-induced lung injury following radiotherapy for lung cancer,and its impact on transforming growth factor-β1(TGF-β1)and interleukin-6(IL-6)levels.Methods A total of 70 patients with radiation-induced lung injury following radio-therapy for lung cancer,were treated at Longhua Hospital Shanghai University of TCM from January 2022 to January 2023 and were selected as study subjects.They were divided into a control and an observation group using the random number table method,with 35 patients in each group.The control group received conventional Western medicine,including predni-sone acetate tablets,while the observation group received Yangyin Qingfei decoction in addition to the treatment given to the control group.After 2 weeks of treatment,the clinical efficacy,adverse reactions,traditional Chinese medicine(TCM)syndrome scores,lung function indicators[peak expiratory flow(PEF),forced vital capacity(FVC),forced expiratory vol-ume in one second(FEV1),FEV1/FVC ratio],Karnofsky performance status(KPS)scores,quality of life scores(QLQ-C30),and levels of TGF-β1 and IL-6 were observed and compared between the two groups.Results After treatment,scores of cough with less sputum,hemoptysis,chest pain,hot flashes and night sweats,oral dryness and thirst,shortness of breath,and dysphoria were significantly reduced in both groups compared to before treatment,with a statistically significant difference(P＜0.05);the TCM syndrome scores in the observation group were significantly lower than those in the control group,with a statistically significant difference(P＜0.05).The levels of PEF,FVC,FEV1,and FEV1/FVC were signifi-cantly higher in both groups after treatment compared to before treatment,with a statistically significant difference(P＜0.05);these indicators were significantly higher in the observation group compared to the control group,with a statistically significant difference(P＜0.05).KPS score and QLQ-C30 scores were significantly increased in both groups after treat-ment compared to before treatment,with a statistically significant difference(P＜0.05);KPS score and QLQ-C30 scores were significantly higher in the observation group compared to the control group,with a statistically significant difference(P＜0.05).TGF-β1 and IL-6 levels were significantly lower in both groups after treatment compared to before treatment,with a statistically significant difference(P＜0.05);TGF-β1 and IL-6 levels were significantly lower in the observation group compared to the control group,with a statistically significant difference(P＜0.05).The overall clinical effective rate in the observation group was 94.29％(33/35),significantly higher than that of 74.29％(26/35)in the control group,with a statistically significant difference(P＜0.05).No drug-related adverse reactions were observed in either group during the treatment period.Conclusion Yangyin Qingfei decoction combined with conventional Western medicine treatment,in-cluding prednisone acetate tablets,is effective in treating radiation-induced lung injury following radiotherapy for lung cancer.It can further alleviate clinical symptoms,reduce TGF-β1 and IL-6 levels,protect lung function,and improve the quality of life for patients.
Lung CancerRadiation TherapyRadiation-Induced Lung InjuryYangyin Qingfei DecoctionTrans-forming Growth Factor-β1Interleukin-6Pulmonary Function
万方数据
维普
