清燥救肺汤加黄芪对放射性肺损伤干预作用及对肿瘤坏死因子.docVIP

　　清燥救肺汤加黄芪对放射性肺损伤干预作用及对肿瘤坏死因子 作者：奚蕾，夏德洪，沈伟生，许晨，周剑波，舒中琴，于波，侯昕珩，王珂 【摘要】 　　目的观察清燥救肺汤加黄芪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200 ml，黄芪口服液10 ml，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 d起观测临床症状、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（1.92±0.49）ng/ml，放射治疗后为（2.51±0.73）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（Plt;0.001）。治疗组放射治疗前血浆ET为（56.73±18.35）pg/ml，放射治疗后为（68.97±21.76）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（Plt;0.001）。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（Plt;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（Plt;0.05）。结论清燥救肺汤加黄芪能抑制放射治疗后血浆TNF-α、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治疗和预防。 【关键词】 放射治疗　 清燥救肺汤　 黄芪　 肺损伤　肿瘤坏死因子　 内皮素 　　Abstract：ObjectiveTo observe the effect of “Qin Zao Jiu FEi Recipe” and Astragalus membranaceus on radiation-induced lung injury and levels of plasma tumor necrosis factor-α(TNF-α)and endothelin (ET) in partial mid and late stage chest tumor patients id and late stage chest tumor patients ly divided into control group and therapy group, therapy group l ,po,bid and Astragalus membranaceus10 ml,po,bid before radiotherapy and continued for 6 months.Plasma TNF-α and ET ined before and at the end of radiotherapy,Clinicalsymptoms,lung function and high-resolution puted tomography of thorax a TNF-α for（1.92±0.49）ng/ml in therapy group and （1.90±0.51）ng/m in control group,at the end of radiotherapy,the level of plasma TNF-α in control group uch higher than in therapy group(5.12±1.01ng/ml vs2.51±0.73ng/ml，Plt;0.001）.Before radiotherapy, plasma ET l in therapy group and （58.93±16.98）pg/ml in control group,at the end of radiotherapy,the level of plasma ET in control group uch higher than that of therapy group(97.87±37.83 pg/ml vs 68.97±21.76 pg/ml，Plt;0.001）.Five months and ten months after radiotherapy,reduced CO diffusion capacity of lung (DLCO) in therapy group onia and pulmonary fibrosis embranaceus can inhibit overexpression of plasma TNF-α and ET after rad