丹参川芎嗪注射液对局部晚期非小细胞肺癌患者放射性肺损伤的防治效果
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摘要
目的探讨丹参川芎嗪注射液对局部晚期非小细胞肺癌患者放射性肺损伤的防治效果。方法选择2016年12月～2017年11月于我院进行治疗的局部晚期非小细胞肺癌患者80例,按照随机数字表法分为对照组40例和观察组40例。两组均进行三维适形放射治疗,观察组在此基础上给予丹参川芎嗪注射液。比较两组放射疗效,治疗前后血浆转化生长因子-β1(TGF-β1)水平、血清细胞间黏附分子(ICAM-1)水平、肺功能指标[用力肺活量(FVC)、第1秒用力呼气量(FEV_1)及一氧化碳弥散量(DLCO)];对两组进行影像学检查,记录放射性肺损伤情况,并统计其不良反应发生情况。结果两组有效缓解率比较差异无统计学意义(P>0.05)。治疗后,观察组血浆TGF-β1和血清ICAM-1水平均低于对照组(P<0.05);观察组FVC、FEV_1水平与对照组比较差异无统计学意义(P>0.05);观察组DLCO水平高于对照组(P<0.05)。观察组放射性肺炎及放射性肺纤维化发生率均低于对照组(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论丹参川芎嗪注射液可改善局部晚期非小细胞肺癌患者肺弥散功能,减少放射性肺损伤。
Objective To investigate the control effect of Danshen Chuanxiongqin injection on radiation-induced lung injury in patients with locally advanced non-small cell lung cancer(NSCLC). Methods Eighty patients with locally advanced NSCLC treated in the hospital from December 2016 to November 2017 were divided into the control group and the observation group by the random number table method, 40 cases in each group. Both groups were given radiotherapy, and on the basis, the observation group was additionally treated with Danshen Chuanxiongqin injection. Effects of radiotherapy, levels of plasma transforming growth factor-β1(TGF-β1), serum intercellular adhesion molecule(ICAM-1) and lung function indicators [forced vital capacity(FVC), forced expiratory volume in 1 second(FEV_1) and carbon monoxide diffusion capacity(DLCO)] were compared between the two groups. Imaging examinations were performed on both groups, and the incidence of adverse reactions was recorded. Results There was no significant difference between the effective remission rate between the two groups(57.50% vs 50.00%)(P>0.05). Levels of plasma TGF-β1 and serum ICAM-1 in the observation group after treatment were lower than those in the control group(P<0.05), but there was no significant difference in FVC or FEV_1(P>0.05). The DLCO level was higher than that in the control group(P<0.05). The incidence rates of radiation pneumonitis and radiation-induced pulmonary fibrosis in the observation group(12.50% and 10.00%) were lower than those in the control group(32.50% and 32.50%)(P<0.05). There was no significant differences in adverse reactions between the two groups(P>0.05). Conclusion Danshen Chuanxiongqin injection can improve the lung diffusion function and reduce radiation-induced lung injury in patients with locally advanced NSCLC.
Objective To investigate the control effect of Danshen Chuanxiongqin injection on radiation-induced lung injury in patients with locally advanced non-small cell lung cancer(NSCLC). Methods Eighty patients with locally advanced NSCLC treated in the hospital from December 2016 to November 2017 were divided into the control group and the observation group by the random number table method, 40 cases in each group. Both groups were given radiotherapy, and on the basis, the observation group was additionally treated with Danshen Chuanxiongqin injection. Effects of radiotherapy, levels of plasma transforming growth factor-β1(TGF-β1), serum intercellular adhesion molecule(ICAM-1) and lung function indicators [forced vital capacity(FVC), forced expiratory volume in 1 second(FEV_1) and carbon monoxide diffusion capacity(DLCO)] were compared between the two groups. Imaging examinations were performed on both groups, and the incidence of adverse reactions was recorded. Results There was no significant difference between the effective remission rate between the two groups(57.50% vs 50.00%)(P>0.05). Levels of plasma TGF-β1 and serum ICAM-1 in the observation group after treatment were lower than those in the control group(P<0.05), but there was no significant difference in FVC or FEV_1(P>0.05). The DLCO level was higher than that in the control group(P<0.05). The incidence rates of radiation pneumonitis and radiation-induced pulmonary fibrosis in the observation group(12.50% and 10.00%) were lower than those in the control group(32.50% and 32.50%)(P<0.05). There was no significant differences in adverse reactions between the two groups(P>0.05). Conclusion Danshen Chuanxiongqin injection can improve the lung diffusion function and reduce radiation-induced lung injury in patients with locally advanced NSCLC.
引文
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[19] 陈志远,董卓,魏威,等.TGF-β1对放射性肺纤维化作用的研究进展[J].辐射防护,2018,38(2):171-175.
[20] 张振勇,曹秋婷,吴荣.放射性肺损伤中核因子κB和细胞间黏附分子1的表达及意义[J].中国医科大学学报,2014,43(2):155-158.
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[24] 李倩,高晓峰.丹参川芎嗪注射液联合曲美他嗪治疗病毒性心肌炎急性期的临床观察[J].中国药房,2016,27(32):4568-4570.
[25] Wang Q,Tang Z,Zhang W.Brain microdialysate,CSF and plasma pharmacokinetics of ligustrazine hydrochloride in rats after intranasal and intravenous administration[J].Biopharmaceutics & Drug Disposition,2013,34(7):417-422.
[26] 耿旭红,尹希,梁续飞,等.中晚期肺癌患者调强放射治疗前后肺功能的变化[J].山东医药,2017,57(6):40-42.
[2] Ding L,Li QJ,You K Y,et al.The Use of Apatinib in Treating Nonsmall-Cell Lung Cancer:Case Report and Review of Literature[J].Medicine,2016,95(20):e3598.
[3] Picardo AL,Torres AJ,Maestro M,et al.Quantitative analysis of carcinoembryonic antigen,squamous cell carcinoma antigen,CA 125,and CA 50 cytosolic content in non-small cell lung cancer[J].Cancer,2015,73(9):2305-2311.
[4] 段哲萍,于新江,吕艳玲,等.复方苦参注射液对非小细胞肺癌放疗患者放射性肺损伤及骨髓抑制的防治作用及机制[J].山东医药,2016,56(32):81-83.
[5] Wang J,Xie X,Peng F,et al.Baseline Plasma Proteomic Analysis to Identify Glycoproteins for Prediction of Radiation Induced Lung Toxicity in Patients with Non-Small Cell Lung Cancer[J].International Journal of Radiation Oncology Biology Physics,2015,93(3):S151-S152.
[6] Kim HJ,Lee CH.Postoperative Acute Lung Injury Following Lobectomy for Non-Small Cell Lung Cancer:What Are the Risk Factors?[J].Chest,2017,152(4):A638.
[7] 王彬,罗毅,梁桂林,等.痰热清注射液联合丹参川芎嗪治疗慢性阻塞性肺疾病的疗效评价及作用机制[J].广东医学,2016,37(6):921-924.
[8] 帅晓明,高金波,刘兴华,等.新辅助化疗联合腹腔镜辅助胃癌根治术治疗进展期胃癌的疗效分析[J].中华消化外科杂志,2016,15(3):241-246.
[9] 安宁,兰海涛,张明,等.阿瑞匹坦用于小细胞肺癌EP方案化疗预防性止吐的临床疗效评价[J].西部医学,2018,30(2):242-245.
[10] Han S,Gu F,Lin G,et al.Analysis of Clinical and Dosimetric Factors Influencing Radiation-Induced Lung Injury in Patients with Lung Cancer[J].Journal of Cancer,2015,6(11):1172-1178.
[11] Bao P,Zhao W,Li Y,et al.Protective effect of ulinastatin in patients with non-small cell lung cancer after radiation therapy:a randomized,placebo-controlled study[J].Medical Oncology,2015,32(1):405.
[12] 李金伟,王蓉,肖海,等.盐酸川芎嗪预防放射性肺损伤的临床研究[J].现代预防医学,2014,41(18):3439-3442.
[13] 王绿化,傅小龙,陈明,等.放射性肺损伤的诊断及治疗[J].中华放射肿瘤学杂志,2015,24(1):4-9.
[14] 陈曦,赵路军,徐利明,等.氧化应激在放射性肺损伤中的相关研究进展[J].中华放射医学与防护杂志,2016,36(4):312-315.
[15] Liou CJ,Lai YR,Chen YL,et al.Matrine Attenuates COX-2 and ICAM-1 Expressions in Human Lung Epithelial Cells and Prevents Acute Lung Injury in LPS-Induced Mice[J].Mediators of inflammation,2016,2016(8):3630485.
[16] Calik M,Yavas G,Calik S,et al.Expression of TGF-β-1 Alterations in Radiation-Induced Lung Injury by Halofuginone[J].Chest,2014,146(4):585A.
[17] Li SJ,Wang XJ,Hu JB,et al.Targeting delivery of simvastatin using ICAM-1 antibody-conjugated nanostructured lipid carriers for acute lung injury therapy[J].Drug Delivery,2017,24(1):402-413.
[18] 林白桦,袁国荣,贾勇士,等.黄芪多糖对放射性肺损伤小鼠模型的TGF-β1、SOD的影响[J].中华中医药学刊,2015,33(6):1411-1413.
[19] 陈志远,董卓,魏威,等.TGF-β1对放射性肺纤维化作用的研究进展[J].辐射防护,2018,38(2):171-175.
[20] 张振勇,曹秋婷,吴荣.放射性肺损伤中核因子κB和细胞间黏附分子1的表达及意义[J].中国医科大学学报,2014,43(2):155-158.
[21] Jie K,Li L,Dingding W,et al.Isolation and bioactivity of diterpenoids from the roots of Salvia grandifolia[J].Phytochemistry,2015,116(1):337-48.
[22] Eghtesadi F,Farimani MM,Hazeri N,et al.Abietane and nor-abitane diterpenoids from the roots of Salvia rhytidea[J].Springerplus,2016,5(1):1068.
[23] Búfalo J,Cantrell CL,Jacob MR,et al.Antimicrobial and Antileishmanial Activities of Diterpenoids Isolated from the Roots of Salvia deserta[J].Planta Medica,2015,82(01/02):131-137.
[24] 李倩,高晓峰.丹参川芎嗪注射液联合曲美他嗪治疗病毒性心肌炎急性期的临床观察[J].中国药房,2016,27(32):4568-4570.
[25] Wang Q,Tang Z,Zhang W.Brain microdialysate,CSF and plasma pharmacokinetics of ligustrazine hydrochloride in rats after intranasal and intravenous administration[J].Biopharmaceutics & Drug Disposition,2013,34(7):417-422.
[26] 耿旭红,尹希,梁续飞,等.中晚期肺癌患者调强放射治疗前后肺功能的变化[J].山东医药,2017,57(6):40-42.