金银花水煎液联合地塞米松治疗放射性食管炎
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摘要
目的:观察金银花水煎液联合地塞米松对放射性食管炎的治疗效果,并探讨其可能存在的作用机制。方法:选取156例食管癌患者作为研究对象,所有患者随机分为对照组及治疗组,对照组给予地塞米松(10 mg/d),治疗组口服金银花水煎液并根据照射剂量给予不同剂量地塞米松治疗。观察两组患者放射性食管炎的发生率及发病程度、发生时间、持续时间、T淋巴细胞亚群及后期生活质量变化情况。结果:对照组放射性食管炎发生率为59. 0%,治疗组放射性食管炎发生率为25. 6%,两组患者比较差异显著(P <0. 05);治疗组患者放射性食管炎发生时间推迟,持续时间缩短,CD3~+T、CD4~+T比例显著升高(P <0. 05),CD4~+/CD8~+比值显著升高(P <0. 05),KPS评分及体重改善。结论:利用金银花水煎液联合地塞米松可有效降低患者放射性食管炎的发生,改善患者生活质量,其作用机制可能与清热解毒,增强患者免疫功能有关。
Objective: To observe the therapeutic effects of decoction of honeysuckle combined with dexamethasone on radiation-induced esophagitis,and study its possible mechanism of action. Methods: 156 cases of esophageal cancer were selected as the research object,and all the patients were randomly divided into the control group and the treatment group. The control group was given dexamethasone( 10 mg/d). The treatment group was orally administered with the decoction of honeysuckle and received different dosages of dexamethasone according to the irradiation dose.The incidence of esophagitis,occurrence time,duration,change of T lymphocyte subsets and quality of life in later period were observed in two groups. Results: The incidence of esophagitis in control group was 59. 0%,and the incidence of esophagitis in treatment group was 25. 6 %. There was significant difference between the two groups( P <0. 05). Patients in the treatment group had delayed onset of esophagitis,decreased duration,significantly increased the proportion of CD3~+T and CD4~+T( P < 0. 05),significantly increased the ratio of CD4~+/CD8~+( P < 0. 05),and improved the KPS score and body weight. Conclusion: The use of decoction of honeysuckle combined with dexamethasone can effectively reduce the incidence of esophagitis in patients with improved quality of life of patients,its mechanism may be related to detoxification and enhance immune function in patients.
Objective: To observe the therapeutic effects of decoction of honeysuckle combined with dexamethasone on radiation-induced esophagitis,and study its possible mechanism of action. Methods: 156 cases of esophageal cancer were selected as the research object,and all the patients were randomly divided into the control group and the treatment group. The control group was given dexamethasone( 10 mg/d). The treatment group was orally administered with the decoction of honeysuckle and received different dosages of dexamethasone according to the irradiation dose.The incidence of esophagitis,occurrence time,duration,change of T lymphocyte subsets and quality of life in later period were observed in two groups. Results: The incidence of esophagitis in control group was 59. 0%,and the incidence of esophagitis in treatment group was 25. 6 %. There was significant difference between the two groups( P <0. 05). Patients in the treatment group had delayed onset of esophagitis,decreased duration,significantly increased the proportion of CD3~+T and CD4~+T( P < 0. 05),significantly increased the ratio of CD4~+/CD8~+( P < 0. 05),and improved the KPS score and body weight. Conclusion: The use of decoction of honeysuckle combined with dexamethasone can effectively reduce the incidence of esophagitis in patients with improved quality of life of patients,its mechanism may be related to detoxification and enhance immune function in patients.
引文
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[8]Xu Jing,Deng Xue,Peng Jin,et al. Randomized controlled study of GM-CSF containing solution in preventing and treating esophagitis in esophageal cancer patients[J]. Modern Oncology,2017,25(17):2737-2740.[徐静,邓雪,彭进,等. GM-CSF含服液防治食管癌患者放射性食管炎的随机对照研究[J].现代肿瘤医学,2017,25(17):2737-2740.]
[9]Yu LL,Xing LG. Advances in research on physical and biological factors in predicting radiation esophagitis[J]. Chinese Journal of Cancer Prevention and Treatment,2016,23(14):974-978.[余丽娌,邢力刚.预测放射性食管炎的物理及生物学因素研究进展[J].中华肿瘤防治杂志,2016,23(14):974-978.]
[10]Zhou X,Yang WX. Research progress of glucocorticoid in the treatment of acute lung injury/acute respiratory distress syndrome[J]. China Pharmacy,2015,14(23):3306-3308.[周绚,杨文贤.糖皮质激素治疗急性肺损伤/急性呼吸窘迫综合征的抗炎机制研究进展[J].中国药房,2015,14(23):3306-3308.]
[11]Wang LJ,Lu W,Zhou TY. Advances in the application of dexamethasone in cancer treatment[J]. Acta Pharmaceutica Sinica,2015,24(10):1217-1224.[王丽杰,卢炜,周田彦.地塞米松应用于肿瘤治疗的研究进展[J].药学学报,2015,24(10):1217-1224.]
[12]Wang L,Xu T,Tang Y. 199 cases of dexamethasone adverse reactions literature analysis[J]. Chinese Journal of Hospital Pharmacy,2008,28(18):1623-1624.[王丽,徐珽,唐尧. 199例地塞米松不良反应文献分析[J].中国医院药学杂志,2008,28(18):1623-1624.]
[13]Yuan WZ. Low dose gemcitabine combined with oxaliplatin and dexamethasone in the treatment of recurrent non Hodgkin's lymphoma[J]. Chinese Journal of Cancer Prevention and Treatment,2016,23(1):226-227.[袁文志.低剂量吉西他滨联合奥沙利铂、地塞米松治疗复发性非霍奇金淋巴瘤的近期疗效及不良反应分析[J].中华肿瘤防治杂志,2016,23(1):226-227.]
[14]Lu JZ,Zhang L. Chinese medicine prevention and treatment of acute radiation esophagitis[J]. China Journal of Traditional Chinese Medicine and Pharmacy,2012,10(12):3019-3022.[路军章,张蕾.中医药防治急性放射性食管炎[J].中华中医药杂志,2012,10(12):3019-3022.]
[15]Huang Hui,Fan Xiaojing. Clinical observation on the prevention and treatment of acute radiation-induced esophagitis by Fuzheng Jian Du granule[J]. Modern Oncology,2015,23(13):1849-1852.[黄辉,樊晓静.扶正减毒颗粒防治急性放射性食管炎的临床观察[J].现代肿瘤医学,2015,23(13):1849-1852.]
[16]Cui Z,Liu W,Zhou Y,et al. Clinical observation of Jiedu Shengji prescription in prevention and treatment of acute radiation-induced esophagitis caused by radiotherapy of esophageal cancer[J]. Chinese Journal of Integrated Traditional and Western Medicine,2016,36(7):810-813.[崔珍,柳雯,周燕,等.解毒生肌方防治食管癌放疗所致急性放射性食管炎的临床观察[J].中国中西医结合杂志,2016,36(7):810-813.]
[17]Wang YD,Yang JB,Dai Z,et al. Research progress of Chinese medicine honeysuckle[J]. Chinese Journal of Pharmaceutical Analysis,2014,16(11):1928-1935.[王亚丹,杨建波,戴忠,等.中药金银花的研究进展[J].药物分析杂志,2014,16(11):1928-1935.]
[18]Zhang HL,Wang GR,Zhang SB,et al. Observation of skin reaction induced by radiotherapy plus cetuximab on prevention and treatment effect of liquid heat and moisture of honeysuckle[J].Chinese Journal of Nursing,2010,45(4):307-310.[张海霖,王国蓉,张仕碧,等.金银花液热湿敷防治放疗加西妥昔单抗致皮肤反应的效果观察[J].中华护理杂志,2010,45(4):307-310.]
[2]Bai MS,Huang J,Shen HM,et al. Progress in TCM Research on radionuclitis[J]. Chinese Journal of Experimental Traditional Medical Formulae,2011,17(20):293-296.[柏茂树,黄杰,沈红梅,等.放射性食管炎中医研究进展[J].中国实验方剂学杂志,2011,17(20):293-296.]
[3]Hamilton SR,Aaltonen LA. Tumours of the oesophagus,pathology and genetics of tumours of the digestive system,World Health Organization classification of tumours[M]. Lyon:IARC,2000:7-28.
[4]Halabi H,Paetzold P,Sharp GC,et al. A contralateral esophagussparing technique to limit severe esophagitis associated with concurrent high-dose radiation and chemotherapy in patients with thoracic malignancies[J]. Int J Radiat Oncol Biol Fhys,2015,92(4):803-810.
[5]Li MW,Lu JZ. Experimental research progress of acute radiation esophagitis[J]. Pharmaceutical Journal of Chinese People's Liberation Army,2017,29(5):18-20.[李明伟,路军章.急性放射性食管炎的实验研究进展[J].解放军医药杂志,2017,29(5):18-20.]
[6]Liu Jiang,Ren Wei,Liu Baorui,et al. Research progress on related predictive factors and prevention and treatment of radionuclitis[J].Modern Oncology,2014,22(7):1690-1693.[刘江,任伟,刘宝瑞,等.放射性食管炎相关预测因素及防治的研究进展[J].现代肿瘤医学,2014,22(7):1690-1693.]
[7]Li CM,Yu GS. Effect of kangfuxin solution on acute radiation esophagitis in patients with NSCLC treated by radiotherapy[J].Shandong Medical Journal,2014,54(4):98-99.[李春鸣,余更生.康复新液预防NSCLC放疗患者急性放射性食管炎的效果观察[J].山东医药,2014,54(4):98-99.]
[8]Xu Jing,Deng Xue,Peng Jin,et al. Randomized controlled study of GM-CSF containing solution in preventing and treating esophagitis in esophageal cancer patients[J]. Modern Oncology,2017,25(17):2737-2740.[徐静,邓雪,彭进,等. GM-CSF含服液防治食管癌患者放射性食管炎的随机对照研究[J].现代肿瘤医学,2017,25(17):2737-2740.]
[9]Yu LL,Xing LG. Advances in research on physical and biological factors in predicting radiation esophagitis[J]. Chinese Journal of Cancer Prevention and Treatment,2016,23(14):974-978.[余丽娌,邢力刚.预测放射性食管炎的物理及生物学因素研究进展[J].中华肿瘤防治杂志,2016,23(14):974-978.]
[10]Zhou X,Yang WX. Research progress of glucocorticoid in the treatment of acute lung injury/acute respiratory distress syndrome[J]. China Pharmacy,2015,14(23):3306-3308.[周绚,杨文贤.糖皮质激素治疗急性肺损伤/急性呼吸窘迫综合征的抗炎机制研究进展[J].中国药房,2015,14(23):3306-3308.]
[11]Wang LJ,Lu W,Zhou TY. Advances in the application of dexamethasone in cancer treatment[J]. Acta Pharmaceutica Sinica,2015,24(10):1217-1224.[王丽杰,卢炜,周田彦.地塞米松应用于肿瘤治疗的研究进展[J].药学学报,2015,24(10):1217-1224.]
[12]Wang L,Xu T,Tang Y. 199 cases of dexamethasone adverse reactions literature analysis[J]. Chinese Journal of Hospital Pharmacy,2008,28(18):1623-1624.[王丽,徐珽,唐尧. 199例地塞米松不良反应文献分析[J].中国医院药学杂志,2008,28(18):1623-1624.]
[13]Yuan WZ. Low dose gemcitabine combined with oxaliplatin and dexamethasone in the treatment of recurrent non Hodgkin's lymphoma[J]. Chinese Journal of Cancer Prevention and Treatment,2016,23(1):226-227.[袁文志.低剂量吉西他滨联合奥沙利铂、地塞米松治疗复发性非霍奇金淋巴瘤的近期疗效及不良反应分析[J].中华肿瘤防治杂志,2016,23(1):226-227.]
[14]Lu JZ,Zhang L. Chinese medicine prevention and treatment of acute radiation esophagitis[J]. China Journal of Traditional Chinese Medicine and Pharmacy,2012,10(12):3019-3022.[路军章,张蕾.中医药防治急性放射性食管炎[J].中华中医药杂志,2012,10(12):3019-3022.]
[15]Huang Hui,Fan Xiaojing. Clinical observation on the prevention and treatment of acute radiation-induced esophagitis by Fuzheng Jian Du granule[J]. Modern Oncology,2015,23(13):1849-1852.[黄辉,樊晓静.扶正减毒颗粒防治急性放射性食管炎的临床观察[J].现代肿瘤医学,2015,23(13):1849-1852.]
[16]Cui Z,Liu W,Zhou Y,et al. Clinical observation of Jiedu Shengji prescription in prevention and treatment of acute radiation-induced esophagitis caused by radiotherapy of esophageal cancer[J]. Chinese Journal of Integrated Traditional and Western Medicine,2016,36(7):810-813.[崔珍,柳雯,周燕,等.解毒生肌方防治食管癌放疗所致急性放射性食管炎的临床观察[J].中国中西医结合杂志,2016,36(7):810-813.]
[17]Wang YD,Yang JB,Dai Z,et al. Research progress of Chinese medicine honeysuckle[J]. Chinese Journal of Pharmaceutical Analysis,2014,16(11):1928-1935.[王亚丹,杨建波,戴忠,等.中药金银花的研究进展[J].药物分析杂志,2014,16(11):1928-1935.]
[18]Zhang HL,Wang GR,Zhang SB,et al. Observation of skin reaction induced by radiotherapy plus cetuximab on prevention and treatment effect of liquid heat and moisture of honeysuckle[J].Chinese Journal of Nursing,2010,45(4):307-310.[张海霖,王国蓉,张仕碧,等.金银花液热湿敷防治放疗加西妥昔单抗致皮肤反应的效果观察[J].中华护理杂志,2010,45(4):307-310.]