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【目的】研究藏药雪莲联合糖皮质激素在放射性肺炎进展期的干预作用。【方法】选取65例接受食道癌放疗后的放射性肺炎患者,随机分为3组:西药组20例、联合组21例和藏药组24例。西药组给予口服泼尼松(剂量为1 mg/kg)治疗,联合组给予口服泼尼松(剂量为0.5 mg/kg)联合肌肉注射雪莲注射液(剂量为2 m L/d)治疗,藏药组给予肌肉注射雪莲注射液(剂量为4 m L/d)治疗,以上药物均持续应用6周。观察各组患者治疗前后胸部高分辨率CT(HRCT)评分、LCQ咳嗽评分、6 min步行试验、肺功能[肺活量(VC),肺总量(TLC),弥散功能(DLco)]、动脉血气分析[动脉氧分压(PO2)]等的变化情况。【结果】(1)治疗后,联合组HRCT评分、6 min步行试验、LCQ咳嗽评分的改善值均高于西药组和藏药组(P<0.05),而藏药组仅LCQ咳嗽评分中的心理、社会评分改善值及改善后总分高于西药组(P<0.05)。(2)治疗后,联合组及藏药组的肺功能及PO2改善值均高于西药组(P<0.05),且联合组肺功能中的DLco及PO2改善值也均高于藏药组(P<0.05)。【结论】雪莲注射液联合糖皮质激素对于进展期的放射性肺炎有较好的治疗作用;大剂量雪莲注射液对于进展期的放射性肺炎的症状及影像学改善也有一定的帮助。
【Objective】 To investigate the intervention effect of Tibetan yacon combined with glucocorticoid on the progression of radiation pneumonitis. 【Methods】 Sixty-five patients with radiation pneumonitis undergoing esophageal cancer radiotherapy were randomly divided into three groups: 20 in Western medicine group, 21 in combined group and 24 in Tibetan medicine group. The western medicine group was treated with oral prednisone (1 mg / kg), and the combination group was treated with oral prednisone (0.5 mg / kg) and intramuscular injection of lotus seed (2 m L / d) The medicine group was given intramuscular injection of lotus seed (4 m L / d) for 6 weeks. The HRCT score, LCQ cough score, 6 min walk test, pulmonary function (VC), total lung volume (TLC) and diffusion function (DLco) before and after treatment were observed in all groups. [Arterial oxygen pressure (PO2)] and other changes. 【Results】 (1) After treatment, HRCT score, 6-min walking test and improvement of LCQ cough score in combination group were higher than those in western medicine group and Tibetan medicine group (P <0.05), while in Tibetan medicine group only LCQ cough score Psychological and social scores improve and improve the total score higher than western medicine group (P <0.05). (2) After treatment, the lung function and the PO2 in the combined group and the Tibetan group were higher than those in the western medicine group (P <0.05), and the improvement of DLco and PO2 in the lung function of the combined group were also higher than those in the Tibetan medicine group P <0.05). 【Conclusion】 Xuelian injection combined with glucocorticoid has a good therapeutic effect on advanced radiation pneumonitis. Large dose of Xuelian injection can also help to improve the symptoms and imaging of advanced radiation pneumonitis.