肺癌放射治療致放射性肺炎的臨床效果

　　[摘要]目的 探討肺癌放射治療致放射性肺炎的臨床效果。方法 選擇2013年1月～2016年12月在我院行放射治療所致放射性肺炎的74例肺癌患者，依據不同治療方案分為對照組、觀察組，每組37例。對照組實施常規(guī)西醫(yī)治療，觀察組實施中西醫(yī)結合治療，比較兩組患者的臨床療效、癥狀改善情況、炎癥因子水平、KPS評分及不良反應。結果 觀察組的總有效率顯著高于對照組，差異有統(tǒng)計學意義（P<0.05）；觀察組患者治療后癥狀評分顯著低于對照組，差異有統(tǒng)計學意義（P<0.05）；觀察組治療后白細胞計數、hs-CRP顯著低于對照組，差異有統(tǒng)計學意義（P<0.05）；觀察組治療后KPS評分顯著高于對照組；差異有統(tǒng)計學意義（P<0.05）；觀察組的不良反應發(fā)生率顯著低于對照組，差異有統(tǒng)計學意義（P<0.05）。結論 肺癌放射治療致放射性肺炎采用中西醫(yī)結合治療有良好效果，能有效緩解癥狀，促進炎癥的消退，提高患者生存質量，具有積極的臨床意義。
　　[關鍵詞]肺癌放射治療；放射性肺炎；中西醫(yī)結合治療
　　[中圖分類號] R735.1 [文獻標識碼] A [文章編號] 1674-4721（2018）2（b）-0077-03
　　Clinical effect of radiotherapy on radiation pneumonitis caused by lung cancer
　　CHEN Hai-wen ZHANG Kun-qiang YANG Chang-fu LU Yao-yong WEI Hua-jun
　　Department of Oncology， People′s Hospital in Gaozhou City of Guangdong Province，Gaozhou 525200，China
　　[Abstract]Objective To investigate the clinical effect of radiation pneumonitis induced by lung cancer radiotherapy.Methods 74 lung cancer patients with radiation pneumonitis caused by radiotherapy in our hospital from January 2013 to December 2016 were selected and divided into control group and observation group according to different treatment schemes，with 37 cases in each group.The control group was treated with conventional western medicine，and the observation group was treated with integrated traditional Chinese and Western medicine.The clinical efficacy，symptom improvement，inflammatory factor level，KPS score and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group （P<0.05）.After treatment，the symptom score of the observation group was significantly lower than that of the control group （P<0.05）.After treatment，the white blood cell count and hs-CRP in the observation group were significantly lower than those in the control group （P<0.05）.KPS score of observation group was significantly higher than that of control group，the difference was statistically significant （P<0.05）.The incidence of adverse reactions in the observation group was significantly lower than that in the control group （P<0.05）.Conclusion Radiation pneumonitis caused by lung cancer radiotherapy has good effect，can effectively relieve symptoms，promote the regression of inflammation，improve the quality of life of patients， has a positive clinical significance.
　　[Key words]Lung cancer radiotherapy；Radiation pneumonitis；Integrated traditional Chinese and Western medicine treatment
　　肺癌是臨床常見的腫瘤類型，對不能手術治療、不愿意行手術治療或因年紀大且基礎病多而難以接受手術的肺癌患者，放療是其主要的治療手段，臨床研究顯示患者采用放療能提高患者的腫瘤局部控制率和生存率。但是放射性肺炎（radiation pneumonitis，RP）是其最常見的并發(fā)癥，臨床發(fā)病率達9%～28%[1]，可引發(fā)肺纖維化、肺功能不全等慢性并發(fā)癥，導致治療失敗，甚至危及生命。因此，積極防治RP對放療效果的發(fā)揮和生活質量的提高有重要的臨床意義。西醫(yī)治療本病多采用糖皮質激素聯(lián)合抗生素治療的方式，有較好療效，但長期使用存在顯著不良反應[2]。中醫(yī)辨證論治具有良好的扶正固本、祛邪外出的功效。本研究分析中西醫(yī)結合治療肺癌放射治療所致RP，評估對患者治療和預后的影響，現(xiàn)報道如下。

相關熱詞搜索：肺癌 放射 臨床 效果 性肺炎