本文選題：放射性肺炎 + 清金化痰湯��； 參考：《遼寧中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:觀察清金化痰湯聯合激素治療急性放射性肺炎的臨床療效。急性放射性肺炎的中醫(yī)病機為熱邪郁肺氣陰兩虛,造成肺宣降失常,臨床中可根據放射性肺炎患者的證型進行治療。本試驗應用清金化痰湯聯合激素治療熱邪郁肺氣陰兩虛型急性放射性肺炎,探究并分析患者的生活質量評分、血TGF-β1水平、肺功能、影像學的變化。材料與方法:采用單盲前瞻性隨機對照臨床試驗設計,鞍鋼總醫(yī)院2014年10月至2016年10月收治的急性放射性肺炎患者60例,中醫(yī)辨證分型均為熱邪郁肺氣陰兩虛型。將患者隨機分為試驗組和對照組,入組患者均符合納入標準,不符合排除標準,病人自愿參加試驗并簽署知情同意書。對照組患者激素強的松30-50 mg/d口服,試驗組使用強的松30-50 mg/d加清金化痰湯加減口服,兩組患者均治療4周。通過生活質量評分、肺功能、血中TGF-β水平(酶聯免疫法)、胸部CT幾個方面判定療效。最后經SPSS 21.0進行統(tǒng)計分析并得出結果。結果:總有效率:治療后,試驗組符合有效標準的患者(28)例,無效(2例),總有效率93.33%。對照組符合有效標準的患者(22)例,無效(8)例,總有效率73.33%。試驗組總有效率高于對照組,經χ2檢驗差異有統(tǒng)計學意義(P0.05);TGF-β1水平:治療前試驗組和對照組TGF-β1水平為(37.90±4.91)和(38.71±4.01);治療后試驗組和對照組TGF-β1水平(26.24±5.37)和(30.26±5.51)。試驗組對TGF-β1水平的降低優(yōu)于對照組,兩組血TGF-β1的降低效果的差異有統(tǒng)計學意義(P0.05);KPS評分:治療前試驗組及對照組患者KPS評分為(67.00±5.96)和(65.00±5.72)。治療后試驗組及對照組KPS評分為(85.00±8.20)和(78.30±10.31)。兩組患者治療前后在KPS平分提高方面的差異有統(tǒng)計學意義(P0.05),相較對照組,試驗組的KPS評分在治療后提高更優(yōu)(P0.05);肺功能:治療前試驗組和對照組的FEV1為(1.33±0.13)和(1.31±0.15),FEV1%為(64.03±2.10)和(63.11±1.68)。治療后試驗組和對照組FEV1為(1.86±0.28)和(1.57±0.25),FEV1%為(76.35±4.50)和(71.50±4.31)。治療后試驗組的肺功能的恢復情況明顯優(yōu)于對照組,兩組在放射性肺炎造成的肺損傷恢復效果方面的差異有統(tǒng)計學意義(P0.05);。結論:1.放射性肺炎在使用清金化痰湯加減聯合激素治療后能夠獲得更顯著的療效,能夠有效改善患者的生活質量,明顯減輕患者胸部CT陰影、顯著改善患者的肺功能,比單純激素治療放射性肺炎效果更好。2.清金化痰湯聯合激素治療能夠顯著的降低TGF-β1的水平,進一步抑制患者免疫因子的聚集和浸潤,使患者肺組織炎癥得到減輕,使患者的肺部損傷降到最低。
[Abstract]:Objective: to observe the clinical effect of Qingjin Huatan decoction combined with hormone in the treatment of acute radiation pneumonia. The TCM pathogenesis of acute radiation pneumonia is heat evil stagnation of lung qi and yin deficiency of both lung qi and yin, which results in abnormal declaration of the lung, which can be treated according to the syndromes of patients with radiation pneumonia. In this experiment, Qingjin Huatan decoction combined with hormone was used to treat acute radiation pneumonia with heat evil, stagnation of lung qi and yin deficiency. The quality of life score, blood TGF- 尾 1 level, pulmonary function and imaging changes were investigated and analyzed. Materials and methods: 60 patients with acute radiation pneumonia treated in Angang General Hospital from October 2014 to October 2016 were divided into two types: heat evil stagnation of lung qi and yin deficiency. Patients were randomly divided into experimental group and control group. The patients in the group met the inclusion criteria and did not meet the exclusion criteria. The patients volunteered to participate in the test and sign the informed consent. The patients in the control group were treated with prednisone for 30 to 50 mg/d, the test group was treated with prednisone 30-50 mg/d plus Qingjinhuatan decoction for 4 weeks. Quality of life score, lung function, blood TGF- 尾 level (enzyme linked immunosorbent assay, chest CT) were used to evaluate the curative effect. Finally, the statistical analysis was carried out by SPSS 21. 0 and the results were obtained. Results: total effective rate: after treatment, 28 patients in the test group met the effective standard, 2 patients were ineffective and the total effective rate was 93.33. In the control group, 22 patients met the effective standard and 8 patients failed. The total effective rate was 73.33. The total effective rate of the trial group was higher than that of the control group (蠂 2 test). The levels of TGF- 尾 1 in the test group and the control group were 37.90 鹵4.91 and 38.71 鹵4.01 respectively, and the TGF- 尾 1 levels in the experimental group and the control group were 26.24 鹵5.37) and 30.26 鹵5.51 respectively. The decrease of TGF- 尾 1 level in the trial group was better than that in the control group. There was significant difference in the effect of TGF- 尾 1 reduction between the two groups. The KPS scores of the patients in the trial group and the control group were 67.00 鹵5.96 and 65.00 鹵5.72 respectively before treatment. After treatment, the KPS scores of the experimental group and the control group were 85.00 鹵8.20 and 78.30 鹵10.31 respectively. There was significant difference between the two groups in improving the KPS score before and after treatment. Compared with the control group, the KPS score of the test group was better than that of the control group, and the pulmonary function of the experimental group and the control group was 1.33 鹵0.13) and 1.31 鹵0.15% (64.03 鹵2.10) and 63.11 鹵1.68%, respectively. After treatment, the FEV1 of the experimental group and the control group were 1.86 鹵0.28) and 1.57 鹵0.25% respectively. The FEV1% was 76.35 鹵4.50) and the FEV1 was 71.50 鹵4.31%. After treatment, the recovery of lung function in the experimental group was significantly better than that in the control group, and the difference between the two groups in the recovery effect of lung injury caused by radiation pneumonia was statistically significant (P 0.05). Conclusion 1. After using Qingjin Huatan decoction combined with hormone therapy, radiation pneumonia can obtain more significant curative effect, can effectively improve the quality of life of patients, obviously alleviate the chest CT shadow of patients, and significantly improve the pulmonary function of patients. Treatment of radiation pneumonia is better than hormone alone. 2. 2. Qingjinhuatan decoction combined with hormone therapy can significantly reduce the level of TGF- 尾 1, further inhibit the accumulation and infiltration of immune factors, reduce the inflammation of lung tissue and minimize the lung injury.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R273

【參考文獻】

相關期刊論文 前10條

1 陳波;楊曉洪;劉濤;王曉芹;陳曉紅;;近十年中醫(yī)藥防治放射性肺損傷的研究進展[J];時珍國醫(yī)國藥;2014年12期

2 胥常琴;;丹參川芎嗪注射液治療放射性肺炎的療效及護理[J];時珍國醫(yī)國藥;2013年07期

3 蔡勇;周道安;;非小細胞肺癌放射性肺炎相關因素分析[J];中華醫(yī)院感染學雜志;2011年16期

4 孫荏苒;張滿云;陳勤;;桔梗皂苷膠囊抗炎止咳平喘作用研究[J];中藥藥理與臨床;2010年04期

5 張利偉;趙娟;;中西醫(yī)結合治療放射性肺炎的臨床研究[J];中國實用醫(yī)藥;2008年24期

6 李文;毛兵;王剛;王蕾;常靜;張穎;萬美華;郭佳;;從氣道炎癥和氣道黏液高分泌研究清熱化痰法治療慢性阻塞性肺疾病急性加重期痰熱阻肺證的機制[J];中西醫(yī)結合學報;2008年08期

7 張霆;馬勝林;岳建華;賈英杰;潘曉嬋;鄧清華;湯忠祝;謝廣茹;徐粟;;清金潤肺湯結合激素和抗生素治療放射性肺炎的臨床觀察[J];中國中西醫(yī)結合雜志;2007年03期

8 馮學禎;姚惠青;;健脾補肺法結合西藥治療慢性阻塞性肺病穩(wěn)定期36例臨床觀察[J];青海醫(yī)藥雜志;2006年09期

9 劉卓;金英;姚素艷;鄭德宇;郭曉麗;齊志敏;;知母皂苷對淀粉樣β蛋白片段25~35引起的神經細胞凋亡的保護作用(英文)[J];中國藥理學與毒理學雜志;2006年04期

10 張明發(fā);沈雅琴;;桑白皮的藥理研究進展[J];上海醫(yī)藥;2006年04期

相關碩士學位論文 前1條

1 楊俊;解毒益氣方加減聯合糖皮質激素治療放射性肺炎的臨床研究[D];湖南中醫(yī)藥大學;2007年

，

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