| ObjectiveTo investigate the protective effect of Qingdi mixture against radiation-induced lung injury(RILI)and its mechanism,and to provide a scientific basis for the clinical application of Qingdi mixture.MethodsClinical retrospective study: a total of 137 non-small cell lung cancer patients who received chest radiotherapy in the Radiotherapy Department Affiliated Hospital of Qingdao University from 2016 to 2017 were retrospectively collected.71 were treated with Qingdi mixture(Qingdi mixture group)and 66 were treated with radiotherapy alone(control group),DT: 56-66Gy/25-30f/5.0-6.0w.In the Qingdi mixture group,125 ml bid was given daily from the day of radiotherapy;The two groups were compared in terms of the incidence rate,onset time,and duration of RILI and the number of patients who were forced to discontinue radiotherapy,as well as pulmonary function parameters including the ratio of the measured value of maximal voluntary ventilation(MVV)to its predicted value(MVV-measured/predicted%)and the ratio of forced expiratory volume in 1 second to forced vital capacity(FEV1/FVC%)at different time points.In the animal experiment: 45 C57BL/6 mice were randomly divided into blank control group,irradiation alone group and Qingdi mixture group.Except for the blank control group,the other two groups of mice were given whole chest 12 Gy irradiation,and the mice in the Qingdi mixture group were given Qingdi mixture(0.02 ml/g)by gavage once a day according to the weight change every week for 4 weeks.The remaining two groups were given the same amount of saline.After 4 weeks of treatment,the mice were sacrificed,the content of Superoxide Dismutase(SOD)and Malondialdehyde(MDA)in the lung tissue of the mice and the histopathological changes were detected.ResultsThe clinical study showed that the incidence of grade II or above radiation pneumonia in the Qingdi mixture group was similar to that in the irradiation alone group(?2=1.736,P>0.05),but Qingdi mixture could delay the onset of RILI with shorter duration of onset and number of patients who were forced to discontinue radiotherapy(t=3.146?3.876,?2=5.011,P<0.05).The results of pulmonary function examination showed that MVV-measured/predicted% and FEV1/FVC% could be affected at different time points and whether Qingdi mixture was used or not(F=6.327~8.224,P<0.05),MVV-measured/predicted% and FEV1/FVC% in Qingdi mixture group and control group were the lowest immediately after radiotherapy.With the prolongation of radiotherapy time,MVV-measured/predicted% and FEV1/FVC% in Qingdi mixture group were higher than those in control group(F = 6.327,6.615;P < 0.05);from each time point,MVV-measured/predicted% and FEV1/FVC% in Qingdi mixture group were higher than those in control group(F=6.327,6.615;P < 0.05)It was found that MVV-measured/predicted% and FEV1/FVC% of patients in Qingdi mixture group were higher than those in control group at 4 and 8 weeks after radiotherapy,with statistical difference(P < 0.05),and there was interaction between before and after radiotherapy and whether Qingdi mixture was used on patients' lung function(F=6.548,7.124,P< 0.05).The results of animal experiments showed that the lung inflammation in Qingdi mixture group was better than that in irradiation alone group,mainly with mild-moderate inflammation.The MDA content in lung tissue of mice in Qingdi Mixture group was significantly lower than that in irradiation alone group(FMDA=6.744,P<0.05),while the SOD was significantly higher than that in irradiation alone group(FSOD=9.352,P=0.05).ConclusionQingdi Mixture has a certain protective effect on radiation-induced lung injury,and its possible mechanism is related to alleviating radiation-induced inflammation by intervening in the Redox System(ROS),by upregulating the activity of SOD and reducing the content of MDA in lung tissue and thus alleviating lung inflammation induced by irradiation. |
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