参松养心胶囊加红景天干预放射性心脏损伤的临床研究

目的?探讨参松养心胶囊对胸部肿瘤放射治疗（简称放疗）病人的心脏保护作用。方法?胸部肿瘤（肺癌、乳腺癌、纵隔肿瘤、食管癌）需放疗病人120例，均行放疗，随机分为加服参松养心胶囊组（A组）、红景天组（B组）、参松养心胶囊加红景天组（C组）和单纯放疗对照组（D组）各30例，比较放疗开始后3月内各组血清转化生长因子（TGF-β₁）、肿瘤坏死因子（TNF-α）、内皮素（ET）含量、放射性心脏损伤发生率，及第3月时心肌背向散射积分（IBS）数据变化情况。结果?A、B、C3组放疗后TGF-β₁、TNF-α和ET在血清内的含量均较D组低（P<0.01）；3组放疗后1～3月急性心脏损伤发生率低于D组（P<0.05）；放疗后3月时D组前壁、前室间隔的IBS明显升高，而A、B、C3组未见升高。结论?参松养心胶囊和红景天均能减少放疗期间血清中细胞炎性因子的产生，抑制IBS值的升高，对心脏有放射保护作用。 

Clinical Research of Shensong Yangxin Capsule Combined with Rhodiola Rosea on Radioactive Heart Damage

OBJECTIVE?To explore the cardiac protective effects of Shensong Yangxin Capsule on patients with chest tumor radiotherapy. METHODS?120 patients with thoracic tumors(including lung cancer， breast cancer， mediastinal tumor and esophageal cancer) requiring radiotherapy were randomly divided into radiotherapy combined with Shensong Yangxin Capsule group (group A)， radiotherapy with Rhodiola rosea group(group B)， radiotherapy plus Shensong Yangxin Capsule and Rhodiola rosea group(group C) and radiotherapy alone group (group D)， with 30 patients in each group. Levels of serum transforming growth factor(TGF-β₁)， tumor necrosis factor(TNF-α)， endothelin(ET) contents， occurrence rate of radioactive heart damage of each group were compared within three months after radiotherapy and changes of myocardial integrated back scatter(IBS) in the third month were observed. RESULTS?After radiotherapy the contents of TGF-β₁， TNF-α and ET contents of group A B and C were lower than those of the group D (P<0.01). The incidence rates of acute cardiac injury of the first three groups were also lower than those of the group D within one to three months after radiotherapy(P<0.05). IBS levels of anterior wall and anterior inter-ventricular septum in the third month after radiotherapy were increased significantly in the group D while no changes were detected in the other three groups.CONCULSION?Shensong Yangxin Capsule combined with Rhodiola rosea is able to reduce the production of inflammatory cytokines in tissues and inhibit the increase of IBS during radiotherapy so as to protect heart from radiation injury.