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放疗是乳腺癌、肺癌、食管癌以及纵隔淋巴瘤等胸部肿瘤的主要治疗方法之一,在控制与治疗恶性肿瘤方面发挥着重要作用。放疗过程中部分正常肺组织(肺组织对射线属中度敏感器官)会不可避免地受到照射,导致放射性肺损伤(radiation-induced lung injury,RILI)的发生率高达15%以上。通常在完成放疗后1~3个月发生放射性肺炎,6 ~24个月后可发生永久性肺纤维化。这些并发症严重影响着患者的生活质量、预后及生存率。目前临床多采用糖皮质激素、细胞因子抑制剂等治疗RILI,虽然这些药物具有一定的疗效,但均存在较大的不良反应。因此,寻找高效低毒的RILI防治药物仍然是目前亟待解决的问题。
植物提取物是以植物为原料,按照对提取的最终产品的用途需要,经过物理化学提取分离过程,定向获取和浓集植物中的某一种或多种有效成分,不改变其有效成分结构而形成的产品。按照提取植物的成分不同,分为甙、多酚、多糖、萜类、黄酮、生物碱等[1]。近年来的研究发现,一些植物提取物具有显著的抗炎、抗氧化、免疫调节、抗感染和抗纤维化作用,在防治RILI方面具有良好的效果,以其广泛的药理学作用与不良反应小的特点,越来越受到放射医学研究者的关注。目前植物提取物用于防治肺损伤的研究热点主要集中于多酚类、生物碱类、萜类等。现将近年来研究较热的几种植物提取物对RILI的防治情况综述如下。
植物提取物防治放射性肺损伤的现状与展望
Protective and therapeutic effects of plant extracts on radiation-induced lung injury:present status and future prospects
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摘要: 放射性肺损伤(RILI)是放射治疗最为常见的并发症之一, 包括放射性肺炎与放射性肺纤维化。RILI影响患者的生活质量与肿瘤治疗效率。目前临床多采用糖皮质激素、细胞因子抑制剂等治疗RILI, 虽然这些疗法具有一定的疗效, 但均存在较大的不良反应。因此, 寻找高效低毒的RILI防治药物仍是目前亟待解决的问题。近年来, 大量研究表明, 天然的植物提取物在防治RILI方面具有良好的效果, 且不良反应小, 药理作用广泛, 具有潜在的应用和开发价值。笔者综述了近年来RILI防治研究领域中的天然植物提取物及相关进展, 为植物提取物更好地开发应用提供参考。Abstract: Radiation-induced lung injury(RILI) is a common complication of thoracic radiotherapy, including pneumonitis and the latter fibrosis. It had great impact on long term quality of life and could result in fatal respiratory insufficiency. At present the usual method for it are corticosteroids and cytokine inhibitor. But the side effects of such drugs were also evident. Therefore, identification of safer and more effective radioprotectants for radiation-induced lung injury is urgently required. Fortunately, a great deal of research shows that plant extracts can be great potential for the treatment of RILI. Herein, we review the literature on plant extracts treatment of radiation-induced lung injury. Plant extracts generally have little toxicity and vast pharmacological apllications. This review creates a solid foundation upon which to further study the efficacy of plants that are both currently used as reduce radiation-induced lung injury medicines.
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Key words:
- Radiotherapy /
- Plant extracts /
- Therapeutic uses /
- Radiation-induced lung injury
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