矽肺治疗临床研究及效果评价  

ClinicaltrialandevaluationoftreatmentforsilicosisTaskgroupofclinicalevaluationontherepeuticeffectsofdrugtreatmentforsilicosis.

作　　者：InstituteofOcupationalMedicine,ChineseAcademyofPreventiveMedicine,Beijing100050 

机构地区：[1]<矽肺治疗措施及效果评价研究>课题组,中国预防医学科学院劳动卫生与职业病研究所

出　　处：《中华劳动卫生职业病杂志》1996年第3期130-134,共5页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金："八五"国家科技攻关基金

摘　　要：为探讨矽肺治疗措施及其效果评价，进行了汉防己甲素（简称汉甲）和羟基磷酸哌喹（简称羟哌）、汉甲和克矽平、柠檬酸铝（简称柠铝）和羟哌３种联合用药方案和采用大容量肺灌洗治疗矽肺的临床研究。结果表明，３种联合用药治疗与对照组比较均显示明显疗效８，呼吸系统症状的有效率达５５．７％～６６．０％，Ｘ线胸片好转率为５．５％～１１．８％（对照组没有好转病例）。在高暴露粉尘组病变进展快的病例，Ｘ线胸片的好转率达１８％～３６％；而对照组Ｘ线胸片病变显示进展的病例达３０％～６７％，明显高于治疗组的（３．３％～１３．３％）。大容量肺灌洗具有改善呼吸系统症状的作用，但Ｘ线未见明显疗效。结果提示，联合用药对矽肺病变的进展有明显抑制作用。Poly-2-vinylpyridine-nitrogeneoxide(PVNO),bis-benzylisoquinoline(tetrandrine,TD),quinolylpiperazinehydroxylposphate(QOHP),aluminiumcitrate(ALC)andmasivewholelunglavagewereusedforthetreatmentofsilicoticpatients.540patientswithsilicosisweredividedintotreatedgroup(355)andcontrolgroup(185).Thetreatedgroupwassubdividedinto4subgroupsbasedondiferentcombinationofthedrugs,TD+QOHP,TD+PVNO,QOHP+ALCaswelaslavage.Theclinicaleficacywasevaluatedbyclinicalsymptoms:lungfunction,chestX-rayfilmandlaboratoryex-aminations.Theresultshowedthatapparentrespiratorysymptomaticimprovementwasseenin55.7%～60.0%ofthedrugtreatedgroups,significantlyhigherthancontrol.Therateofcomplicationwithin-fectionwasobviouslydecreased.TherateofimprovementinX-rayfilmswas5.5%～11.8%intreatedgroupswhereasnocaseincontrolpresentedimprovedX-rayfilm.Patientsexposedtohighlevelofdustsshowedabout18.0%～36.0%ofimprovmentinX-rayfilm,while30.0%～67.0%ofthepatientsincontrolshowedprogresioninX-rayfilms,significantlyhigherthantreatedgroups(3.3%～13.3%).Therespiratorysymptomswerealsoimprovedinmasivewholelunglavagetreatmentbutnoimprove-mentfoundinX-rayfilms.Itisconcludedthatadministrationofcombinationofthedrugsshowedobvi-ousinhibitionontheprocessoffibrosisformationandimprovementofclinicalsymptoms,andlowersideefectthanTDdrugalone.

关 键 词：矽肺 汉防己甲素 羟基磷酸哌喹 克矽平 

分 类 号：R598.2[医药卫生—内科学] R974[医药卫生—临床医学]