汉防己甲素与克矽平联合治疗矽肺远期疗效观察  

The Long-term Effects of Combination Therapy with Tetrandrine and PVNO in Silicosis Patients

作　　者：周泽深[1] 王飞云[1] 胡一本[1] 孙金礼[1] 孙文灏[1] 彭娟娟[1] 闻军[1] 胡天锡[1] 李学祯 蔡铁安 谷圣常 

机构地区：[1]上海市职业病医院,上海200433 [2]鲁中冶金矿山公司职工医院,山东271113

出　　处：《环境与职业医学》2002年第2期116-119,共4页Journal of Environmental and Occupational Medicine

基　　金：国家科学技术委员会"九.五"科技攻关项目 (编号 :96 90 6 0 4 1 0 )

摘　　要：[目的 ]病人按国家“八·五”课题《矽肺治疗措施及效果评价研究》的汉防己甲素和克矽平联合治疗矽肺的方案治疗 2年后 ,停药 1年 ,继续进行治疗并观察远期疗效。 [方法 ]根据 3 0例矽肺病人胸片的读片结果分成全量复治组 (简称全量组 ) 6例 ,维持量组 (简称维量组 ) 6例 ,继续停药观察组 (简称停药组 ) 7例和对照组 11例。全量组 :以汉防己甲素 2 0 0mg/d ,每周服药 6d ;1%克矽平 14 4ml在纤维支气管镜直视下滴注 ,每年滴注一次。维量组 :汉防己甲素 3 0 0mg/周 ,每周一分 3次口服。停药组和对照组 :口服安慰剂 4片 ,每周一口服。每 3个月为一疗程 ,停药 1个月再进行下一疗程 ,共进行 6个疗程 (2年 )的继续治疗观察。 [结果 ]全量组和维量组的症状好转率较停药组和对照组高 ,尤其是呼吸困难症状。X线胸片全量组有明显好转病例 2例 ,有进展的病例也较其他组少。好转病例仍集中在过去接触高浓度矽尘的病例。停药后病变出现反跳的经继续用药 ,可以好转。不良反应较轻。 [结论 ]汉防己甲素和克矽平联合用药治疗矽肺可提高疗效 。Studying the long term curative effects on the silicosis patients treated previously first in according to the national '8·15' project 'Studying on Therapy Method and Curative Effects for Silicosis of Combination Therapy with tetrandrine(TT) and polyvinylpyridine N oxide(PVNO)'for two years,then stopping therapy for one year and then continueing therapy again. All these patients were divided into four groups according to the chest X ray result:①original dosage group:TT 200 mg/day,6 days per week;1% PVNO 144 ml was dropped into bronchi through fibro bronchiendoscope,once a year. ②continuous dosage group:TT 100 mg 3 times per day,one day per week. ③therapy ceased group and ④control group:take 4 placebo tablets,once a week. A course of treatment takes three months and with one month interval between two courses,alltogether six courses carried out during two years. It was higher that the symptoms mended in the first and second group,especially for the symptom of dyspnea. There was significant improvement on chest X ray film for 2 cases in the first group. Number of cases with advancing of disease in the first group are less than that in other three groups. Improved cases were concentrated in heavily exposed group. Patients condition was improved after medical therapy again,if his condition was rebound after interrupted therapy. The side effect and toxicity of this kind of therapy is light. [Conclusion] Tetrandrine and PVNO in combination for silicosis therapy have better currative effects and lower adverse effects.

关 键 词：矽肺 汉防己甲素 克矽平 治疗 

分 类 号：R135.2[医药卫生—劳动卫生]