参麦开肺散对系统性硬化症肺纤维化患者气道重塑指标及肺功能的影响  

Effects of Shenmai-kaifei powders on the indexes of airway remodeling and pulmonary function in systemic sclerosis patients with pulmonary fibrosis

作　　者：郭刚[1] 李小佼[2] 李慧云[1] 张海顺[1] 钟起诚[1] 

机构地区：[1]河北医科大学附属以岭医院风湿免疫科,河北石家庄050091 [2]河北医科大学附属以岭医院医学影像科,河北石家庄050091

出　　处：《河北中医》2016年第2期177-180,184,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:81270120);河北省中医药管理局2007年度科研课题计划(编号:2007140)

摘　　要：目的观察参麦开肺散治疗系统性硬化症(SSc)肺纤维化的临床疗效及对气道重塑指标和肺功能的影响。方法将60例SSc肺纤维化患者随机分为2组。2组均予基础常规治疗,治疗组30例另给予参麦开肺散治疗,对照组30例另给予罗红霉素、乙酰半胱氨酸治疗。2组均12周为1个疗程。观察2组治疗前后肺功能指标、血气分析指标、气道重塑指标变化情况,并统计评价临床疗效。结果治疗组总有效率93.30%,优于对照组(70.00%,P<0.05)。2组治疗后动脉血氧分压[p(O_2)]、p H、血氧饱和度(SaO_2)、深吸气量(IC)、第1 s用力呼气容积(FEV1)、用力肺活量(FVC)及FEV1/FVC均升高(P<0.05,P<0.01),二氧化碳分压[p(CO_2)]、透明质酸(HA)、层黏连蛋白(LN)及Ⅲ型前胶原(PCⅢ)均降低(P<0.05,P<0.01),且治疗组改善情况均优于对照组(P<0.05,P<0.01)。结论参麦开肺散治疗SSc肺纤维化患者可以明显改善其肺功能,并干预气道重塑,无明显不良反应,临床疗效显著。Objective To observe the clinical effects of Shenmai-kaifei powders on the treatment of systemic sclerosis（ SSc） combined with pulmonary fibrosis.Methods 60 SSc patients with pulmonary fibrosis were randomly divided into two groups.Both were given basic routine therapy.30 patients in treatment group were treated by Shenmai-kaifei powders.30 patients in control group were treated by roxithromycin and acetylcysteine.The treatment course was 12 weeks in two groups.The indexes of pulmonary function,blood gas analysis and airway remodeling before and after treatment were observed,and the clinical effects were statistically evaluated.Results The total effective rate in treatment group（ 93.30%） was superior to that in control group（ 70.00%,P〈0.05）.The arterial partial pressure of oxygen [p（ CO2） ],p H,blood oxygen saturation（ Sa O2）,inspiratory capacity（ IC）,forced expiratory volume 1 second（ FEV1）,forced expiratory volume（ FVC） and FEV1/FVC ratio after treatment were increased in two groups（ P〈0.05,P〈0.01）,and the partial pressure of CO2[p（ CO2） ],hyaluronic acid（ HA）,laminin（ LN） and procollagen type Ⅲ（ PCⅢ） were decreased（ P〈0.05,P〈0.01）.The improvements in treatment group was superior to those in control group（ P〈0.05,P〈0.01）.Conclusion Shenmai-kaifei powders can significantly improve the pulmonary function in SSc patients with pulmonary fibrosis,and intervene in airway remodeling,without obvious adverse reactions,have significant clinical effect.

关 键 词：人参 麦冬 硬皮病 系统性 肺疾病 间质性 中西医结合疗法 

分 类 号：R593.25[医药卫生—内科学] R563.058[医药卫生—临床医学]