补肺化纤饮加减联合泼尼松对特发性肺纤维化患者的治疗效果研究  

Effect of Bufei Huaxian Decoction combined with prednisone on idiopathic pulmonary fibrosis

作　　者：贾丹[1] 唐明文[1] 余燕[1] 周游 熊广[1] 张小瑾 陈生[1] JIA Dan;TANG Ming-wen;YU Yan;ZHOU You;XIONG Guang;ZHANG Xiao-jin;CHEN Sheng(Department of Respiratory Diseases, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong 518000, China;Department of Respiratory Diseases, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510080, China)

机构地区：[1]深圳市中医院呼吸病科,广东深圳518000 [2]广州中医药大学第一附属医院呼吸病科,广东广州510080

出　　处：《海南医学院学报》2019年第24期1864-1868,共5页Journal of Hainan Medical University

基　　金：广东省中医药局科研项目(20171246);深圳市“医疗卫生三名工程”项目(编号:SZSM201812063)~~

摘　　要：目的探究补肺化纤饮加减联合泼尼松对特发性肺纤维化患者的治疗效果。方法选取2018年1月~2019年1月于深圳市中医院接受治疗的特发性肺纤维化患者80例,随机分为泼尼松组、联合组,各40例,泼尼松组患者使用泼尼松进行治疗,联合组患者使用补肺化纤饮加减联合泼尼松进行治疗。对肺功能指标最大呼气流量(PEF)、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)水平进行检测,酶联免疫吸附实验法检测透明质酸酶(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、转化生长因子-β1(TGF-β1)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平,免疫透射比浊法检测谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平,对比两组患者T淋巴细胞亚群水平及治疗效果。结果治疗后联合组患者PEF、FEV1、FVC水平均高于泼尼松组(P<0.05)。治疗后联合组患者HA、LN、PC-Ⅲ水平均低于泼尼松组(P<0.05)。治疗后联合组患者血清TGF-β1、hs-CRP、TNF-α水平均低于泼尼松组(P<0.05)。治疗后联合组患者血清GSH-Px、SOD水平高于泼尼松组,MDA水平低于泼尼松组(P<0.05)。治疗后联合组患者治疗后CD8+水平低于泼尼松组,CD4+、CD3+水平高于泼尼松组(P<0.05)。联合组患者治疗总有效率95.00%高于泼尼松组80.00%(P<0.05)。结论使用补肺化纤饮加减联合泼尼松对特发性肺纤维化患者进行治疗,能够改善患者肺功能,减轻患者肺纤维化严重程度,提升患者抗氧化能力及免疫功能,治疗效果显著。Objective To explore the therapeutic effect of Bufei Huaxian Decoction combined with prednisone on patients with idiopathic pulmonary fibrosis.Methods A total of 80 patients with idiopathic pulmonary fibrosis treated in our hospital from January 2018 to January 2019 were randomly divided into prednisone group and combination group,40 cases in each group.Prednisone group was treated with prednisone,while combination group received Bufei Huaxian Decoction and prednisone.Maximum expiratory flow(PEF),forced expiratory volume(FEV1)and forced vital capacity(FVC)were measured.Hyaluronidase(HA),laminin(LN),procollagen type III(PCⅢ),transforming growth factor-β1(TGF-β1),hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor alpha(TNF-α)were detected by enzyme-linked immunosorbent assay(ELISA).In addition,the levels of glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),and malondialdehyde(MDA)were measured by immunoturbidimetry.The levels of T lymphocyte subsets and therapeutic effects were compared between the two groups.Results After treatment,the levels of PEF,FEV1 and FVC in the combination group were higher than those in the prednisone group(P<0.05),whereas,the levels of HA,LN and PC-Ⅲin the combination group were lower than those in the prednisone group(P<0.05).Moreover,the levels of serum TGF-β1,hs-CRP and TNF-αin the combination group were lower than those in the prednisone group(P<0.05)while serum GSH-Px and SOD levels were higher than those in the prednisone group with lower MDA levels(P<0.05).The combination group showed lower levels of CD8+,and higher levels of CD4+and CD3+compared with prednisone group(P<0.05).In addition,the total effective rate of the combination group was 95.00%,which was higher than 80.00%of prednisone group(P<0.05).Conclusion Bufei Huaxian Decoction combined with prednisone can improve the pulmonary function of patients with idiopathic pulmonary fibrosis,reduce the severity of pulmonary fibrosis,and enhance the antioxidant capacity and immune function of patient

关 键 词：泼尼松 特发性肺纤维化 肺功能 免疫功能 

分 类 号：R563[医药卫生—呼吸系统]