止咳化痰汤联合糖皮质激素治疗特发性肺间质纤维化疗效分析  

Effect Observation of Zhike Huatan Decoction Combined with Glucocorticoid on Idiopathic Pulmonary Fibrosis

作　　者：薛晓彤 姚凤 张元君 Xue Xiaotong;Yao Feng;Zhang Yuanjun(Integrated Traditional Chinese and W estern medicine for pulmonary diseases of the Shandong Taishan H ospital,Taian 271000)

机构地区：[1]山东省泰山医院中西医结合肺病科,泰安271000

出　　处：《中药药理与临床》2020年第3期219-223,共5页Pharmacology and Clinics of Chinese Materia Medica

基　　金：山东省泰安市科学技术局科技计划项目(编号:2016NS1212)。

摘　　要：目的:探讨自拟止咳化痰汤联合糖皮质激素治疗特发性肺间质纤维化的临床疗效。方法:选取本院入住的112例特发性肺间质纤维化患者,随机分为观察组和对照组,观察组采用自拟止咳化痰汤+常规糖皮质激素治疗(60例);对照组采用常规糖皮质激素治疗(52例)。对照组患者接受常规的糖皮质激素治疗;疗程均为6个月。治疗前和疗程结束后对2组患者的肺功能指标、肺高辨率CT、血气分析指标、肺纤维化指标和治疗效果进行检测和评估,并对治疗期间不良反应发生和常规性检测指标进行比较。结果:治疗前,两组患者的肺功能指标、肺高辨率CT情况、血气分析指标、肺纤维化指标和中医证候评分均无显著性差异(P﹥0.05);与治疗前比较,治疗后两组在肺通气功能(FEV1、FVC和PEF)、HRCT情况(网格影、斑片影)、血气分析指标[Pa(O)2、Pa(CO)2、SaO2、HCO3和pH]、血清肺纤维化指标(Ⅳ-C、Ⅲ-C和HA)和中医证候评分(气喘、汗出乏力、口干口渴)均有明显改善(P<0.05),与对照组比较,观察组上述指标改善情况明显优于同期对照组(P<0.05);观察组和对照组的不良反应发生率无显著性差异(P>0.05)。结论:在糖皮质激素治疗特发性肺间质纤维化患者的基础上,联合自拟止咳化痰汤治疗,临床疗效确切,安全性较高,可作为特发性肺间质纤维化疾病的优选治疗方案。Objective:To explore the clinical result of Self-made zhikehuatan decoction combined with Glucocorticoid in the treatment of Idiopathic Pulmonary Fibrosis disease.Methods:112 patients with idiopathic pulmonary interstitial fibrosis admitted to our hospital were seleted and randomly divided into the observation group and the control group.The patients in the observation group were treated with Zhike Huatan Decoction+conventional glucocorticoid(60 cases),while those in the control group were treated with conventional glucocorticoid(52 cases).Patients in both groups received therapy for 6 months.Before and after the treatment,the pulmonary function index,lung high resolution CT,blood-gas analysis index,pulmonary fibrosis index and therapeutic effect in the two groups were tested and evaluated.The adverse reactions during treatment and the routine detection index were compared.Results:Before treatment,the pulmonary function index,lung high resolution CT,blood gas analysis index,pulmonary fibrosis index and TCM symptom score showed no significant differences between the two groups(P>0.05).After treatment,the lung ventilation function(FEV1、FVC和PEF),HRCT(grid shadow,patchy shadow),blood gas analysis index(PaO2,PaCO2,SaO2,HCO3 and pH),serum pulmonary fibrosis index(IV-C,III-C and HA)and TCM symptom score(asthma,sweating fatigue,thirst)were significantly improved in both groups(P<0.05),while they in the observation group showed more significant difference than those in the control group(P<0.05).The adverse reaction rate showed no significant difference between the two groups(P>0.05).Conclusion:Based on glucocorticoid therapy for patients with idiopathic pulmonary interstitial fibrosis,self-made Zhike Huatan Decoction is combined with it,which shows definite clinical efficacy and high safety,and can be used as an optimal treatment for idiopathic pulmonary interstitial fibrosis.

关 键 词：止咳化痰汤 糖皮质激素 特发性肺间质纤维化 肺通气功能 纤维化相关指标 血气分析 

分 类 号：R563.9[医药卫生—呼吸系统]