双龙抗纤胶囊对结缔组织病相关肺纤维化患者血清KL-6及T淋巴细胞亚群的影响  

Effect of Shuanglong Antifibrin Capsule on KL-6 and T lymphocyte subsets in patients with connective tissue disease associated with pulmonary fibrosis

作　　者：钮含春[1] 李晓云[1] 白明明 祁腾飞 王晓军[1] NIU Hanchun;LI Xiaoyun;BAI Mingming;QI Tengfei;WANG Xiaojun(Department of Rheumatology,Pingan Hospital Affiliated to Hebei Medical University,Shijiazhuang,Hebei 050021,China;Department of Experimental Diagnostics,Pingan Hospital Affiliated to Hebei Medical University,Shijiazhuang,Hebei 050021,China)

机构地区：[1]河北医科大学附属石家庄平安医院风湿病科,河北石家庄050021 [2]河北医科大学附属石家庄平安医院实验诊断学部,河北石家庄050021

出　　处：《上海中医药杂志》2021年第5期41-45,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2019423)。

摘　　要：目的观察双龙抗纤胶囊对结缔组织病相关肺纤维化患者血清涎液化糖链抗原(KL-6)及外周血T淋巴细胞亚群的影响。方法将80例结缔组织病相关肺纤维化患者随机分为治疗组和对照组,每组40例。两组均给予基础治疗,治疗组加用双龙抗纤胶囊,对照组加用安慰剂。两组疗程均为12周,观察中医证候积分、肺部高分辨CT评分,以及血清KL-6和外周血T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平的变化情况。结果 (1)治疗过程中,治疗组、对照组各脱落2例,完成试验者两组各38例。(2)治疗前后组内比较,两组中医证候积分、血清KL-6水平均降低(P<0.05),肺部高分辨CT评分无明显变化(P>0.05);组间治疗后比较,治疗组中医证候积分、血清KL-6水平均低于对照组(P<0.05),肺部高分辨CT评分比较差异无统计学意义(P>0.05)。(3)治疗前后组内比较,治疗组CD4^(+)T淋巴细胞、CD4^(+)/CD8^(+)均升高(P<0.05),CD8^(+) T淋巴细胞明显下降(P<0.05),对照组CD4^(+)T淋巴细胞、CD8^(+) T淋巴细胞、CD4^(+)/CD8^(+)均无明显变化(P>0.05);组间治疗后比较,治疗组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平均优于对照组(P<0.05)。结论双龙抗纤胶囊治疗结缔组织病相关肺纤维化有一定疗效,其机制可能与降低肺泡Ⅱ型上皮细胞分泌KL-6,提高外周血CD4^(+)T淋巴细胞、降低CD8^(+)T淋巴细胞水平,改善细胞免疫有关。Objective To observe the efficacy of Shuanglong Antifiber Capsule(SAC) in patients with connective tissue disease associated with pulmonary fibrosis and its effect on serum KL-6 and T lymphocyte subsets in peripheral blood. Methods A total of 80 patients with pulmonary fibrosis in connective tissue disease were randomly divided into treatment group and control group, 40 cases in each group. On the basic treatment, the treatment group was treated with SAC, and the control group was treated with placebo. The treatment course was 12 weeks. The TCM syndrome score, high resolution CT(HRCT) score, peripheral blood T lymphocyte subsets(CD4^(+), CD8^(+)) levels and serum levels of KL-6 were compared between the two groups. Results(1)During the treatment, 2 cases were lost and 38 cases were completed the experiment in each group.(2)After treatment, the TCM syndrome scores and serum KL-6 level of both groups were decreased(P<0.05), but the HRCT scores of both groups were no significant changes(P>0.05). The TCM syndrome scores and serum KL-6 level in the treatment group were lower than those in the control group(P<0.05).But the HRCT scores were no statistical difference between the two groups(P>0.05).(3)After treatment, CD4^(+)T lymphocytes and CD4^(+)/CD8^(+) in the treatment group were increased(P<0.05), and CD8^(+) T lymphocytes were decreased(P<0.05), while there were no significant changes in CD4^(+)T lymphocytes, CD8^(+) T lymphocytes and CD4^(+)/CD8^(+) in the control group(P>0.05).After treatment, CD4^(+)T lymphocytes, CD8^(+)T lymphocytes and CD4^(+)/CD8^(+) in the treatment group were better than those in the control group(P<0.05). Conclusions SAC had good efficacy in the treatment of connective tissue disease associated with pulmonary fibrosis. The mechanism might be associated with the decreased expression of KL-6 which secreted by alveolar epithelial cells Ⅱ.In addition,SAC could improve CD4^(+)T lymphocytes and decrease CD8^(+)T lymphocytes of the peripheral blood to adjust cellular immunity.

关 键 词：双龙抗纤胶囊 结缔组织病 肺纤维化 KL-6 T淋巴细胞亚群 临床观察 

分 类 号：R563[医药卫生—呼吸系统]