人参平肺方治疗特发性肺纤维化气阴不足、痰瘀互结证患者的回顾性队列研究  

A retrospective cohort study on treatment of idiopathic pulmonary fibrosis patients with Qi-Yin deficiency and phlegm-stasis binding syndrome with Ginseng Pingfei Decoction

作　　者：孙宇博 孙子凯[2] 朱益敏[3] 周贤梅[2] 范欣生[1] 主父瑶 严璐[3] 洪玲玲[1] SUN Yubo;SUN Zikai;ZHU Yimin;ZHOU Xianmei;FAN Xinsheng;ZHU Fuyao;YAN Lu;HONG Lingling(School of Traditional Chinese Medicine&Integrated Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu,China;Jiangsu Provincial Hospital of Chinese Medicine/The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China;The Second Jiangsu Provincial Hospital of Chinese medicine/The Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210017,Jiangsu,China)

机构地区：[1]南京中医药大学中医学院·中西医结合学院,江苏南京210023 [2]江苏省中医院/南京中医药大学附属医院,江苏南京210029 [3]江苏省第二中医院/南京中医药大学附属第二医院,江苏南京210017

出　　处：《现代中西医结合杂志》2021年第29期3212-3217,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：江苏省中药资源产业化过程协同创新中心重点课题(ZDXM-1-4,ZDXM-2020-22)。

摘　　要：目的回顾性分析研究人参平肺方对特发性肺纤维化气阴不足、痰瘀互结证患者肺功能、生活质量的影响。方法根据中医诊断标准,对2015年1月—2019年4月就诊于江苏省中医院、江苏省第二中医院的特发性肺纤维化气阴不足、痰瘀互结证患者临床资料进行回顾性队列研究,其中采用人参平肺方对症加减治疗的30例患者作为人参平肺方组,未使用中药治疗的15例患者作为非中药组,2组观察周期均为6个月。观察2组治疗前后中医症状量化积分、圣-乔治医院呼吸问题调查问卷(SGRQ)评分、肺功能[一氧化碳弥散量占预计值百分比(DLCO%)、用力肺活量占预计值百分比(FVC%)、第1秒用力呼气容积占用力肺活量的百分比(FEV_(1)/FVC%)]、复合生理指数(CPI)、肺部高分辨率CT(HRCT)灰度值及纤维化面积评分,记录2组疗效和治疗安全性。结果治疗6个月后,人参平肺方组咳嗽、喘息、气短、胸闷、痰量评分及总评分,SGRQ问卷中症状评分、疾病影响评分及总评分均明显低于非中药组(P均<0.05);2组DLCO%、FVC%、FEV_(1)/FVC/%均有不同程度下降,CPI指数均不同程度升高,但人参平肺方组各指标与治疗前比较差异均无统计学意义(P均>0.05),而人参平肺方组FVC%明显高于非中药组(P<0.05)、CPI指数明显低于非中药组(P<0.05);人参平肺方组患者HRCT灰度值及纤维化面积评分无明显变化,非中药组患者HRCT灰度值及纤维化面积评分较治疗前有增高趋势,但2组各指标组内及组间比较差异均无统计学意义(P均>0.05)。人参平肺方组症状总有效率为80%(24/30),非中药组为42.9%(6/14),人参平肺方组明显高于非中药组(P<0.05)。人参平肺方组患者治疗期间未见肝肾功能损害等不良反应,无急性加重事件发生;非中药组有3例患者出现肝肾功能轻度损伤,1例出现急性加重死亡。结论在常规治疗基础上应用人参平肺方能显著改善特发性肺纤维�Objective It is to retrospectively analyze and study the effects of Ginseng Pingfei Decoction on the lung function and quality of life of patients with idiopathic pulmonary fibrosis(IPF)with Qi-Yin deficiency syndrome and phlegm-stasis binding syndrome.Methods According to the diagnostic criteria of traditional Chinese medicine,the clinical data of patients with IPF with Qi-Yin deficiency syndrome and phlegm-stasis binding syndrome in Jiangsu Provincial Hospital of Chinese Medicine and Jiangsu Provincial Second Hospital of Traditional Chinese Medicine from January 2015 to April 2019 were retrospectively reviewed in a cohort study,30 patients treated with Ginseng Pingfei Decoction as Ginseng Pingfei Decoction group,and 15 patients who were not treated with Chinese medicine as non-Chinese medicine group.The observation period of both groups was 6 months.The quantitative scores of TCM symptoms,scores of St.George’s Hospital Respiratory Questionnaire(SGRQ),lung function[percentage of carbon monoxide diffusion as a percentage of predicted value(DLCO%),forced vital capacity as a percentage of predicted value(FVC%),forced expiratory volume in 1 second as a percentage of vital capacity(FEV_(1)/FVC%)],composite physiological index(CPI),pulmonary high-resolution CT(HRCT)gray value and fibrosis area score before and after treatment were observed in the two groups,and the therapeutic effects and treatment safety were recorded in the two groups.Results After 6 months of treatment,the scores of cough,wheezing,shortness of breath,chest tightness,sputum volume,sputum color and total score,symptom score,disease impact score and total score in the SGRQ questionnaire in the Ginseng Pingfei Decoction group were significantly lower than those in the non-Chinese medicine group(all P<0.05);the DLCO%,FVC%,FEV_(1)/FVC/%of the two groups were all decreased to different degrees,and the CPI index were increased to different degrees,but there was no statistically significant difference in the indicators of the Ginseng Pingfei Decoction gro

关 键 词：人参平肺方 特发性肺纤维化 气阴不足、痰瘀互结证 队列研究 

分 类 号：R563[医药卫生—呼吸系统]