益气通络法联合吡非尼酮治疗肺络闭阻证特发性肺纤维化患者临床研究  

Clinical study of Yiqi Tongluo method combined with pirfenidone in the treatment of patients with idiopathic pulmonary fibrosis with pulmonary collateral obstruction syndrome

作　　者：张秀芳[1] 王丽[1] 陈景行[1] ZHANG Xiufang;WANG Li;CHEN Jingxing(Department of Respiratory and Critical Care Medicine,Anyang People's Hospital,Anyang,Henan,China,455000)

机构地区：[1]安阳市人民医院呼吸与危重症医学科,河南安阳455000

出　　处：《分子诊断与治疗杂志》2022年第6期975-978,982,共5页Journal of Molecular Diagnostics and Therapy

基　　金：白求恩·医学科学研究基金(SCZ029AN)。

摘　　要：目的 探究益气通络法联合吡非尼酮对特发性肺纤维化(IPF)患者氧化应激反应及血清血管内皮生长因子(VEGF)、白细胞介素-13(IL-13)水平的影响。方法 选取2018年1月至2020年2月安阳市人民医院129例IPF患者,简单随机化分3组,各43例。对照A组予以吡非尼酮治疗,对照B组予以益气通络法治疗,观察组C组予以益气通络法联合吡非尼酮治疗。对比3组临床疗效及治疗前、治疗6周后、12周后中医证候积分与生理(CRP)评分、血清Ⅲ型胶原(Ⅲ-C)、四型胶原(IV-C)、丙二醛(MDA)、超氧化物歧化酶(SOD)、VEGF、IL-13水平。结果 观察组临床治疗总有效率高于对照A、B组,差异有统计学意义(χ^(2)=6.649,P<0.05);治疗6周后、12周后,观察组中医证候积分、CRP评分低于对照A、B组,差异有统计学意义(P<0.05);治疗6周后、12周后观察组Ⅲ-C、IV-C、MDA、VEGF、IL-13水平低于对照A、B组,SOD水平高于对照A、B组,差异有统计学意义(P<0.05),对照A组Ⅲ-C、IV-C、MDA、VEGF、IL-13水平低于对照B组,SOD水平高于对照B组,差异有统计学意义(P<0.05)。结论 益气通络法联合吡非尼酮治疗IPF,可显著改善患者肺纤维化,降低氧化应激反应及血清VEGF、IL-13水平,进一步提高治疗效果。Objective To explore the effect of Yiqi Tongluo method combined with pirfenidone on oxidative stress response and serum vascular endothelial growth factor(VEGF)and interleukin-13(IL-13)levels in patients with idiopathic pulmonary fibrosis(IPF). Methods A total of 129 patients with IPF in our hospital from January 2018 to February 2020 were selected and grouped by simple randomization,with 43 cases in each group. The control group A was treated with pirfenidone,the control group B was treated with Yiqi Tongluo method,and the observation group was treated with Yiqi Tongluo method combined with pirfenidone.The clinical efficacy and TCM syndrome scores and physiology(CRP)scores,serum type Ⅲcollagen(Ⅲ-C),type IV collagen(Ⅳ-C),hyaluronic acid(HA),malondialdehyde(MDA),superoxide dismutase(SOD),VEGF,IL-13 levels,and peripheral blood T lymphocyte subsets were compared among the three groups before treatment,6 weeks and 12 weeks after treatment. Results The total effective rate of clinical treatment in the observation group was higher than that in the control groups A and B,and the difference was statistically significant(P<0.05). Compared with the control groups A and B,the difference was not statistically significant(P>0.05). After 6 weeks and 12 weeks of treatment,the TCM syndrome scores and CRP scores in the observation group were lower than those in the control groups A and B,and the differences were statistically sig-nificant(P<0.05). After 6 weeks and 12 weeks of treatment,the levels of Ⅲ-C,Ⅳ-C,MDA,VEGF and IL-13 in the observation group were lower than those in the control groups A and B,and the SOD levels were higher than those in the control groups A and B,and the differences were statistically significant(P<0.05).The levels of Ⅲ-C,Ⅳ-C,MDA,VEGF,and IL-13 in control group A were lower than those in control group B,and the SOD level was higher than that in control group B,and the differences were statistically significant(P<0.05). After 6 weeks and 12 weeks of treatment,the levels of CD4+and CD4+/CD8+

关 键 词：特发性肺纤维化 益气通络法 吡非尼酮 氧化应激 VEGF IL-13 

分 类 号：R563[医药卫生—呼吸系统]