木防己汤加味方联合中药离子导入治疗气虚痰瘀型弥漫性肺间质纤维化临床研究  

Clinical Study on Modified Mufangji Tang and Chinese Herbs Iontophoresis for Diffuse Pulmonary Interstitial Fibrosis of Qi Deficiency and Phlegm-Stasis Type

作　　者：宋东升[1] 周庆伟[1] 崔伟锋[1] SONG Dongsheng;ZHOU Qingwei;CUI Weifeng

机构地区：[1]河南中医药大学第一附属医院,河南郑州451199

出　　处：《新中医》2022年第12期60-65,共6页New Chinese Medicine

摘　　要：目的:观察木防己汤加味方联合中药离子导入治疗气虚痰瘀型弥漫性肺间质纤维化的临床疗效。方法:将60例弥漫性肺间质纤维化患者随机分为观察组和对照组各30例。对照组在抗菌、对症支持治疗的基础上给予强的松片口服,观察组在对照组的基础上给予木防己汤加味方联合中药离子导入治疗。2组均连续治疗4周。观察治疗后2组患者临床疗效,治疗前后中医证候积分、肺功能[用力肺活量(FVC)、FEV_(1)占预计值百分比(FEV_(1)%)、一氧化碳弥散量(DLCO)、氧分压(PO_(2))]、全血白细胞、中性粒细胞、嗜酸性粒细胞、血管内皮生长因子(VEGF)及肺泡灌洗液中肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平。结果:治疗后,观察组总有效率为90.00%,对照组为56.67%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组中医证候积分比较,差异无统计学意义(P>0.05);治疗后,2组中医证候积分均显著低于治疗前(P<0.05),且观察组中医证候积分显著低于对照组(P<0.05)。治疗前,2组肺功能指标FVC、FEV_(1)%、DLCO、PO_(2)水平比较,差异无统计学意义(P>0.05);治疗后,2组上述肺功能指标均较治疗前明显改善(P<0.05),且观察组各项指标改善较对照组更显著(P<0.05)。治疗期间,2组血液白细胞、中性粒细胞、嗜酸性粒细胞水平治疗前后比较,差异无统计学意义(P>0.05)。治疗前,2组血清VEGF值比较,差异无统计学意义(P>0.05);治疗后,观察组血清VEGF水平较治疗前降低,且低于对照组(P<0.05);而对照组VEGF水平则与治疗前差异不太(P>0.05)。治疗前,2组TNF-α、IL-1β、IL-6水平比较,差异无统计学意义(P>0.05);治疗后,2组TNF-α、IL-1β、IL-6水平均较治疗前降低(P<0.05),且观察组TNF-α、IL-1β、IL-6水平均低于对照组(P<0.05)。结论:在常规治疗的基础上采用木防己汤加味方及中药离子导入治疗气虚痰瘀型弥漫性肺间质纤维Objective:To observe the clinical effect of the therapy of modified Mufangji tang and Chinese herbs iontophoresis on diffuse pulmonary interstitial fibrosis of qi deficiency and phlegm-stasis type.Methods:A total of 60 patients with diffuse pulmonary interstitial fibrosis were randomly divided into the observation group and the control group,with 30cases in each group.The control group was orally given prednisone tablets based on the antibacterial and symptomatic supportive treatment,and the observation group was additionally given the therapy of modified Mufangji tang and Chinese herbs iontophoresis based on the treatment of the control group.Both groups were treated for four weeks.The clinical effects in the two groups after treatment,and the Chinese medicine syndrome scores,levels of lung function indexes including forced vital capacity(FVC),the percentage of FEV_(1) to evaluated value(FEV_(1)%),diffusing capacity of the lungs for carbon monoxide(DLCO)and oxygen partial pressure(PO_(2)),whole blood leukocytes,neutrophils,eosinophils,vascular endothelia growth factor(VEGF),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and interleukin-6(IL-6)in alveolar lavage fluid before and after treatment were observed.Results:After treatment,the total effective rate was 90.00%in the observation group and 56.67%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference in Chinese medicine syndrome scores between the two groups(P>0.05).After treatment,the Chinese medicine syndrome scores in both groups were significantly lower than those before treatment(P<0.05),and the score in the observation group was significantly lower than that in the control group(P<0.05).Before treatment,there was no significant difference in the levels of FVC,FEV_(1)%,DLCO and PO_(2)between the two groups(P>0.05).After treatment,the improvement of the above lung function indexes in both groups was better than that before treatment(P<0.05),and the improvement of the above indexes in the

关 键 词：弥漫性肺间质纤维化 气虚痰瘀 木防己汤加味方 中药离子导入 强的松片 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]