芪术肺纤汤对特发性肺间质纤维化患者血清KL-6水平和肺功能影响的疗效观察  

Effect of Qizhu Feixian Decoction on Serum KL-6 Level and Lung Function in Patients with Idiopathic Pulmonary Fibrosis

作　　者：张雯静 尹建坤 李萌[1] 李辉[1] 李光熙[1] 王秋铭 高扬[1] 刘世刚[1] 李国勤(指导)[1] ZHANG Wenjing;YIN Jiankun;LI Meng(Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing(100053),China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《浙江中医药大学学报》2023年第11期1323-1329,共7页Journal of Zhejiang Chinese Medical University

基　　金：国家自然科学基金青年项目(82004347);中央本级重大增减支项目(2060302)。

摘　　要：[目的]探讨芪术肺纤汤对特发性肺间质纤维化(idiopathic pulmonary fibrosis,IPF)患者血清涎液化糖链抗原6(Krebs Von Den Lungen-6,KL-6)水平和肺功能的影响。[方法]搜集2019年10月1日至2021年12月31日于中国中医科学院广安门医院就诊的IPF患者40例,分为试验组和对照组各20例,对照组口服乙酰半胱氨酸胶囊加百令胶囊,试验组在此基础上加用芪术肺纤汤,3个月后观察两组患者治疗前后肺功能、中医症状积分、血清KL-6水平变化及不良反应。[结果]与治疗前比较,治疗后试验组最大肺活量占预计值的百分比(vital capacity max/predict value,VCmax%)、一氧化碳弥散量占预计值的百分比(carbon monoxide diffusing capacity/predict value,DLCO%)及肺总量占预计值的百分比(total lung capacity/predict value,TLC%)均上升,TLC%差异有统计学意义(P<0.05);对照组TLC%、DLCO%及VCmax%均下降,且VCmax%差异有统计学意义(P<0.01)。治疗后组间比较,试验组VCmax%、TLC%和DLCO%均高于对照组,且DLCO%差异有统计学意义(P<0.01)。与治疗前比较,治疗后两组患者中医症状总积分、主症总积分及次症总积分均较前下降(P<0.01,P<0.05)。其中试验组主症喘息、气短、咳痰积分及次症乏力积分均较前显著下降(P<0.01,P<0.05),对照组仅主症气短积分显著下降(P<0.05),余如喘息、咳嗽、咳痰、乏力等症状积分略有下降,差异无统计学意义(P>0.05)。治疗后组间比较,试验组症状总积分、主症总积分、主症喘息、气短、咳嗽积分显著低于对照组,差异具有统计学意义(P<0.01,P<0.05)。与治疗前比较,治疗后试验组血清KL-6水平下降,但差异无统计学意义(P>0.05);对照组血清KL-6水平上升(P<0.01)。治疗后组间比较,试验组血清KL-6水平明显低于对照组,差异具有统计学意义(P<0.05)。两组患者均无不良反应发生。[结论]芪术肺纤汤可提高IPF患者肺功能,显著升高DLCO%指标,改善喘息气短、咳痰[Objective]To investigate the effects of Qizhu Feixian Decoction on serum Krebs Von Den Lungen-6(KL-6)level,and lung function in patients with idiopathic pulmonary fibrosis(IPF).[Methods]A total of 40 patients with IPF admitted to the Guang’anmen Hospital of Chinese Academy of Chinese Medical Sciences from October 1,2019,to December 31,2021 were selected,and the patients were split into 2 groups.The control group was treated with Acetylcysteine Capsules and Bailing Capsules,and the trial group was treated with Qizhu Feixian Decoction based on the former.After 3 months of treatment,the lung function,the traditional Chinese medicine(TCM)syndrome scores,serum KL-6 level and adverse reactions were contrasted between the two groups.[Results]After treatment,the vital capacity max/predict value(VCmax%),carbon monoxide diffusing capacity/predict value(DLCO%)and total lung capacity/predict value(TLC%)in trial group were significantly higher than those before treatment,the difference in TLC%was statistically significant(P<0.05),while the TLC%,DLCO%and VCmax%in control group were lower than those before treatment,and VCmax%had significant difference(P<0.01).After treatment,VCmax%,TLC%and DLCO%in the trial group were higher than those in control group,and DLCO%had significant difference(P<0.01).Compared with before treatment,the total scores of TCM symptoms,main symptoms and minor symptoms in both groups decreased(P<0.01,P<0.05).The scores of wheezing,shortness of breath,expectoration and fatigue were remarkably decreased in trial group(P<0.01,P<0.05),but only the scores of shortness of breath were remarkably decreased in control group(P<0.05),the scores of other symptoms such as wheezing,cough,expectoration and fatigue decreased slightly(P>0.05).After treatment,the total scores of symptoms,main symptoms,main symptoms of wheezing,shortness of breath and cough in trial group were remarkably lower than those in control group,and the difference was statistically significant(P<0.01,P<0.05).After treatment,the serum KL-6 level

关 键 词：芪术肺纤汤 特发性肺间质纤维化 KL-6 肺功能 临床疗效 李国勤 

分 类 号：R273[医药卫生—中西医结合]