加减麻杏薏甘汤治疗湿热阻滞型抗合成酶综合征患者的疗效观察  

Observation on Efficacy of Modified Maxingyigan Decoction in Treating Patients with Damp-Heat Stagnation Type Anti-Synthetase Syndrome

作　　者：张宗学[1] 焦以庆[1] 王玉光[1] ZHANG Zong-xue;JIAO Yi-qing;WANG Yu-guang(Beijing Hospital of Traditional Chinese Medicine,Beijing 100010)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《世界中西医结合杂志》2024年第11期2279-2283,2290,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：首都卫生发展科研专项项目(首发2020-2-2233);北京市属医院科研培育计划项目(PZ2020010)。

摘　　要：目的观察加减麻杏薏甘汤治疗湿热阻滞型抗合成酶综合征的疗效和安全性。方法选取2020年7月—2022年5月期间于首都医科大学附属北京中医医院呼吸科就诊的湿热阻滞型抗合成酶综合征患者120例,采用随机信封的方式,使用SAS 9.3编程,采取区组随机的方法,生成随机盲底。将患者按照1∶1的方式,分为对照组和治疗组,每组各60例。对照组采用原有小剂量激素加安慰剂,治疗组在原有小剂量激素基础上加用加减麻杏薏甘汤口服颗粒剂治疗,总疗程8周。观察比较两组患者临床疗效、不良反应情况,治疗前后肺功能用力肺活量(Forced vital capacity,FVC)、肺一氧化碳弥散功能(DLCO single-breath method,DLCO-sb)、莱斯特咳嗽评分表(The Leicester Cough Questionnaire,LCQ)、6 min步行试验(6-minute walking test,6MWT)步行距离、中医证候积分变化。结果治疗后治疗组肌无力、胸闷、喘息、咳嗽、咳痰、身体困重、皮疹、技工手中医证候评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组肌无力、胸闷、喘息、咳嗽、咳痰、身体困重、皮疹、技工手中医证候评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组6 min步行实验距离明显增加,差异有统计学意义(P<0.05);且治疗组6 min步行实验距离明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者FVC、DLCO-sb指标均较治疗前降低,差异有统计学意义(P<0.05);组间比较,差异无统计学意义(P>0.05)。治疗后治疗组咳嗽LCQ评分较治疗前明显升高,差异有统计学意义(P<0.05);且治疗组咳嗽LCQ评分明显高于对照组,差异有统计学意义(P<0.05)。治疗后治疗组临床总有效率90.00%(54/60)明显高于对照组70.20%(40/57),差异有统计学意义(P<0.05)。治疗期间,两组患者肝肾功能未见明显异常,无严重不良事件发生;两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。Objective To observe the efficacy and safety of modified Maxingyigan decoction in treating patients with damp-heat stagnation type anti-synthetase syndrome(ASS).Methods A total of 120 patients with damp-heat stagnation type ASS were treated at the Respiratory Department at Beijing Hospital of Traditional Chinese Medicine between July 2020 to May 2022 and were selected for the study.The random envelope method was employed,and block randomization was generated using SAS 9.3 programming to create a blinded random allocation.The patients were divided into a control group and a treatment group in a 1:1 ratio,with 60 patients in each group.The control group was treated with low-dose glucocorticoid plus placebo,while the treatment group was treated with low-dose glucocorticoid combined with modified Maxingyigan decoction granules.The total treatment course was 8 weeks.The clinical efficacy,adverse reactions,lung function[forced vital capacity(FVC),diffusing capacity of the lung for carbon monoxide(DLCO single-breath method,DLCO-sb)],Leicester cough questionnaire(LCQ)scores,6-minute walking test(6MWT)distance,and changes in traditional Chinese medicine(TCM)syndrome scores before and after treatment were observed and compared between the two groups.Results After treatment,TCM syndrome scores for muscle weakness,chest treatment。with statistically significant differences(P<0.05).These scores wene also significantly lower in the treatment group compared to the control group,with statistically significant difrences(P<0.05).The 6MWT distance significantly increased in the treatment group after treatment,with stistically significant diferences(P<0.05);the 6MWT distanoe in the treatment group was also significantly higher than in the contro group,with a staistically sigificant diference(P<0.05).Affter treatment,FVC and DLCO-sb values decreased in both groups compared to before treatment,with statistical-ly sigificant dfferences(P<0.05),but there was no stistically signifcant diference between the groups(P>0.05).LCQ scores for

关 键 词：特发性炎症性肌病 间质性肺疾病 抗合成酶综合征 

分 类 号：R593[医药卫生—内科学]