清金化痰汤配合定向药透治疗肺结节的临床研究  

Clinical Study on Treatment of Pulmonary Nodules with Qingjin Huatan Decoction and Targeted Drug Penetration

作　　者：刘璐 高金柱[2] LIU Lu;GAO Jinzhu(Jining Traditional Chinese Medicine Hospital,Jining 272000,China;Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]山东省济宁市中医院,济宁272000 [2]中国中医科学院西苑医院,北京100091

出　　处：《世界中医药》2024年第24期3849-3854,共6页World Chinese Medicine

基　　金：国家自然科学基金项目(82074367)。

摘　　要：目的:探讨清金化痰汤配合定向药透治疗痰热型炎性磨玻璃型肺结节(GGN)的临床效果。方法:2022年1月至2023年3月济宁市中医院CT室明确诊断的GGN患者120例作为研究对象,由患者自行选择后续诊疗方案,据此将受试者分入对照组(定期影像学随访)和观察组(中医干预治疗),每组60例。对照组定期随访观察,观察组给予清金化痰汤配合定向药透治疗。分别于入组时、治疗2个疗程后,比较2组患者的GGN直径和密度、血清T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、白细胞介素2(IL-2)、白细胞介素10(IL-10)、肿瘤坏死因子-α(TNF-α)和γ干扰素(IFN-γ)水平。记录观察组不良反应。结果:2个疗程后,对照组患者GGN直径、密度,血清CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+),IL-2、IL-10、TNF-α、IFN-γ均未见明显变化(均P>0.05);观察组患者GGN直径、密度均减小,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)及IL-2均升高,CD8^(+)及IL-10、TNF-α、IFN-γ降低(均P<0.05);观察组患者GGN直径、密度均低于对照组,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)及IL-2均高于对照组,CD8^(+)及IL-10、TNF-α、IFN-γ低于对照组(均P<0.05)。观察组患者不良反应发生率为5.17%。结论:清金化痰汤配合定向药透治疗痰热型炎性磨玻璃型肺结节具有良好的效果,增强了免疫功能,抑制了炎症反应,缩小或逆转了结节,具有较高的安全性。Objective:To explore the clinical efficacy of Qingjin Huatan Decoction combined with targeted drug penetration in the treatment of inflammatory ground-glass nodules(GGN)of phlegm heat type.Methods:A total of 120 patients diagnosed with GGN in the computer tomography(CT)room of Jining Traditional Chinese Medicine Hospital from January 2022 to March 2023 were selected.According to the follow-up diagnosis and treatment plan selected by the patients themselves,the subjects were divided into the control group(regular imaging follow-up)and the observation group(traditional Chinese medicine(TCM)intervention),with 60 cases in each group.The patients in the control group were regularly followed up,while the patients in the observation group were treated with Qingjin Huatan Decoction combined with targeted drug penetration.At the time of enrollment and two courses after treatment,the diameter and density of GGN,serum T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)),interleukin-2(IL-2),IL-10,tumor necrosis factor-α(TNF-α),and interferon-γ(IFN-γ)were compared between the two groups.The adverse reactions in the observation group were recorded.Results:After two courses of treatment,there were no significant changes in the diameter and density of GGN,serum CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),IL-2,IL-10,TNF-α,and IFN-γin the control group(P>0.05).The diameter and density of GGN were decreased in the observation group,and the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and IL-2 were increased,yet CD8^(+),IL-10,TNF-α,and IFN-γwere decreased(P<0.05).The diameter and density of GGN in the observation group were lower than those in the control group,and the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and IL-2 were higher than those in the control group.The levels of CD8^(+),IL-10,TNF-α,and IFN-γwere lower than those in the control group(P<0.05).The adverse reaction rate was 5.17%in the observation group.Conclusion:Qingjin Huatan Decoction combined with targeted drug penetration has a good effect in the trea

关 键 词：肺结节 磨玻璃结节(GGN) 痰热型 清金化痰汤 定向药透 中医 免疫功能 炎症 

分 类 号：R256.19[医药卫生—中医内科学]