清肺化瘀汤对间质性肺疾病患者肺功能、气道炎症反应、血清KL-6水平的影响  

Influence of Qingfei Huayu Decoction(清肺化瘀汤)on Lung Function,Airway Inflammatory Response and Serum KL-6 level in Patients with Interstitial Lung Disease

作　　者：李峻[1] 陈明[1] LI Jun;CHEN Ming(Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《辽宁中医杂志》2025年第3期104-107,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：北京市自然科学基金项目(7072046)。

摘　　要：目的观察间质性肺疾病(interstitial lung disease,ILD)患者采用清肺化瘀汤治疗后对患者肺功能、气道炎症和Ⅱ型肺泡细胞表面抗原(kerbs von lungren 6 antigen,KL-6)水平的影响。方法纳入2021年5月—2024年5月该院收治的ILD患者106例,随机均分为两组。西医组53例,给予镇咳、氧支持及肺康复等综合治疗,研究组则在此基础上加用清肺化瘀汤治疗,观察治疗后患者中医证候、肺功能、气道炎症反应、血清KL-6、转化生长因子-β1(transforming growth factor-β1,TGF-β1)水平的变化。结果治疗后,两组咳嗽、咳痰、喘促、面唇紫黯评分明显下降,研究组咳嗽、咳痰、喘促、面唇紫黯评分明显低于西医组(P<0.05),两组治疗前后第1秒用力肺活量(first second forced vital capacity,FEV1)、一氧化碳弥散量(diffusion capacity of carbon monoxide,DLCO)占预计值百分比变化差异无统计学意义(P>0.05),两组间患者FEV1、DLCO水平差异无统计学意义(P>0.05);两组在治疗1、3周一氧化氮(nitric oxide,NO)水平差异有统计学意义(P>0.05),研究组与西医组比较,治疗1、3周的NO水平较低(P<0.05),且研究组治疗后NO水平降低趋势较西医组差异有统计学意义(P<0.05);两组治疗后KL-6、TGF-β1明显下降(P<0.05),且研究组KL-6、TGF-β1水平明显低于西医组(P<0.05),两组治疗安全性差异无统计学意义(P>0.05)。结论ILD患者采用清肺化瘀汤治疗能有效促进症状进一步缓解,并能通过抑制NO、KL-6、TGF-β1水平来控制炎症和纤维化的发展。Objective To observe the influence on lung function,airway inflammatory response and kerbs von lungren 6 antigen(KL-6)in patients with interstitial lung disease(ILD)after treatment with Qingfei Huayu Decoction(清肺化瘀汤).Methods A total of 106 patients with ILD in the hospital were included from May 2021 to May 2024,and were randomly divided into two groups,53 cases in each group.The patients in the conventional western medicine group were given comprehensive treatments such as cough relief,oxygen support and pulmonary rehabilitation,and on this basis,those in the study group were additionally treated with Qingfei Huayu Decoction.The changes in TCM syndromes,lung function,airway inflammatory response[nitric oxide(NO),matrix metalloproteinase-9(MMP-9)],serum KL-6 and transforming growth factor-β1(TGF-β1)were observed after treatment.Results After treatment,the scores of cough,expectoration,shortness of breath and purplish darkness of face and lip in the two groups were decreased significantly,and the above scores in the study group were significantly lower than those in the western medicine group(P<0.05).There were no obvious differences in FEV1 or DLCO in the two groups before and after treatment(P>0.05),and no significant differences were shown between groups(P>0.05).The levels of NO,MMP-9,KL-6 and TGF-β1 in both groups after treatment were significantly declined(P<0.05),and the levels were significantly lower in the study group than those in the western medicine group(P<0.05).The treatment safety was not obviously different between both groups(P>0.05).Conclusion Qingfei Huayu Decoction for ILD patients can effectively promote the further relief of symptoms,and can control the development of inflammation and fibrosis by inhibiting the levels of NO,KL-6 and TGF-β1.

关 键 词：间质性肺疾病 清肺化瘀汤 肺功能 炎症 Ⅱ型肺泡细胞表面抗原 

分 类 号：R259[医药卫生—中西医结合]