补肺缓纤汤治疗特发性肺间质纤维化对FSTL1、Syndecan-1及肺纤维化指标影响  

Effect of Bufei Huanxian Decoction on FSTL1,Syndecan-1 and Pulmonary Fibrosis Indexes in the Treatment of Idiopathic Pulmonary Fibrosis

作　　者：张一[1,2] 尹丽 李路广 李婷婷 董春英 ZHANG Yi;YIN Li;LI Luguang;LI Tingting;DONG Chunying(Department of Respiratory Medicine,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan 450000,China;The First Clinical Medical School of Henan University of Chinese Medicine,Zhengzhou Henan 450000,China;Zhengzhou Traditional Chinese Medicine Hospital,Zhengzhou Henan 450006,China;Department of Pulmonary Diseases,Zhoukou Hospital of Traditional Chinese Medicine,Zhoukou Henan 466000,China)

机构地区：[1]河南中医药大学第一附属医院呼吸科,河南郑州450000 [2]河南中医药大学第一临床医学院,河南郑州450000 [3]郑州市中医院,河南郑州450006 [4]周口市中医院肺病科,河南周口466000

出　　处：《新中医》2025年第8期60-64,共5页New Chinese Medicine

基　　金：河南省中医药科学研究专项课题(20-21ZY2174)。

摘　　要：目的:观察补肺缓纤汤治疗特发性肺间质纤维化(IPF)对血清卵泡抑素样蛋白1 (FSTL1)、多配体蛋白聚糖1 (Syndecan-1)和肺纤维化指标水平的影响。方法:选取93例2022年1月1日—2024年1月31日河南中医药大学第一附属医院呼吸科门诊及病房就诊的IPF患者,按照随机数字表法分为对照组、补肺缓纤组和联合组各31例。对照组给予尼达尼布口服治疗,补肺缓纤组给予补肺缓纤汤口服治疗,联合组给予补肺缓纤汤联合尼达尼布治疗。治疗12周后对3组治疗前后肺功能指标[最大肺活量(VC_(max))、肺总量(TLC)和一氧化碳弥散量(DLCO)]、6 min步行试验(6MWT)、圣乔治呼吸问卷(SGRQ)、血清涎液化糖链抗原6(KL-6)、FSTL1、Syndecan-1和肺纤维化指标[层粘连蛋白(LN)、透明脂酸(HA)、Ⅲ型前胶原(PCⅢ)]水平进行比较。结果:治疗后,联合组VC_(max)、TLC及DLCO水平均较治疗前升高(P<0.05),且3项肺功能指标水平均高于对照组、补肺缓纤组(P<0.05);对照组、补肺缓纤组3项肺功能指标水平治疗前后比较,差异无统计学意义(P>0.05)。治疗后,联合组6MWT距离较治疗前增加(P<0.05),SGRQ评分较治疗前降低(P<0.05);且2项指标水平改善均优于对照组、补肺缓纤组(P<0.05);对照组、补肺缓纤组6MWT、SGRQ评分治疗前后比较,差异无统计学意义(P>0.05)。治疗后,联合组KL-6、FSTL-1、Syndecan-1水平均较治疗前降低(P<0.05),且3项指标水平均低于对照组及补肺缓纤组(P<0.05);对照组、补肺缓纤组KL-6、FSTL-1、Syndecan-1水平治疗前后比较,差异无统计学意义(P>0.05)。治疗后,3组LN、HA、PCⅢ水平均较治疗前降低(P<0.05),且联合组3项肺纤维化指标水平均低于对照组、补肺缓纤组(P<0.05);对照组、补肺缓纤组3项肺纤维化指标水平比较,差异均无统计学意义(P>0.05)。结论:补肺缓纤汤联合尼达尼布可延缓IPF患者血管内皮损伤,更好地改善肺弥散功能,提高运动耐量及生Objective:To observe the effect of Bufei Huanxian Decoction on follistatin-like protein 1(FSTL1),Syndecan-1 and pulmonary fibrosis indexes in the treatment of idiopathic pulmonary fibrosis(IPF).Methods:A total of 93 IPF patients who visited the Respiratory Department Outpatient and Ward of the First Affiliated Hospital of Henan University of Chinese Medicine from January 1,2022 to January 31,2024 were selected and randomly divided into the control group,the Bufei Huanxian Decoction group,and the combination group using a random number table method,with 31 patients in each group.The control group received oral treatment with Nintedanib,the Bufei Huanxian Decoction group received oral treatment with Bufei Huanxian Decoction,and the combination group received treatment with Bufei Huanxian Decoction combined with Nintedanib.After 12 weeks of treatment,three groups of lung function indexes before and after treatment were compared,including maximum vital capacity(VC_(max)),total lung capacity(TLC),and diffusion capacity of carbon monoxide(DLCO),6-minute walk test(6MWT),St.George's Respiratory Questionnaire(SGRQ),serum Krebs von den Lungen-6(KL-6),FSTL1,and Syndecan-1,as well as pulmonary fibrosis indicators such as lamin(LN),hyaluronic acid(HA),and typeⅢprocollagen(PCⅢ).Results:After treatment,the levels of VC_(max),TLC,and DLCO in the combination group were increased when compared with those before treatment(P<0.05),and the levels of the three lung function indexes were higher than those in the control group and the Bufei Huanxian Decoction group(P<0.05);there was no significant difference in the levels of three lung function indexes before and after treatment between the control group and the Bufei Huanxian Decoction group(P>0.05).After treatment,the 6MWT in the combination group was increased when compared with that before treatment(P<0.05),and the SGRQ score was decreased when compared with that before treatment(P<0.05);the improvement of both indicators was better than that in the control group and the Bufei H

关 键 词：特发性肺间质纤维化 补肺缓纤汤 尼达尼布 卵泡抑素样蛋白1 多配体蛋白聚糖1 肺纤维化指标 

分 类 号：R563[医药卫生—呼吸系统]