陶承志, 方申存, 吴静, 许斌, 王彩英, 张映铭, 张海涛. 养阴化瘀法联合汉防己甲素治疗矽肺肺纤维化的临床疗效研究[J]. 职业卫生与应急救援, 2019, 37(4): 307-310, 315. DOI: 10.16369/j.oher.issn.1007-1326.2019.04.003
引用本文: 陶承志, 方申存, 吴静, 许斌, 王彩英, 张映铭, 张海涛. 养阴化瘀法联合汉防己甲素治疗矽肺肺纤维化的临床疗效研究[J]. 职业卫生与应急救援, 2019, 37(4): 307-310, 315. DOI: 10.16369/j.oher.issn.1007-1326.2019.04.003
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TAO Chengzhi, FANG Shencun, WU Jing, XU Bin, WANG Caiying, ZHANG Yingming, ZHANG Haitao. Clinical effects of Chinese medicine prescription of both nourishing Yin and removing stasis combined with tetrandrine in treatment of silicosis[J]. Occupational Health and Emergency Rescue, 2019, 37(4): 307-310, 315. DOI: 10.16369/j.oher.issn.1007-1326.2019.04.003
Citation: TAO Chengzhi, FANG Shencun, WU Jing, XU Bin, WANG Caiying, ZHANG Yingming, ZHANG Haitao. Clinical effects of Chinese medicine prescription of both nourishing Yin and removing stasis combined with tetrandrine in treatment of silicosis[J]. Occupational Health and Emergency Rescue, 2019, 37(4): 307-310, 315. DOI: 10.16369/j.oher.issn.1007-1326.2019.04.003
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养阴化瘀法联合汉防己甲素治疗矽肺肺纤维化的临床疗效研究

Clinical effects of Chinese medicine prescription of both nourishing Yin and removing stasis combined with tetrandrine in treatment of silicosis

    摘要
  • 摘要:
    目的 观察养阴化瘀中药联合汉防己甲素治疗矽肺肺纤维化的临床疗效，对其作用机制进行初步探讨。
    方法 选取2017年6月—2018年12月在东南大学医学院附属南京市胸科医院收治的矽肺患者120例，将其随机分为观察组和对照组，每组均为60例，对照组在常规止咳、平喘、抗感染治疗的基础上联合汉防己甲素片口服治疗，观察组在对照组治疗的基础上加用养阴化瘀中药。分别于治疗3个月和6个月时比较两组患者的6 min步行试验、临床症状及生活质量评分、肺功能指标、肺纤维化指标。
    结果 治疗3个月后，对照组患者仅有咳嗽、咳痰症状评分较治疗前改善，而观察组患者的6 min步行试验、症状评分、活动评分、SGRQ总分、FVC、TGF-β1、IL-6均较治疗前改善（P < 0.05）。治疗6个月后，两组患者的6 min步行试验、症状评分、活动评分、SGRQ总分、FVC、FEV1、FEV1/FVC、FEV1%、α-SMA、KGF均较治疗前改善（P < 0.05），且观察组以上大部分指标均好于对照组（P < 0.05），而TGF-β1、IL-6水平与治疗前相比，仅在观察组患者中有改善（P < 0.05）；观察组患者肝功能损害发生率低于对照组（P < 0.05）。
    结论 养阴化瘀法可以帮助矽肺患者改善临床症状，提高生活质量。

     

    Abstract:
    Objective To observe the clinical effect of Chinese medicine prescription of both nourishing Yin and removing stasis (Yangyin Huayu decoction)combined with tetrandrine on pulmonary fibrosis of pneumoconiosis.
    Methods A total of 120 pneumoconiosis patients with pulmonary fibrosis were randomly divided into experimental treatment group (n=60) and routing treatment(reference) group(n=60). Besides corresponding basic antitussive, anti-asthmatic and anti-inflammatoric therapy, the patients in the experimental treatment group were given Yangyin Huayu decoction. After three months and six months of the treatment, the result of 6-minute walking test, the clinic improvement, the changes of SGRQ scores, pulmonary function and pulmonary fibrosis level were compared.
    Results After 3 months treatment, the patients in the reference group had only improvement of cough and sputum symptom scores compared with pre-treatment, while the patients in treatment group had improvement of 6-minute walking test, symptom score, activity score, SGRQ total score, FVC, TGF-beta 1 and IL-6 compared with pre-treatment (P < 0.05). After 6 months treatment, the patients in both groups had improvement of 6-minute walking test, symptom score, activity score, SGRQ total score, FVC, FEV1, FEV1, FEV1/FVC, FEV1, alpha-SMA and KGF compared with pre-treatment(P < 0.05), and most of the above indexes in the treatment group were more improved than those in the reference group (P < 0.05). Only the patients in the experimental treatment group had improvement of TGF-beta 1 and IL-6 level compared with pre-treatment(P < 0.05). The incidence of liver function damage in the treatment group was also lower than that in the reference group(P < 0.05).
    Conclusion Yangyin Huayu Decoction could relieve the clinical symptoms and improve the quality of life of pneumoconiosis patients with pulmonary fibrosis.

     

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