黄芪联合丹参预防肺结核肺纤维化的研究

Research on preventing pulmonary fibrosis of pulmonary tuberculosis patient with Huang Qi and salvia miltiorrhiza

目的探讨细胞外基质(ECM)在肺结核病中的变化及丹参、黄芪治疗对其的影响。方法将106例初治菌阳肺结核患者分为A组55例和B组51例,在抗结核治疗的基础上A组加用丹参、黄芪,同时选择50例健康人群作为正常对照组;治疗前、后均进行血清透明质酸(HA)、层粘蛋白(LN)、Ⅲ型胶原肽(PⅢP)及Ⅳ型胶原(C-Ⅳ)测定,比较2组病例血清纤维化指标下降率、痰菌阴转率及肺部病灶的吸收情况等。结果106例肺结核患者治疗前HA、LN及C-Ⅳ水平明显高于健康人群组(P<0.05),治疗后A组HA、LN及C-Ⅳ水平明显低于B组(P<0.05),早期痰菌阴转率、肺部病灶显著吸收率、肺功能好转及主要症状改善情况均高于B组(P<0.05或P<0.01)。结论ECM在肺结核病的发展中具有重要意义,黄芪、丹参有预防和逆转肺纤维化的作用。

Objective To discusses the change of ECM in the pulmonary tuberculosis patient and the effect of Huang Qi and salvia mihiorrhiza in its prevention. Methods 106 pulmonary tuberculosis patients were divided ifito group A with 55 cases and group B with 51 cases. Based on the anti-tuberculosis treatment, group A added Huang Qi and salvia miltiorrhiza. Simultaneously, 50 healthy persons were recruited in the control group. HA, LN, PⅢ P and C-Ⅳ were examined before and after the treatment. The blood serum HA, LN, PⅢ P and C-Ⅳ, sputum conversion rate and the absorption of the focus in the lung were compared between the two groups. Results Before the treatment, the HA , LN and C-Ⅳ were significantly higher in the 106 pulmonary tuberculosis patients than the control group（ P 〈 0.05）. After the treatment, the HA , LN and C-Ⅳ were lower in group A than those in group B（ P 〈 0.05）. The following indicators were better in group A than those in group B, including sputum conversion rate at early stage, the absorption rate of the focus in the lung, the improvement of the lung function changes and the improvement of the main symptoms （ P 〈 0.05 or P 〈 0.01）. Conclusion ECM plays an important role in the progress of pulmonary tuberculosis, Huang Qi and salvia mihiorrhiza have active effect on preventing and reversing the pulmonary fibrosis.