益气养阴方治疗特发性肺纤维化气阴两虚证的临床研究

Yiqi Yangyin Fang for treating syndrome of dual deficiency of qi and yin of idiopathic pulmonary fibrosis

目的观察自拟益气养阴方治疗特发性肺纤维化(IPF)气阴两虚证的疗效。方法收集2007年1月—2011年9月新加坡MINO Chinese Medical Clinic诊所IPF气阴两虚证病例44例,按疗程分成A组(疗程≤6个月)21例,B组(疗程>6个月)23例,给予中药自拟益气养阴方治疗。于治疗前、治疗后6,12,24,36个月分别(SPO2)、Borg呼吸困难评分的变化。结果中药治疗总有效率79.55%,A组有效率66.67%,B组有效率评估Ⅱ型肺泡细胞表面抗原(KL-6),6分钟步行试验,包括6分钟步行距离、最低手指血氧饱和度最低值91.30%,2组相比有显著统计学差异,P<0.05。A组6个月时Borg指数低于治疗前,有统计学意义,P<0.05。与治疗前比较,B组12,24个月时KL-6、最低SPO2、Borg指数均有显著差异,P<0.05或P<0.01;36个月时最低SPO2、Borg指数均有显著性差异,P<0.05。结论与短疗程益气养阴方治疗相比,长疗程中药治疗气阴两虚型IPF对改善呼吸困难症状、降低KL-6有一定临床意义。

Objective To observe the curative effect of self-disigned Yiqi Yangyin Fang on syndrome of dual deficiency of qi and yin of idiopathic pulmonary fibrosis （IPF）. Methods The cases with syndrome of dual deficiency of qi and yin of IPF （n=44） were selected from MINO Chinese Medical Clinic in Singapore from Jan. 2007 to Sept. 2011, and then they were divided, according to the therapeutic course, into group A （n=21, therapeutic course ~〈6 months） and group B （n=23, therapeutic course〉6 months）. The two groups were treated with Yiqi Yangyin Fang and then the changes of type Ⅱ alveolar cell surface antigen （KL-6）, 6-minute walk test （including 6-minute walk distance）, the lowest value of transcutaneous oxygen saturation （SPO2） and Borg dyspnea scoring were assessed at different time points （before treatment and 6, 12, 24 and 36 months after treatment）. Results The total effective rate of Yiqi Yangyin Fang was 79.55% and effective rate was 66.67% in group A and 91.30% in group B （P〈0.05）. In group A, Borg dyspnea score was lower after 6 months than that before treatment （P〈0.05）. In group B, the changes of KL-6, the lowest value of SPO2 and Borg dyspnea score had significance after 12 and 24 months （P〈0.05 or P〈0.01）, and the changes of the lowest value of SPO2 and Borg dyspnea score had significance after 36 months （P〈O.05）. Conclusion A long-term treatment of syndrome of dual deficiency of qi and yin of IPF with Chinese medicinal has some clinical significance in relieving symptoms of dyspnea and reducing KL-6