汉防己甲素联合苦参碱注射液治疗矽肺的疗效观察

Therapeutic efficacy of tetrandrine tablets combined with matrine injection in treatment of silicosis

目的观察汉防己甲素与苦参碱注射液联合应用治疗矽肺的临床疗效。方法63例矽肺患者随机分为治疗组（33例）和对照组（30例），两组均常规给予抗炎、止咳、平喘等治疗，治疗组同时给予汉防己甲素和苦参碱注射液，汉防己甲素100mg，每日2次，3个月为1疗程，休息1个月开始下一个疗程，共4个疗程；苦参碱注射液150mg，每日1次，每月连用15d，3个月为1疗程，休息1个月开始下一个疗程，共2个疗程。观察临床症状、肺通气功能、血清超氧化物歧化酶（SOD）、X线胸片影像的变化。结果与治疗前比较，治疗后胸闷、胸痛、气急等呼吸道症状明显改善，差异有统计学意义（P〈0．05）。治疗组治疗后SOD活力明显高于治疗前及对照组，差异有统计学意义（P〈0．05）。治疗组治疗后FVC、FEV1．0明显高于对照组及治疗前，差异有统计学意义（P〈0．05）；X线胸片治疗组有5例（其中Ⅱ期4例、Ⅲ期1例，均属快进型）矽肺小阴影较治疗前缩小，略有变淡，边缘较治疗前清晰，总体密集度较治疗前有所降低；12例肺纹理明显减少、清晰。结论汉防己甲素与苦参碱注射液联合应用对矽肺有一定治疗效果。

Objective To observe the therapeutic efficacy of tetrandrine tablets combined with matrine injection in the treatment of silicosis. Methods Sixty-three patients with silicosis were randomly divided into treatment group （n = 33） and control group （n = 30）. Both groups received anti-inflammatory, cough-relieving, and anti-asthmatic treatment. Meanwhile, the treatment group was given tetrandrine tablets （100 mg bid） and matrine injection （ 150 mg qd）. There were 4 courses of tetrandrine treatment （each course = 3 months）, with one-month intervals among them. Matrine injection was used for 15 consecutive days in each month. There were 2 courses of matrine treatment （each course = 3 months）, with a one-month interval in between. The clinical symptoms, pulmonary function, serum superoxide dismutase （SOD） activity, and chest X-ray images were observed before and after treatment. Results After treatment, chest distress, chest pain, shortness of breath, and other respiratory symptoms were relieved significantly （P〈0.05）. The treatment group showed significantly higher SOD activity than before treatment and the control group （P〈0.05） and significantly higher forced vital capacity and forced expiratory volume in one second than before treatment and the control group （P〈0.05）. After treatment, 5 patients （4 stage Ⅱ cases and 1 stage Ⅲ case, all in rapidly progressive forms） in the treatment group showed smaller, lighter, and clearer shadows with decreased overall intensity on chest X-ray; 12 patients showed significantly fewer and clearer lung markings on chest X-ray. Conclusion Tetrandrine tablets combined with matrine injection have some therapeutic effect on silicosis.