清肺化痰法治疗痰热壅肺型特发性肺(间质)纤维化合并感染的临床观察

Treatment of idiopathic pulmonary (interstitial) fibrosis complicating infection (type of phlegm-heat obstructing lung) with therapy of clearing lung and resolving phlegm

目的观察清肺化痰法治疗痰热壅肺型特发性肺(间质)纤维化合并感染的临床疗效。方法将81例痰热壅肺型特发性肺(间质)纤维化合并感染的患者分为对照组27例、治疗组54例。对照组给予静点莫西沙星、沐舒坦,口服乙酰半胱氨酸胶囊治疗,治疗组在西医治疗基础上,加用清肺化痰中药汤药口服。比较2组中医证候疗效,症状积分变化,6min步行试验距离,血气分析中PO2变化,肺功能中肺总量(TLC)、肺活量(VC)、一氧化碳弥散量(DLCO)情况。结果中医证候疗效治疗组54例中,显效10例(18.5%),有效35例(64.8%),无效9例(16.7%),总有效率为83.3%;对照组27例中,显效3例(11.1%),有效14例(51.9%),无效10例(37.0%),总有效率为63.0%。经Ridit分析,U=-2.197,P=0.037,P<0.05,说明治疗组疗效优于对照组。2组治疗后咳嗽、动喘、发热、胸闷、胸痛、便干、心烦、气短、黄痰、湿啰音评分较本组治疗前均降低(P<0.05)。治疗组咳嗽、动喘、胸闷、胸痛、便干、心烦、气短、黄痰评分较对照组降低明显,治疗前后评分差值与对照组比较均有统计学意义(P<0.05)。2组6min步行距离治疗后较本组治疗前均增加(P<0.01),治疗组前后差值较对照组增加明显(P<0.001)。2组血气分析中PO2治疗后较本组治疗前均增加(P<0.01),治疗组前后差值较对照组增加明显(P<0.01)。2组肺功能中DLCO治疗后较本组治疗前均增加(P<0.01),治疗组前后差值较对照组增加明显(P<0.001)。结论清肺化痰法治疗痰热壅肺型特发性肺(间质)纤维化合并感染具有较好的临床疗效。

Objective To observe the curative effect of therapy of clearing lung and resolving phlegm on idiopathic pulmonary （interstitial） fibrosis （IIP, type of phlegm-heat obstructing lung） complicating infection. Methods The patients （n=81） with IIP were divided into control group （n=27） and treatment group （n=54）. Control group was treated with intravenous drip of moxifloxacin, Mucosolvin and oral Acetyleysteine Capsules, and treatment group was given the decoction of Chinese medicinal with actions of clearing lung and resolving phlegm besides the same Western medicinal as control group. The curative effect on TCM syndromes, changes of symptom integrals, 6-minute walk distance test （6MWD）, PO2 changes in blood gas analysis, and total lung capacity （TLC）, breathing capacity （VC） and DLco in lung function were compared between two groups. Results In treatment group, there were 10 cases （18.5%） with obvious effects, 35 （64.8%） with effects, 9 （16.7%） without effects, and the total effective rate was 83.3%. In control group, there were 3 cases （11.1%）, 14 with （51.9%） effects, 10 （37.0%） without effects, and the total effective rate was 63.0%. U=-2.197, P=0.037 and P〈0.05 after Ridit analysis. The scores of cough, plasma, fever, chest distress and pain, dry stool, upset, shortness of breath, yellow phlegm and moist rales were all decreased in two groups than those before treatment （P〈0.05）, which were more significant in treatment group （P〈0.05）. 6MWD was increased in two groups than that before treatment （P〈0.01）, which was more significant in treatment group （P〈0.001）. In blood gas analysis, P02 increased in two groups than that before treatment （P〈0.01）, which was more significant in treatment group （P〈0.01）. In lung function DLco increased in two groups than that before treatment （P〈0.01）, which was more significant in treatment group （P〈0.001）. Conclusion The therapy of clearing lung and resolving phlegm has a good curative effect on IIP （type of phlegm-heat obstructing lung）.