“肺痿冲剂”治疗特发性肺间质纤维化20例临床疗效观察

Observation of Curative Effect of Feiwei Granules on Twenty Cases of Idiopathic Pulmonary Fibrosis

目的:观察"肺痿冲剂"治疗特发性肺间质纤维(IPF)肺肾不足、气虚血瘀证的临床疗效。方法:收集2009年5月—2011年10月在北京中医药大学东方医院呼吸热病科门诊就诊及病房住院的,符合西医特发性肺纤维化IPF诊断标准及中医肺痿病肺肾不足、气虚血瘀证辨证标准,且病情严重程度属轻中度的患者20例,采用自身前后对照的方法,给予"肺痿冲剂"治疗,每日1剂,分早晚2次口服,疗程为6个月。分别于治疗前、治疗后3个月、治疗后6个月评估患者总体临床疗效、中医证候积分的变化、肺功能变化、6 min步行试验(6MWT)及圣乔治医院呼吸问题调查问卷(SGRQ)情况。结果:治疗3个月总有效率75%,治疗6个月总有效率70%;治疗后各疗程中医证候总分及喘息、气短、咳嗽、咯痰各主要症状积分均比治疗前明显减少,差异有统计学意义(P<0.05);肺活量(VC)较治疗前明显升高,且呈现出逐渐增长趋势,与治疗前比较差异有统计学意义(P<0.05);6 min步行距离、最低血氧饱和度(SPO2)均有所升高,均呈现逐渐增长趋势,与治疗前相比差异有统计学意义(P<0.01);SGRQ中呼吸症状、活动受限、疾病影响及总积分比治疗前均明显减少,差异均有统计学意义(P<0.05)。结论:"肺痿冲剂"治疗特发性肺间质纤维肺肾不足、气虚血瘀证,在改善患者临床症状、提高患者生存质量等方面,具有显著疗效。

Objective：To observe the curative effect of Feiwei Granules on twenty cases with lung and kidney deficiency, qi deficiency and blood stasis syndrome of Idiopathic Pulmonary Fibrosis （ IPF ）. Method ： The twenty cases with lung and kidney deficiency, qi deficiency and blood stasis syndrome of mild or moderate IPF were selected from outpatient and ward of respiratory department in Dongfang Hospital of Beijing University of Chinese Medicine, from May.2009 to Oct.2011. Twenty cases were treated with Feiwei Granules, one packet for every day, at morning and in the evening, lasting for six months. The self controlled study was used to assess the overall clinical curative effect, changes of TCM syndrome scoring, changes of pulmonary function, 6-minute walk test （ 6MWT ）, St.George respiratory questionnaire （ SGRQ ） at different time points （ before treatment and 3,6 months after treatment ）. Results ： The total effective rate was 75% and 70% in 3 months and 6 months after treatment respectively; the TCM syndrome score and the main symptoms score of wheezing, short of breath, cough and expectoration were significantly decreased than those before treatment respectively （ P〈O.05 ）, with statistical significance ; vital capacity （ VC ） was significantly increased than that before treatment, appearing gradually increasing tendency, with statistical significance （ P〈O.05 ）; 6-minute walk distance and the lowest oxygen saturation （ SPO2 ） was significantly increased than that before treatment, appearing gradually increasing tendency, with statistical significance （ P〈0.01 ）; symptoms score, activity score, impacts score and total score were significantly decreased than those before treatment respectively （ P〈O.05 ）, with statistical significance. Conclusion ： The treatment of lung and kidney deficiency, qi deficiency and blood stasis syndrome of IPF with Feiwei Granules, has clinical significant curative fffect in improving the clinical symptoms and life quality.