化纤通络汤联合乙酰半胱氨酸治疗特发性肺纤维化临床观察

Clinical Observation of Huaxian Tongluo Decoction Combined with Acetylcysteine in the Treatment of Idiopathic Pulmonary Fibrosis

目的:观察化纤通络汤联合乙酰半胱氨酸治疗特发性肺纤维化(IPF)的临床疗效。方法:采用简单随机抽样法将60例IPF患者分为对照组和观察组,每组30例;对照组给予乙酰半胱氨酸治疗,观察组在对照组基础上加服化纤通络汤,疗程均为3个月;比较两组治疗前后中医证候积分、6min步行距离、圣·乔治医院呼吸问题调查问卷(SGRQ)评分、血气分析指标[动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO2)]、肺功能指标[肺活量(VC)、肺总量(TLC)、一氧化碳弥散量(DLCO)]等变化。结果:治疗后,观察组喘息、咳嗽、咳痰等症状积分及中医证候总分、SGRQ评分较治疗前明显降低(P<0.05),6min步行距离较治疗前明显增大(P<0.05);治疗后,对照组各症状积分及中医证候总分、6min步行距离、SGRQ评分与治疗前比较差异无统计学意义(P>0.05);治疗后,观察组喘息、干咳、咳嗽、咳痰等症状积分、中医证候总分、SGRQ评分均明显低于对照组,6min步行距离明显高于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组PaO2、VC、TLC、DLCO与治疗前及对照组比较均有所升高,PaCO2与治疗前及对照组比较有所降低,但差异均无统计学意义(P>0.05)。结论:化纤通络汤能够有效缓解IPF患者临床症状,提高患者运动耐力,改善患者生活质量,并可在一定程度上延缓肺功能恶化进程。

Objective:To observe the clinical efficacy of Huaxian Tongluo Decoction combined with acetylcysteine in the treatment of idiopathic pulmonary fibrosis(IPF). Methods:60 cases of patients with IPF were divided into control group and observation group according to the simple random sampling method, with 30 cases in each group. Control group was treated with acetylcysteine,and observation group was treated with Huaxian Tongluo Decoction on the basis of control group,and they were treated for 3 months. The TCM syndromes scores,6 min walking distance,St. George's respiratory questionnaire(SGRQ)score,blood gas analysis indexes [arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide (PaCO2)] and lung function indicators [vital capacity(VC),total lung capacity(TLC),carbon monoxide diffusion capacity(DLCO)] were compared between the two groups before and after treatment. Results: After treatment,the scores of symptoms of wheezing,cough and expectoration,total score of TCM syndromes and the SGRQ score in observation group were significantly lower than those before treatment(P <0.05), and the 6 min walking distance was significantly higher than that before treatment(P <0.05). After treatment,there was no significant differences in the symptoms scores,total score of TCM syndromes,6 min walking distance and SGRQ score in control group compared with those before treatment(P >0.05). After treatment,the scores of symptoms of wheezing,dry cough,cough and expectoration,total score of TCM syndromes and the SGRQ score in observation group were significantly lower than those in control group,and the 6 min walking distance was significantly higher than that in control group(P <0.05). After treatment,the PaO2,VC,TLC and DLCO in observation group were increased compared with those before treatment and those in control group,and the PaCO2 was decreased compared with that before treatment and that in control group(P >0.05). Conclusion:Huaxian Tongluo Decoction can effectively alleviate the clinical symptoms of patients with IPF,improve the exercise tolerance,promote the quality of life,and delay the deterioration of lung function to some extent.