汉方己甲素片联合大容量全肺灌洗术治疗尘肺的临床研究

Clinical effect of tetrandrine tablets combined with massive whole-lung lavage for the treatment of pneumoconiosis

目的探讨汉方己甲素片联合大容量全肺灌洗术(WLL)治疗尘肺的临床效果。方法将98例尘肺患者根据随机分层法分为对照组和观察组各49例,对照组患者给予常规基础治疗+汉方己甲素片治疗,观察组患者则在对照组基础上联合WLL治疗,比较两组患者治疗前后的肺功能、动脉血氧分压、临床症状以及免疫指标的变化。结果与治疗前比较,两组患者治疗后的第1秒用力呼气量(FEV1)、第1秒用力呼气量/用力肺活量FEV1/FVC、动脉血气氧分压(Pa O2)等指标均明显提高(P<0.05),但观察组患者的FEV1、FEV1/FVC、Pa O2等指标改善幅度明显高于对照组,差异均有统计学意义(P<0.05);观察组患者治疗后的临床症状评分和免疫指标均明显低于对照组,差异均有统计学意义(P<0.05)。结论在常规治疗基础上联用汉方己甲素片及大容量WLL治疗尘肺病可明显改善患者肺功能和动脉血氧分压,缓解临床症状,减少痰液中IL-1、TNF-α含量,提高生存率。

Objective To investigate the clinical effect of tetrandrine tablets combined with massive whole-lung lavage （WLL） in the treaanent of pneumoconiosis. Methods Ninety-eight patients of pneumoconiosis were divided into the control group （n=49, applied conventional treatment and tetrandrine tablets） and the observation group （n=49, combined with WLL on the basis of control group therapy） according to stratified randomized method. Changes of pulmonary function, arterial partial pressure of oxygen, the clinical symptoms and immune indexes were compared before and after treatment in two groups. Results FEV1, FEV1/FVC, PaO2 and other indexes of the two groups aRer treatment were all significantly increased （P〈0.05）, and the improvements of the observation group were significantly better than those of the control group （P〈0.05）. Clinical symptom score and immune indexes of observa- tion group after treatment were significantly lower than those of the control group （P〈0.05）. Conclusion In the treat- ment of pneumoconiosis, tetrandrine tablets can significantly improve lung function and arterial partial pressure, relieve clinical symptoms, reduce the content of IL-1 and TNF-alpha in sputum, and improve the survival rate.