何氏益气化瘀通络汤治疗肺间质纤维化疗效观察

Curative effect of Heshi Yiqi Huayu Tongluo decoction on pulmonary interstitial fibrosis

目的探讨何氏益气化瘀通络汤治疗肺间质纤维化的疗效及对患者生活质量的影响。方法将肺间质纤维化患者86例采用随机数字表法分为观察组和对照组各43例,对照组采用糖皮质激素+环磷酰胺治疗,观察组在对照组基础上给予自拟经验方何氏益气化瘀通络汤,2组均连续治疗3个月,观察记录肺功能、症状体征、胸部HRCT评分及生活质量评分,并评估临床疗效。结果观察组总有效率明显高于对照组(P<0.05)。经过3个月的治疗,2组中医症候积分均较治疗前明显降低(P<0.05);观察组圣乔治呼吸问卷(SGRQ)中症状、活动受限积分均较治疗前明显降低(P<0.05),而心理状况无明显改善;对照组上述指标均无改善。2组HRCT评分无明显改善,观察组TLC和DLco较治疗前明显增加(P均<0.05),对照组的TLC和DLco均无明显变化,2组TLC和DLco比较差异均有统计学意义(P均<0.05)。结论何氏益气化瘀通络汤联合西药治疗肺间质纤维化可以明显改善患者的症状、体征和肺功能,延缓肺纤维化的进程,提高患者的生活质量。

Objective It is to explore the curative effect of Heshi Yiqi Huayu Tongluo decoction on pulmonary interstitial fibrosis and life quality of the patients. Methods 86 patients with pulmonary interstitial fibrosis were randomly divided into observation group and control group with 43 cases in each group. The control group was treated with glucocorticoid combined with cyclophosphamide,and the observation group was added with Heshi Yiqi Huayu Tongluo decoction on the basis of treatment in control group. Both the groups were treated for 3 moths. The scores of lung function,symptom and sign,chest HRCT were recorded before and after treatment,and the clinical effect was compared between the two groups. Results The total effective rate of observation group was higher than that of control group（ P〈0. 05）. After 3 months＇ treatment,the scores of Chinese medicine syndrome were decreased compared with that in both groups（ P〈0. 05）,the scores of symptom and action limit evaluated by SGRQ in observation group were decreased compared with that before treatment,but scores of psychology state was not improved obviously; in the control group,no improvement of the indexes above was found. HRCT scores were not improved in both groups,TLC and DLco increased much compared with that before treatment in observation group,but no obvious changes of TLC and DLco was found in control group. There was significant difference in TLC and DLco between the two groups（ P〈0. 05）. Conclusion Heshi Yiqi Huayu Tongluo decoction combined with western medicine can obviously improve patients＇ symptoms and signs and lung function,delay the development of pulmonary interstitial fibrosis,and improve patients＇ life quality.