中西药联合治疗尘肺病37例疗效分析

Clinical analysis of 37 cases of pneumoconiosis treated with combination of Chinese and western medicine

目的探讨中药联合西药治疗尘肺病的临床疗效及预后。方法选取尘肺病患者74例为研究对象，采用随机数字表法分成观察组37例和对照组37例，对照组采用常规西药治疗，观察组在对照组基础上联合中药治疗，比较两组治疗前后肺功能指标、临床疗效、体征好转时间以及肺部阴影减少等变化。结果观察组肺部阴影减少率为75．67％，对照组肺部阴影减少率为62．16％，两组差异有统计学意义（u=2．419，P=0．015）。观察组总有效率为86．49％，对照组总有效率为67．57％，两组差异有统计学意义（u=2．116，P=0．034）。治疗后，观察组肺活量（VC）、用力肺活量（FVC）及第一秒用力呼吸容积（FEV1）分别为（69．15±18．34）％、（71．08±16．93）％、（68．91±18．75）％，对照组分别为（63．37±20．53）％、（63．13±18．69）％、（55．47±17．58）％，两组均较治疗前显著上升，观察组升高幅度更明显，两组差异均有统计学意义（t=6．778，P=0．000；t=8．836，P=0．000；t=10．133，P=0．000）。观察组喘息、咳嗽、肺部哕音等临床症状体征好转时间均短于对照组，差异均有统计学意义（t=8．220，P=0．000；t=6．836，P=0．000；t=6．909，P=0．000）。结论中药联合西医治疗尘肺病肺部阴影减少率高，肺功能显著好转，咳嗽、喘息等临床症状体征好转时间缩短，优于常规西药治疗。

Objective To explore the curative effect and prognosis of traditional Chinese medicine combined with western medicine in the treatment of silicosis patients. Methods 74 patients with silicosis were selected as the research subjects. According to the admission time, the patients were divided into the observation group and the control group, 37 patients in each group. The control group was treated with conventional western medicine, the observation group was given the combined treatment of traditional Chinese medicine and western medicine. The clinical curative effect,pulmonary function index, symptoms improved time and the reduce of lung shadow were observed and compared. Results The reduction rate of lung shadow in the observation group was 75.67% ,which in the control group was 62.16%, there was statistically significant difference between the two groups （ u = 2. 419, P = 0. 015 ）. The total effective rate of the observation group was 86.49%, which of the control group was 67.57%, there was statistically significant difference between the two groups （ u = 2.116, P = 0.034）. After treatment, the vital capacity （ VC ）, forced vital capacity（FVC） and the first second forced expiratory volume （FEV1 ） in the observation group were （69.15± 18.34）% ,（71.08 ± 16. 93）%, （68.91 ± 18.75）% ,respectively, which in the control group were （63.37 ± 20. 53 ）%, （63.13 ± 18.69）% and （55.47 ± 17.58 ）%, respectively, which in the two groups were, higher than those before treatment,which in the observation group increased significantly, there were statistically significant differences between the two groups（t =6. 778 ,P = 0.000,t = 8. 836 ,P = 0. 000,t = 10. 133 ,P = 0.000）. The wheezing,cough, pulmonary rales and other symptoms improved time in the observation group were shorter than those in the control group, the differences were statistically significant（ t = 8220, P = 0.000, t =6. 836, P = 0.000, t = 6. 909, P = 0. 000）. Conclusion Traditional Chinese medicine combined with western medicine in the treatment of silicosis has higher reduction rate of lung shadow, lung function improved significantly, shorter improved time of cough, wheezing and other symptoms,its curative effect is better than western medicine.