养阴益气活血方治疗结缔组织病相关间质性肺病疗效观察

Observation on the Curative Effect of Yangyin Yiqi Huoxue Decoction on Patients with Connective Tissue Disease-associated Interstitial Lung Disease

目的:观察养阴益气活血方治疗结缔组织病相关间质性肺病(CTD-ILD)的疗效,以期为临床治疗CTD-ILD提供新的思路。方法:将40例本病患者随机分为治疗组20例和对照组20例,对照组予激素+硫唑嘌呤常规治疗,治疗组加用养阴益气活血方口服。中药日1剂煎服,早晚分服。泼尼松口服,每日0.5～1 mg/kg;治疗6周后减量,每周减5 mg;治疗6个月后,每日以7.5～10 mg剂量维持治疗。硫唑嘌呤100 mg/d口服。两组治疗均为2个月。观察两组症状、体征改善情况;治疗前后分别进行高分辨CT、肺功能等检查。结果:总有效率治疗组为90.0%,对照组为70.0%,两组比较,差异有统计学意义(P<0.05);两组治疗后症状评分、Velcro音评分、胸部HRCT评分均显著降低(P<0.05),两组比较,差异有统计学意义(P<0.05);两组治疗后FEV1、FVC、FVC%较治疗前明显改善(P<0.05),两组比较,差异有统计学意义(P<0.05),治疗组优于对照组。结论:养阴益气活血方治疗结缔组织病相关间质性肺病疗效较好。

Objective:To observe the efficacy of Yangyin Yiqi Huoxue Decoction in the treatment of connective tissue disease-associated interstitial lung disease(CTD-ILD),in order to provide a new reference for clinical treatment of CTD-ILD. Methods:Forty patients with this disease were randomly divided into treatment group(n=20)and control group(n=20). The control group received conventional therapy with hormone plus azathioprine. On this basis,the treatment group was supplemented with Yangyin Yiqi Huoxue Decoction. Decoction of 1 dose a day of Yangyin Yiqi Huoxue Decoction,morning and evening takes respectively. Prednisone was orally administered at 0.5-1 mg/kg per day,reduced by 5 mg per week after 6 weeks of treatment,and maintained at a dose of 7.5-10 mg per day after 6 months of treatment. Azopurine was taken orally at 100 mg/d. Both groups were treated for 2 months. The improvement of symptoms and signs of the two groups were observed. High-resolution CT and lung function tests were performed before and after treatment. Results:The total effective rate was 90.0% in the treatment group and 70.0% in the control group,and the difference between the two groups was statistically significant(P<0.05). After treatment,symptom score,Velcro tone score and chest HRCT score of the two groups were significantly reduced(P<0.05). The difference between the two groups was statistically significant(P<0.05). After treatment,FEV1,FVC and FVC% in the two groups were significantly improved compared with that before treatment(P<0.05). The difference between the two groups was statistically significant(P<0.05),and the treatment group was superior to the control group. Conclusion:Yangyin Yiqi Huoxue Decoction is effective in treating connective tissue disease-associated interstitial lung disease.