活血通络益肾方联合环磷酰胺对自身免疫特征间质性肺炎的临床疗效及相关指标的影响

Effect of Huoxue Tongluo Yishen prescription combined with cyclophosphamide on clinical efficacy and related indicators of interstitial pneumonia with autoimmune features

目的 探讨活血通络益肾方联合环磷酰胺对自身免疫特征间质性肺炎(Interstitial pneumonia with autoimmune features,IPAF)的临床疗效及相关指标的影响.方法 选取2015年1月~2018年12月在我院治疗的IPAF患者108例,采用随机数字表法分为观察组和对照组各54例.对照组采用环磷酰胺治疗,观察组在对照组基础上联合活血通络益肾方治疗,两组均连续治疗3个月.比较两组临床治疗效果,治疗前后两组患者肺功能、炎症反应指标的变化情况;并观察比较两组患者治疗前后6 min步行试验结果.结果 观察组的总有效率(87.04%)高于对照组(68.52%),差异有统计学意义(P<0.05).治疗后,两组患者的肺活量(vital capacity,VC)、第1秒用力呼气容积(Forced expiratory volume in one second,FEV1)、呼气峰流速(peak expiratory flow,PEF)水平均升高,且观察组VC、FEV1、PEF水平高于对照组(P<0.05).治疗后,两组患者的白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(High-sensitivity C-reactive protein,hs-CRP)水平均降低,且观察组IL-6、TNF-α、hs-CRP水平低于对照组(P<0.05).治疗后,两组患者6 min步行试验(6-minute walking test, 6MWT)水平均升高,且观察组6MWT水平高于对照组(P<0.05).结论 活血通络益肾方联合环磷酰胺治疗IPAF效果更佳,能有效改善患者的肺功能,减轻机体炎症反应,且能提高6MWT水平,具有一定的临床应用价值.

Objective To explore the effect of Huoxue Tongluo Yishen prescription combined with cyclophosphamide on the clinical efficacy and related indicators of interstitial pneumonia with autoimmune features(IPAF).Methods A total of 108 patients with IPAF who were treated in our hospital from January 2015 to December 2018 were selected and divided into the observation group and the control group by the random number table method,with 54 patients in each group.The control group was treated with cyclophosphamide,and the observation group was treated with Huoxue Tongluo yishen prescription on the basis of the control group.Both groups were treated for 3 months continuously.The clinical treatment effects and the changes of pulmonary function and inflammatory response indexes before and after treatment in the two groups were compared.The results of 6-minute walking test before and after treatment in the two groups were observed and compared.Results The total effective rate of the observation group(87.04%)was higher than that of the control group(68.52%),the difference was significant(P<0.05).After treatment,the levels of vital capacity(VC),forced expiratory volume in one second(FEV1)and peak expiratory flow(PEF)of patients in both groups were increased,and the levels of VC,FEV1 and PEF in the observation group were higher than those in the control group(P<0.05).After treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and high-sensitivity C-reactive protein(hs-CRP)in both groups were decreased,and the levels of IL-6,TNF-αand hs-CRP in the observation group were lower than those in the control group(P<0.05).After treatment,the 6-minute walking test(6MWT)levels in both groups were increased,and the 6MWT levels in the observation group were higher than those in the control group(P<0.05).Conclusion Huoxue Tongluo Yishen prescription combined with cyclophosphamide has a better curative effect in the treatment of IPAF,which can effectively improve the lung function of patients,reduce the inflammatory response of the body,and improve the level of 6MWT,so it has certain clinical application value.