早期应用益生菌联合阿奇霉素对特发性肺间质纤维化的治疗

Effect of early application of probiotics combined with Azithromycin in the treatment of idiopathic pulmonary interstitial fibrosis

目的探讨早期应用益生菌联合阿奇霉素治疗特发性肺间质纤维化的临床效果。方法选取我院2015年1月至2018年1月102例确诊为特发性肺间质纤维化的患者为研究对象并随机分为对照组、阿奇霉素组和益生菌联合应用组,每组各34例。对照组患者给予戒烟、低流量吸氧、抗感染、止咳化痰以及激素治疗,阿奇霉素组在对照组基础上加用阿奇霉素,益生菌联合应用组在阿奇霉素组的基础上加用益生菌联合治疗。3组患者均连续用药3个月,观察并对比治疗前后3组患者的临床疗效、不良反应发生率,血气变化以及肺功能情况。结果治疗后3组患者肺功能状况均有不同程度的改善,其中对照组、阿奇霉素组和益生菌联合应用组的有效率分别为50.00%,76.47%和97.06%,组间比较差异均有统计学意义(χ^2=5.1240、17.0000、4.6100,P=0.0240、<0.0001、0.0320)。治疗后对照组、阿奇霉素组和益生菌联合应用组的不良反应发生率分别为47.06%,23.53%和2.94%,组间比较差异均有统计学意义(χ^2=4.1210、15.3730、4.6100,P=0.0420、<0.0001、0.0320)。与治疗前相比,3组患者治疗后PaO2均有不同程度的升高,但PaCO2和pH的变化不明显。与治疗前相比,治疗后3组患者肺活量、用力肺活量、第1秒用力肺活量、一氧化碳弥散量均有不同程度提高。结论早期应用益生菌联合阿奇霉素对特发性肺间质纤维化的疗效较好。

Objective To explore the clinical effect of probiotics combined with azithromycin on idiopathic pulmonary interstitial fibrosis(IPIF).Methods A total of 102 patients definitely diagnosed with IPIF in our hospital from Jan.2015 to Jan.2018 were selected and randomly divided into control group,Azithromycin group or combination group,34 cases in each group.All the groups were given low-flow oxygen,anti-infection treatment,drugs for relieving cough and reducing phlegm drugs,and hormone therapy;the Azithromycin group was additionally given azithromycin,while the combination group was additionally given probiotics and Azithromycin.All the patients were treated for 3 months.The treatment effect,adverse reaction rate,blood gas analysis results and lung function in the three groups were observed and compared before and after treatment.Results After treatment,the lung function in all groups were ameliorated in different degree.The efficiency rates in the control group,Azithromycin group and combination group were 50.00%,76.47%and 97.06%,respectively.There were statistical differences among the 3 groups(χ^2=5.1240,17.0000,4.6100;P=0.0240,<0.0001,0.0320).The incidence of adverse reactions in the control group,Azithromycin group and combination group were 47.06%,23.53%and 2.94%respectively.There were statistical differences among the 3 groups(χ^2=4.1210,15.3730,4.6100;P=0.0420,<0.0001,0.0320).PaO2 increased in different degrees in all groups after treatment,but PaCO2 and pH did not change significantly.Compared with the data before treatment,the vital capacity,forced vital capacity,first-second forced vital capacity and carbon monoxide diffusion in all the 3 groups increased to different degrees after treatment.Conclusion Probiotics combined with azithromycin has a better effect in the early treatment of idiopathic pulmonary fibrosis.