汉防己甲素片联合吡非尼酮对肺间质纤维化患者肺功能及肺间质纤维化指标的影响

Effect of tetrandrine tablets combined with pirfenidone on pulmonary function and pulmonary fibrosis indicators in patients with pulmonary interstitial fibrosis

目的探讨汉防己甲素片联合吡非尼酮对肺间质纤维化患者肺功能和血清肺间质纤维化(肺纤维化)指标及炎症因子水平的影响。方法选取2020年12月至2021年12月江西省胸科医院收治的60例肺纤维化患者作为研究对象,按照随机数字表法分为对照组与观察组,每组30例。对照组给予吡非尼酮单药治疗,观察组给予汉防己甲素片联合吡非尼酮治疗,比较两组临床疗效和治疗前后肺功能指标、血清肺纤维化指标、炎症因子水平及不良反应发生率。结果观察组治疗总有效率为96.67%,高于对照组的73.33%,差异有统计学意义(P<0.05);治疗后,观察组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)均大于对照组,FVC/FEV1高于对照组,差异有统计学意义(P<0.05);治疗后,观察组透明质酸酶(HA)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组C反应蛋白(CPR)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较差异无统计学意义。结论汉防己甲素片联合吡非尼酮治疗肺纤维化效果显著,可改善患者肺功能和肺纤维化情况,降低炎症因子水平,且具有一定安全性。

Objective To investigate the effect of tetrandrine tablets combined with pirfenidone on pulmonary function,serum pulmonary fibrosis indicators,and inflammatory factors in patients with pulmonary interstitial fibrosis.Methods 60 patients with pulmonary interstitial fibrosis who were admitted to Jiangxi Chest Hospital from December 2020 to December 2021 were selected as the study subjects,and they were divided into the control group and the observation group according to the random number table method,with 30 cases in each group.The control group received pirfenidone treatment alone,and the observation group received with tetrandrine tablets combined with pirfenidone treatment,the clinical efficacy,pulmonary function indicators,serum pulmonary fibrosis indicators and inflammatory factors before and after treatment,and incidence rates of adverse reactions were compared between the two groups.Results The total effective rate in the observation group was 96.67%,which was higher than 73.33%in the control group,and the difference was statistically significant(P<0.05).After treatment,the forced vital capacity(FVC)and forced expiratory volume in one second(FEV1)in the observation group were larger than those in the control group,FVC/FEV1 was higher than that in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of hyaluronidase(HA),laminin(LN),typeⅣcollagen(Ⅳ-C),and typeⅢprocollagen(PCⅢ)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of C-reactive protein(CPR),procalcitonin(PCT),tumor necrosis factor-α(TNF-α)and interleukin-4(IL-4)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups.Conclusion Tetrandrine tablets combined with pirfenidone is effective in the treatment of pulmonary fibrosis,can improve pulmonary function and pulmonary fibrosis of patients,and reduce the level of inflammation factors,and have certain safety.