乙酰半胱氨酸联合百令胶囊治疗新型冠状病毒感染后肺纤维化的临床研究

Clinical study of acetylcysteine combined with Bailing capsule in the treatment of pulmonary fibrosis after COVID-19

目的观察乙酰半胱氨酸联合百令胶囊对新型冠状病毒(新冠病毒)感染后肺纤维化患者的治疗效果。方法将106例患者应用随机数字表法分为试验组和对照组,对照组采用常规治疗方案:使用乙酰半胱氨酸及常规对症治疗;试验组在对照组的基础上联合应用百令胶囊(2.0 g/次,3次/d,口服);对照组及试验组治疗时间均为6个月。结果试验组相比对照组患者,治疗前后肺功能及肺纤维化指标改善程度[用力肺活量(0.60 vs.0.06,P=0.000)、最大呼气流量(1.27 vs.0.27,P=0.001)、一秒用力呼气容积(1.17 vs.0.03,P=0.000)、透明质酸(30.50 vs.-17.17,P=0.000)、层粘连蛋白(20.00 vs.6.00,P=0.005)、Ⅲ型胶原蛋白(10.70 vs.-8.30,P=0.000)、Ⅳ型胶原蛋白(16.75 vs.2.10,P=0.049)]差异均有统计学意义;试验组相比对照组患者,治疗前后高分辨率CT评分改善程度及治疗有效率之间差异均无统计学意义(P均>0.05);2组患者不良反应发生率之间差异无统计学意义(P>0.05)。结论乙酰半胱氨酸联合百令胶囊治疗新冠病毒感染后肺纤维化,能改善患者肺功能指标及肺纤维化指标,延缓肺纤维化进程。

Objective To observe the therapeutic effect of acetylcysteine combined with Bailing capsule on patients with pulmonary fibrosis after COVID-19.Method A total of 106 patients were randomly divided into 2 groups.The control group received conventional treatment with acetylcysteine and routine symptomatic therapy while the experimental group on the basis of the control group’s treatment received Bailing Capsule,2.0 g each time,3 times a day.The total course of treatment was 6 months.Results The experimental group showed statistically significant improvements in lung function and pulmonary fibrosis indicators compared to the control group after treatment,including forced vital capacity(0.60 vs 0.06,P=0.000),peak expiratory flow(1.27 vs 0.27,P=0.001),forced expiratory volume in one second(1.17 vs 0.03,P=0.000),hyaluronic acid(30.50 vs-17.17,P=0.000),laminin(20.00 vs 6.00,P=0.005),collagen type III protein(10.70 vs-8.30,P=0.000)and collagen typeⅣprotein(16.75 vs 2.10,P=0.049).However,there were no significant differences in the improvement of HRCT scores and the effective rate between the 2 groups(P>0.05).The incidence of adverse reactions was also similar in both groups(P>0.05).Conclusion The combination of acetylcysteine and Bailing Capsule in treating pulmonary fibrosis after COVID-19 can improve lung function and pulmonary fibrosis indicators,thus delaying the progression of pulmonary fibrosis.