岩盐气溶胶疗法对尘肺病患者肺功能的影响
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摘要
目的探讨岩盐气溶胶疗法对尘肺病患者肺功能的影响。方法采用多中心随机对照临床试验研究,选取产煤省份地域、尘肺病患者收治情况有代表性的6家单位于2016年11月—2017年4月收治的452例尘肺病患者为研究对象,随机分为治疗组和对照组,分别在治疗前、治疗后2周、治疗后4周检测尘肺患者每分钟最大通气量(MVV)、用力肺活量(FVC)和最大呼气第1秒呼出的气量容积(FEV1),采用SPSS 20.0对结果进行统计学分析。结果 (1)两组患者治疗后MVV和FVC及1秒率(FEV1/FVC)均有所提升,岩盐治疗组治疗前后差异有统计学意义(P<0.05);治疗后各时点患者MVV、FVC改善程度,治疗组均大于对照组,差异有统计学意义(P<0.05);治疗后各时点患者FEV1/FVC改善程度差异无统计学意义(P>0.05)。(2)两组各期别尘肺病患者MVV治疗后均呈升高趋势,治疗组升高的程度大于对照组,其中壹期(治疗后2周、4周)、贰期(治疗后4周)和叁期(治疗后2、4周)差异有统计学意义(P<0.05);两组各期别尘肺病患者FVC治疗后均呈升高趋势,但治疗组升高的程度大于对照组,其中壹期(治疗后4周)、贰期和叁期差异有统计学意义(P<0.05);(3)合并慢性阻塞性肺疾病(COPD)治疗组与合并COPD对照组比较,MVV升高,差异有统计学意义(P<0.05);单纯治疗组与单纯对照组(治疗后2周)相比,MVV变化差异有统计学意义;合并COPD治疗组与合并COPD对照组比较,FVC升高,差异有统计学意义(P<0.05);单纯治疗组与单纯对照组治疗后4周相比,盐岩气溶胶治疗后FVC变化差异有统计学意义(P<0.05)。结论在常规治疗基础上,岩盐气溶胶疗法可以即时性提高MVV和FVC。
[Objective]To explore the effects of halotherapy on pulmonary function of pneumoconiosis patients.[Methods]Through a method of the randomized multi-center clinical study,452 cases of pneumoconiosis patients were collected from six hospitals which are in coal producing provinces and have representativeness of therapeutic characteristics of pneumoconiosis from from November2016 to April 2017,which were randomly divided into treatment group and control group. The maximal voluntary ventilation(MVV),forced vital capacity(FVC) and the first second forced expiratory volume(FEV1) were tested before treatment,two weeks and four weeks after treatment,and the results were analyzed statistically.[Results](1)The levels of MVV,FVC and FEV1/FVC in two groups increased after treatment,and the differences in treatment group was statistically significant between before and after treatment. At all time-points after the treatment,the improvement levels of MVV and FVC in treatment group were higher than those in control group,and the differences were statistically significant. There was no statistically significant difference in improvement level of FEV1/FVC at all time-points after the treatment.(2)After treatment,the level of MVV in patients at different stage increased in both two groups,and the improvement level in treatment group was higher than that in control group,while the differences were statistically significant in stage I( two and four weeks after treatment) and stage II( four weeks after treatment), stage Ⅲ( two and four weeks after treatment). After treatment,the level of FVC in patients at different stage increased in both two groups,and the improvement level in treatment group was higher than that in control group,while the differences were statistically significant in stage I(four weeks after treatment),stage II and stage Ⅲ(P<0.05).(3)The level of MVV in treatment group combined with chronic obstructive pulmonary disease(COPD) was higher than that in control group combined with COPD,and the difference was statistically significant(P<0.05).After two weeks of treatment,the difference in changes of MVV was statistically significant between simple treatment group and simple control group(P<0.05). The level of FVC in treatment group combined with COPD was higher than that in control group combined with COPD,and the difference was statistically significant(P<0.05). After four weeks of treatment,the difference in changes of FVC was statistically significant between simple treatment group and simple control group.[Conclusion]On the basis of conventional treatment,the halotherapy could immediately improve the MVV and FVC.
[Objective]To explore the effects of halotherapy on pulmonary function of pneumoconiosis patients.[Methods]Through a method of the randomized multi-center clinical study,452 cases of pneumoconiosis patients were collected from six hospitals which are in coal producing provinces and have representativeness of therapeutic characteristics of pneumoconiosis from from November2016 to April 2017,which were randomly divided into treatment group and control group. The maximal voluntary ventilation(MVV),forced vital capacity(FVC) and the first second forced expiratory volume(FEV1) were tested before treatment,two weeks and four weeks after treatment,and the results were analyzed statistically.[Results](1)The levels of MVV,FVC and FEV1/FVC in two groups increased after treatment,and the differences in treatment group was statistically significant between before and after treatment. At all time-points after the treatment,the improvement levels of MVV and FVC in treatment group were higher than those in control group,and the differences were statistically significant. There was no statistically significant difference in improvement level of FEV1/FVC at all time-points after the treatment.(2)After treatment,the level of MVV in patients at different stage increased in both two groups,and the improvement level in treatment group was higher than that in control group,while the differences were statistically significant in stage I( two and four weeks after treatment) and stage II( four weeks after treatment), stage Ⅲ( two and four weeks after treatment). After treatment,the level of FVC in patients at different stage increased in both two groups,and the improvement level in treatment group was higher than that in control group,while the differences were statistically significant in stage I(four weeks after treatment),stage II and stage Ⅲ(P<0.05).(3)The level of MVV in treatment group combined with chronic obstructive pulmonary disease(COPD) was higher than that in control group combined with COPD,and the difference was statistically significant(P<0.05).After two weeks of treatment,the difference in changes of MVV was statistically significant between simple treatment group and simple control group(P<0.05). The level of FVC in treatment group combined with COPD was higher than that in control group combined with COPD,and the difference was statistically significant(P<0.05). After four weeks of treatment,the difference in changes of FVC was statistically significant between simple treatment group and simple control group.[Conclusion]On the basis of conventional treatment,the halotherapy could immediately improve the MVV and FVC.
引文
[1]孙嫚丽,宋莉,杨惠敏,等.岩盐气溶胶疗法对职业性变应性接触性皮炎患者血嗜酸性粒细胞及IgE的影响[J].中国工业医学杂志,2016,29(5):350-351.
[2]王洋,刘锡诚,李京淑,等.岩盐气溶胶疗法在尘肺病合并慢性阻塞性肺疾病康复治疗中的应用评价[C].第十三次全国劳动卫生与职业病学术会议,山东:泰安,2014:204.
[3]王洋,姜鹏,马丽丽,等.岩盐气溶胶疗法在尘肺病复治疗中的临床疗效观察[J].大家健康(学术版),2014,8(11):134-135.
[4]马丽丽,姜鹏,王洋,等.30例职业性哮喘岩盐气溶胶疗法的临床观察[J].中国卫生标准管理,2014,5(3):36-37.
[5]姜鹏,王洋,马丽丽,等.岩盐气溶胶疗法治疗职业性哮喘临床疗效的研究[J].大家健康(学术版),2013,7(6):89.
[6]李红艳,翁恒,王琳,等.岩盐气溶胶疗法对支气管哮喘患者外周血IL-4、IFN-γ、IgE水平的影响及临床疗效分析[J].福建医药杂志,2013,35(1):70-72.
[7]孙贵范,邬堂春,牛侨.职业卫生与职业医学[M].7版.北京,人民卫生出版社,2012:169-185.
[8]ENDRE L.Theoretical basis and clinical benefits of dry salt inhalation therapy[J].Orv Hetil,2015,156(41):1643-1652.
[9]麦翠芳,梁雪梅,潘惠珍.高渗盐水雾化吸入联合气道廓清技术在慢性阻塞性肺疾病急性加重期患者排痰管理中的应用[J].中国临床护理,2018,10(3):203-206.
[10]李少莲,卢琼芳,邓海兰,等.高渗氯化钠溶液对建立人工气道患者进行诱导排痰的效果观察[J].护士进修杂志,2016,31(6):560-562.
[11]涂静.渗透压对人气道上皮细胞黏蛋白5AC分泌的调控研究[D].重庆:重庆医科大学,2011:31-34.
[12]涂静,尤列·皮尔曼,维克多·科罗索夫,等.高渗诱导人气道上皮细胞系黏液高分泌[J].基础医学与临床,2011,31(7):723-727.
[13]涂静,周向东.MARCKS及其对气道黏蛋白胞吐作用的调节[J].国际病理科学与临床杂志,2009,29(5):431-435.
[14]刘章锁,李志军,王瑞玲.219名煤矿尘肺病患者肺功能结果分析[J].实用诊断与治疗杂志,2008,22(2):156-157.
[15]胡世平.煤工尘肺和矽肺患者肺功能损伤及其影响因素[J].职业与健康,2016,32(19):2620-2623.
[16]张建芳,王雪涛,胡世平,等.雾化吸入在煤工尘肺并发肺感染治疗中的作用[J].工业卫生与职业病,2006,32(3):178-179.
[2]王洋,刘锡诚,李京淑,等.岩盐气溶胶疗法在尘肺病合并慢性阻塞性肺疾病康复治疗中的应用评价[C].第十三次全国劳动卫生与职业病学术会议,山东:泰安,2014:204.
[3]王洋,姜鹏,马丽丽,等.岩盐气溶胶疗法在尘肺病复治疗中的临床疗效观察[J].大家健康(学术版),2014,8(11):134-135.
[4]马丽丽,姜鹏,王洋,等.30例职业性哮喘岩盐气溶胶疗法的临床观察[J].中国卫生标准管理,2014,5(3):36-37.
[5]姜鹏,王洋,马丽丽,等.岩盐气溶胶疗法治疗职业性哮喘临床疗效的研究[J].大家健康(学术版),2013,7(6):89.
[6]李红艳,翁恒,王琳,等.岩盐气溶胶疗法对支气管哮喘患者外周血IL-4、IFN-γ、IgE水平的影响及临床疗效分析[J].福建医药杂志,2013,35(1):70-72.
[7]孙贵范,邬堂春,牛侨.职业卫生与职业医学[M].7版.北京,人民卫生出版社,2012:169-185.
[8]ENDRE L.Theoretical basis and clinical benefits of dry salt inhalation therapy[J].Orv Hetil,2015,156(41):1643-1652.
[9]麦翠芳,梁雪梅,潘惠珍.高渗盐水雾化吸入联合气道廓清技术在慢性阻塞性肺疾病急性加重期患者排痰管理中的应用[J].中国临床护理,2018,10(3):203-206.
[10]李少莲,卢琼芳,邓海兰,等.高渗氯化钠溶液对建立人工气道患者进行诱导排痰的效果观察[J].护士进修杂志,2016,31(6):560-562.
[11]涂静.渗透压对人气道上皮细胞黏蛋白5AC分泌的调控研究[D].重庆:重庆医科大学,2011:31-34.
[12]涂静,尤列·皮尔曼,维克多·科罗索夫,等.高渗诱导人气道上皮细胞系黏液高分泌[J].基础医学与临床,2011,31(7):723-727.
[13]涂静,周向东.MARCKS及其对气道黏蛋白胞吐作用的调节[J].国际病理科学与临床杂志,2009,29(5):431-435.
[14]刘章锁,李志军,王瑞玲.219名煤矿尘肺病患者肺功能结果分析[J].实用诊断与治疗杂志,2008,22(2):156-157.
[15]胡世平.煤工尘肺和矽肺患者肺功能损伤及其影响因素[J].职业与健康,2016,32(19):2620-2623.
[16]张建芳,王雪涛,胡世平,等.雾化吸入在煤工尘肺并发肺感染治疗中的作用[J].工业卫生与职业病,2006,32(3):178-179.