复方葛根芩连汤联合N-乙酰半胱氨酸胶囊治疗肺纤维化患者的临床效果
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摘要
目的:探讨复方葛根芩连汤联合N-乙酰半胱氨酸胶囊治疗肺纤维化患者的临床效果。方法:选取2014年8月至2016年2月湖北医药学院附属东风医院收治的肺纤维化患者96例,按照随机数字表法分为对照组和观察组,每组48例,对照组给予N-乙酰半胱氨酸胶囊治疗,观察组给予复方葛根芩连汤联合N-乙酰半胱氨酸胶囊治疗,2组都治疗观察3个月。结果:有效率观察组和对照组分别为97. 9%和83. 3%,差异有统计学意义(P <0. 05)。2组治疗前CT磨玻璃影、蜂窝影、网格影等一般资料比较,差异无统计学意义(P> 0. 05),治疗后观察组的上述阳性例数明显低于对照组,差异有统计学意义(P <0. 05)。2组治疗后的肺活量(VC)与肺总量(TLC)明显高于治疗前,差异有统计学意义(P <0. 05),同时治疗后观察组的VC与TLC值也明显高于对照组,差异有统计学意义(P <0. 05)。结论:复方葛根芩连汤联合N-乙酰半胱氨酸胶囊治疗肺纤维化能提高治疗疗效,改善肺纤维化的CT影像学特征,促进患者肺功能的提高。
Objective: To investigate the effects of Compound Gegen Qinlian Decoction combined with N-acetylcysteine Capsules in the treatment of pulmonary fibrosis. Methods: A retrospective study method was used. From August 2014 to February 2016,96 patients with pulmonary fibrosis diagnosed and treated in Dongfeng Hospital Affiliated to Hubei University of Medicine were divided into observation group and control group according to the random number table method,with 48 patients in each group. The control group was given the N-acetylcysteine Capsules treatment,while the observation group was given Compound Gegen Qinlian Decoction combined with N-acetylcysteine capsules treatment,and two groups were observed for 3 months. Results: The effective rates of the observation group and the control group were 97. 9% and 83. 3% respectively. And the effective rate of the observation group was significantly higher than that of the control group( P < 0. 05). There were no significant differences of CT ground glass opacity,interlobular septal thickening image,reticular and honeycombing of positive numbers compared between the observation group and the control group before treatment( P > 0. 05),and those of the observation group were significantly lower than that of the control group after treatment( P < 0. 05). The VC and TLC values in the observation group and control group after treatment were significantly increased than before treatment( P < 0. 05),while those of the observation group after the treatment were also significantly higher than those of the control group( P < 0. 05). Conclusion: Compound Gegen Qinlian Decoction combined with N-acetylcysteine Capsules in treatment of pulmonary fibrosis can improve the curative effect,improve pulmonary fibrosis CT imaging features,promote the pulmonary function of patients,which is worthy of application.
Objective: To investigate the effects of Compound Gegen Qinlian Decoction combined with N-acetylcysteine Capsules in the treatment of pulmonary fibrosis. Methods: A retrospective study method was used. From August 2014 to February 2016,96 patients with pulmonary fibrosis diagnosed and treated in Dongfeng Hospital Affiliated to Hubei University of Medicine were divided into observation group and control group according to the random number table method,with 48 patients in each group. The control group was given the N-acetylcysteine Capsules treatment,while the observation group was given Compound Gegen Qinlian Decoction combined with N-acetylcysteine capsules treatment,and two groups were observed for 3 months. Results: The effective rates of the observation group and the control group were 97. 9% and 83. 3% respectively. And the effective rate of the observation group was significantly higher than that of the control group( P < 0. 05). There were no significant differences of CT ground glass opacity,interlobular septal thickening image,reticular and honeycombing of positive numbers compared between the observation group and the control group before treatment( P > 0. 05),and those of the observation group were significantly lower than that of the control group after treatment( P < 0. 05). The VC and TLC values in the observation group and control group after treatment were significantly increased than before treatment( P < 0. 05),while those of the observation group after the treatment were also significantly higher than those of the control group( P < 0. 05). Conclusion: Compound Gegen Qinlian Decoction combined with N-acetylcysteine Capsules in treatment of pulmonary fibrosis can improve the curative effect,improve pulmonary fibrosis CT imaging features,promote the pulmonary function of patients,which is worthy of application.
引文
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[2]于国强,石绍顺,付东升.旋覆花汤化裁辨治痰瘀痹阻型特发性肺纤维化的临床研究[J].中医临床研究,2016,8(1):18-20.
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[8]张晓丹,王力维,王淑静,等.葛根素通过调控活性氧对缺氧诱导的PASMCs增殖的影响[J].中国中药杂志,2015,40(15):3027-3033.
[9]姚金福,樊湘泽,杨子尧,等.葛根芩连汤对内毒素诱导的急性肺损伤小鼠的保护机制[J].中国老年学杂志,2015,35(7):1899-1900.
[10]Johnson K,Mc Evoy CE,Naqvi S,et al.High-dose oral N-acetylcysteine fails to improve respiratory health status in patients with chronic obstructive pulmonary disease and chronic bronchitis:a randomized,placebo-controlled trial[J].Int J Chron Obstruct Pulmon Dis,2016,11:799-807.
[11]安方玉,刘永琦,骆亚莉,等.泻肺汤对肺纤维化大鼠肺组织及血清自由基代谢的影响[J].中成药,2016,38(3):665-668.
[12]Muramatsu Y,Sugino K,Ishida F,et al.Effect of inhaled N-acetylcysteine monotherapy on lung function and redox balance in idiopathic pulmonary fibrosis[J].Respir Investig,2016,54(3):170-178.
[13]耿艳艳,于冰,周植星,等.甘草次酸衍生物TY501抗肺纤维化作用及机制研究[J].中国药理学通报,2015,31(2):210-215.
[14]Okuda R,Matsushima H,Oba T,et al.Efficacy and safety of inhaled N-acetylcysteine in idiopathic pulmonary fibrosis:A prospective,single-arm study[J].Respir Investig,2016,54(3):156-161.
[15]Rochwerg B,Neupane B,Zhang Y,et al.Treatment of idiopathic pulmonary fibrosis:a network meta-analysis[J].BMC Med,2016,14:18.
[16]肖清萍,孙坚.葛根素对大鼠肺纤维化的干预研究[J].江西医药,2015,50(9):883-886.
[17]王正冠,李芮冰,徐舒敏,等.葛根素联合依达拉奉对烟雾所致吸入性肺损伤大鼠的治疗作用[J].解放军医学杂志,2015,40(1):66-70.
[18]Canestaro WJ,Forrester SH,Raghu G,et al.Drug Treatment of Idiopathic Pulmonary Fibrosis:Systematic Review and Network Meta-A-nalysis[J].Chest,2016,149(3):756-766.
[19]颜晓霞,袁帆,郑访江.补阳还五汤联合N-乙酰半胱氨酸胶囊治疗特发性肺纤维化患者的效果评价[J].内科,2015,10(4):468-470.
[20]Kropski JA,Lawson WE,Blackwell TS.Personalizing Therapy in Idiopathic Pulmonary Fibrosis:A Glimpse of the Future?[J].Am JRespir Crit Care Med,2015,192(12):1409-1411.
[2]于国强,石绍顺,付东升.旋覆花汤化裁辨治痰瘀痹阻型特发性肺纤维化的临床研究[J].中医临床研究,2016,8(1):18-20.
[3]Rogliani P,Calzetta L,Cavalli F,et al.Pirfenidone,nintedanib and N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis:A systematic review and meta-analysis[J].Pulm Pharmacol Ther,2016,40:95-103.
[4]Sun T,Liu J,de W Z.Efficacy of N-Acetylcysteine in Idiopathic Pulmonary Fibrosis:A Systematic Review and Meta-Analysis[J].Medicine(Baltimore),2016,95(19):e3629.
[5]何海明.葛根芩连汤的临床运用思路[J].中医临床研究,2015,7(17):97-99.
[6]张晓丹,杨艳南,王淑静等.葛根素对PI3K/AKT通路介导PASMCS凋亡的影响[J].中国中药杂志,2015,40(15):3041-3046.
[7]Behr J,Bendstrup E,Crestani B,et al.Safety and tolerability of acetylcysteine and pirfenidone combination therapy in idiopathic pulmonary fibrosis:a randomised,double-blind,placebo-controlled,phase 2 trial[J].Lancet Respir Med,2016,4(6):445-453.
[8]张晓丹,王力维,王淑静,等.葛根素通过调控活性氧对缺氧诱导的PASMCs增殖的影响[J].中国中药杂志,2015,40(15):3027-3033.
[9]姚金福,樊湘泽,杨子尧,等.葛根芩连汤对内毒素诱导的急性肺损伤小鼠的保护机制[J].中国老年学杂志,2015,35(7):1899-1900.
[10]Johnson K,Mc Evoy CE,Naqvi S,et al.High-dose oral N-acetylcysteine fails to improve respiratory health status in patients with chronic obstructive pulmonary disease and chronic bronchitis:a randomized,placebo-controlled trial[J].Int J Chron Obstruct Pulmon Dis,2016,11:799-807.
[11]安方玉,刘永琦,骆亚莉,等.泻肺汤对肺纤维化大鼠肺组织及血清自由基代谢的影响[J].中成药,2016,38(3):665-668.
[12]Muramatsu Y,Sugino K,Ishida F,et al.Effect of inhaled N-acetylcysteine monotherapy on lung function and redox balance in idiopathic pulmonary fibrosis[J].Respir Investig,2016,54(3):170-178.
[13]耿艳艳,于冰,周植星,等.甘草次酸衍生物TY501抗肺纤维化作用及机制研究[J].中国药理学通报,2015,31(2):210-215.
[14]Okuda R,Matsushima H,Oba T,et al.Efficacy and safety of inhaled N-acetylcysteine in idiopathic pulmonary fibrosis:A prospective,single-arm study[J].Respir Investig,2016,54(3):156-161.
[15]Rochwerg B,Neupane B,Zhang Y,et al.Treatment of idiopathic pulmonary fibrosis:a network meta-analysis[J].BMC Med,2016,14:18.
[16]肖清萍,孙坚.葛根素对大鼠肺纤维化的干预研究[J].江西医药,2015,50(9):883-886.
[17]王正冠,李芮冰,徐舒敏,等.葛根素联合依达拉奉对烟雾所致吸入性肺损伤大鼠的治疗作用[J].解放军医学杂志,2015,40(1):66-70.
[18]Canestaro WJ,Forrester SH,Raghu G,et al.Drug Treatment of Idiopathic Pulmonary Fibrosis:Systematic Review and Network Meta-A-nalysis[J].Chest,2016,149(3):756-766.
[19]颜晓霞,袁帆,郑访江.补阳还五汤联合N-乙酰半胱氨酸胶囊治疗特发性肺纤维化患者的效果评价[J].内科,2015,10(4):468-470.
[20]Kropski JA,Lawson WE,Blackwell TS.Personalizing Therapy in Idiopathic Pulmonary Fibrosis:A Glimpse of the Future?[J].Am JRespir Crit Care Med,2015,192(12):1409-1411.