丹参川芎嗪联合泼尼松治疗肺间质纤维化
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摘要
目的探讨丹参川芎嗪联合泼尼松在肺间质纤维化患者中的应用效果及对炎症因子的影响。方法选取2016年2月-2018年4月我院收治的肺间质纤维化患者81例,随机分为对照组与研究组。对照组40例,应用泼尼松治疗;研究组41例,应用丹参川芎嗪联合泼尼松治疗。1周为1个疗程,2组均连续治疗8个疗程。比较2组患者临床疗效、炎性因子TGF-β1(转移生长因子)、IL-18(白细胞介素-18)、IL-13(白细胞介素-13)浓度、肺功能、抗氧化因子CAT(过氧化氢酶)、LPO(脂质过氧化物)、GSH-PX(谷胱甘肽过氧化酶)浓度、血气指标Pa O2(血氧分压)、Pa CO2(动脉血二氧化碳分压)、p H。结果研究组有效率为95.2%,优于对照组的67.5%(P <0.05);治疗后研究组炎性因子TGF-β1、IL-18、IL-13浓度低于对照组(P <0.05);治疗后研究组肺功能优于对照组(P <0.05);治疗后研究组抗氧化因子CAT、GSH-PX浓度高于对照组(P <0.05),LPO抗氧化因子浓度低于对照组(P <0.05);治疗后研究组血气指标Pa O2、p H高于对照组(P <0.05);Pa CO2低于对照组(P <0.05)。结论在肺间质纤维化患者的治疗过程中,泼尼松降低了患者炎性因子浓度、抑制巨噬细胞的产生、降低免疫应答反应与气道炎性反应,丹参川芎嗪提高了患者的血氧分压,改善低氧,缓解呼吸困难,恢复肺部功能,减轻炎性反应,控制病情发展。
Objective To investigate the effect of salvia miltiorrhiza, ligustrazine and prednisone in the treatment of pulmonary interstitial fibrosis and its influence on inflammatory factors. Methods Eighty-one patients with pulmonary interstitial fibrosis admitted to our hospital from February 2016 to April 2018 were randomly divided into two groups. The control group was treated with prednisone, and the study group was treated with salvia miltiorrhiza and ligustrazine combined with prednisone. One week was a course of treatment, and both groups were treated for 8 consecutive courses. The therapeutic efficacy, TGF-β1(transfer growth factor), IL-18(interleukin-18), IL-13(interleukin-13) inflammatory factor concentration, pulmonary function, CAT(catalase), LPO(lipid peroxide), GSH-PX(glutathione peroxidase) antioxidant factor concentration, PaO2(partial pressure of oxygen in arterial blood), PaCO2(partial pressure of carbon dioxide in arterial blood) and pH value were compared between the two groups. Results The effective rate was 95.2% in the study group and 67.5% in the control group. The efficacy of the study group was better than that of the control group(P < 0.05). After treatment, TGF-β1, IL-18 and IL-13 were significant lower in the study group than in the control group(P < 0.05). After treatment, the pulmonary function of the study group was better than that of the control group(P < 0.05). After treatment, CAT and GSH-PX antioxidant factor concentration were higher in the study group than in the control group(P < 0.05). The concentration of LPO antioxidant factor in the study group was lower than that in the control group(P < 0.05). The blood gas indexes of PaO2 and pH in the study group were higher than those in the control group(P < 0.05); the blood gas indexes of PaCO2 in the study group were lower than those in the control group(P < 0.05). Conclusion During the treatment of pulmonary interstitial fibrosis, prednisone can reduce the concentration of inflammatory factors, inhibit the production of macrophages, reduce the immune response and airway inflammation. Salvia miltiorrhiza and ligustrazine can increase the partial pressure of oxygen in patients, improve the symptoms of hypoxia, alleviate the symptoms of dyspnea, restore the pulmonary function of patients and alleviate the symptoms of patients with pulmonary interstitial fibrosis. Salvia miltiorrhiza and igustrazine combinded with prednisone are effective in treating inflammatory reaction and controlling the development of the disease.
Objective To investigate the effect of salvia miltiorrhiza, ligustrazine and prednisone in the treatment of pulmonary interstitial fibrosis and its influence on inflammatory factors. Methods Eighty-one patients with pulmonary interstitial fibrosis admitted to our hospital from February 2016 to April 2018 were randomly divided into two groups. The control group was treated with prednisone, and the study group was treated with salvia miltiorrhiza and ligustrazine combined with prednisone. One week was a course of treatment, and both groups were treated for 8 consecutive courses. The therapeutic efficacy, TGF-β1(transfer growth factor), IL-18(interleukin-18), IL-13(interleukin-13) inflammatory factor concentration, pulmonary function, CAT(catalase), LPO(lipid peroxide), GSH-PX(glutathione peroxidase) antioxidant factor concentration, PaO2(partial pressure of oxygen in arterial blood), PaCO2(partial pressure of carbon dioxide in arterial blood) and pH value were compared between the two groups. Results The effective rate was 95.2% in the study group and 67.5% in the control group. The efficacy of the study group was better than that of the control group(P < 0.05). After treatment, TGF-β1, IL-18 and IL-13 were significant lower in the study group than in the control group(P < 0.05). After treatment, the pulmonary function of the study group was better than that of the control group(P < 0.05). After treatment, CAT and GSH-PX antioxidant factor concentration were higher in the study group than in the control group(P < 0.05). The concentration of LPO antioxidant factor in the study group was lower than that in the control group(P < 0.05). The blood gas indexes of PaO2 and pH in the study group were higher than those in the control group(P < 0.05); the blood gas indexes of PaCO2 in the study group were lower than those in the control group(P < 0.05). Conclusion During the treatment of pulmonary interstitial fibrosis, prednisone can reduce the concentration of inflammatory factors, inhibit the production of macrophages, reduce the immune response and airway inflammation. Salvia miltiorrhiza and ligustrazine can increase the partial pressure of oxygen in patients, improve the symptoms of hypoxia, alleviate the symptoms of dyspnea, restore the pulmonary function of patients and alleviate the symptoms of patients with pulmonary interstitial fibrosis. Salvia miltiorrhiza and igustrazine combinded with prednisone are effective in treating inflammatory reaction and controlling the development of the disease.
引文
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[2]王晓芳,周艳,李婧,等.化纤方对肺纤维化模型大鼠的肺系数及炎症因子MCP-1、IL-1β的影响[J].辽宁中医杂志,2016,43(3):633-635.
[3]ZHANG Y,MA X,GUO C,et al.Pretreatment with a combination of ligustrazine and berberine improves cardiac function in rats with coronary microembolization[J].中国药理学报,2016,37(4):463-472.
[4]王晨,王紫娟,张晓梅,等.肺纤方提取物对肺间质纤维化大鼠肺微血管VEGF、VEGFR2、PAI-1、VCAM-1mRNA表达的影响[J].北京中医药大学学报,2017,40(2):143-147.
[5]王晨,王紫娟,张晓梅,等.肺纤方提取物对肺间质纤维化大鼠血管新生的影响[J].北京中医药大学学报,2017,40(1):36-40.
[6]AI Y,ZHU B,REN C,et al.Discovery of new monocarbonyl ligustrazine-curcumin hybrids for intervention of drugsensitive and drug-resistant lung cancer[J].Journal of Medicinal Chemistry,2016,59(5):1747-1760.
[7]徐昌君,王鹏飞,刘杨,等.黄芪甲苷对特发性肺纤维化自噬活性作用及PI3K/Akt/mTOR信号调控的影响[J].中国实验方剂学杂志,2017,23(18):75-82.
[8]王晨,张晓梅,尹婷,等.肺纤方提取物对肺间质纤维化大鼠VEGFR1介导的p38MAPK/PI3K信号通路表达的影响[J].中华中医药杂志,2017,32(6):2659-2661.
[9]KING J,RICHARDSON M,QUINN A M,et al.Bagpipe lung:a new type of interstitial lung disease?[J].Thorax,2017,34(4):380-382.
[10]李瑞琴,金艳,李伟,等.桂附地黄丸抗大鼠肺纤维化的作用及对外周血T淋巴细胞亚群的影响[J].中华中医药学刊,2016,34(12):2938-2940.
[11]刘理静,钱红,尹辉明,等.中华猕猴桃果仁非饱和脂肪酸通过激活Keap1/Nrf2信号通路增强肺纤维化大鼠抗氧化能力[J].细胞与分子免疫学杂志,2016,32(4):479-483.
[12]景菲,张伟.从“久病入络”论治特发性肺纤维化合并肺癌[J].长春中医药大学学报,2018,34(2):267-270.