养阴清肺汤对稳定期尘肺病患者肺功能的影响及改善肺纤维化的作用机制
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R598

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湖州市科学技术局项目(2019GY66)


Effect of Yangyin Qingfei Tang on Lung Function in Patients with Pneumoconiosis in Stable Stage and Its Mechanism of Improving Lung Fibrin
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    摘要:

    目的:观察养阴清肺汤对稳定期尘肺病患者肺功能的影响及改善肺纤维化的作用机制。方法:选取尘肺病患者70 例,根据治疗方式不同进行分组,其中常规组10 例,养阴清肺汤组30 例,吡非尼酮组30 例。常规组给予常规吸入制剂、吸氧、止咳化痰、平喘等治疗,养阴清肺汤组在常规治疗基础上给予养阴清肺汤治疗,吡非尼酮组在常规治疗基础上给予吡非尼酮胶囊治疗。比较3 组治疗前、治疗4 周、治疗16 周时用力肺活量(FVC),第1 秒用力呼气容积(FEV1) 及FEV1/FVC 水平,检测治疗前后外周血中CD3+、CD4+、CD8+、CD4+/CD8+、转化生长因子-β1(TGF-β1)、白细胞介素-2(IL-2)、白细胞介素-17(IL-17)水平。采用《呼吸功能状态和呼吸困难问卷修改版》(PFSDQ-M) 量表评价2 组生活质量,并观察不良反应发生情况。结果:治疗4 周、16 周,3 组FEV1、FVC 及FEV1/FVC 水平逐渐升高,且养阴清肺汤组和吡非尼酮组FEV1、FVC 及FEV1/FVC 水平高于同时间点常规组,差异均有统计学意义(P<0.05)。治疗后,3 组CD3+、CD4+、CD4+/CD8+水平较治疗前升高,CD8+水平降低,差异有统计学意义(P<0.05)。治疗后,养阴清肺汤组和吡非尼酮组CD3+、CD4+、CD4+/CD8+水平高于常规组,CD8+水平低于常规组(P<0.05);养阴清肺汤组CD3+、CD4+、CD4+/CD8+水平高于吡非尼酮组,CD8+水平低于吡非尼酮组(P<0.05)。治疗后,3 组TGF-β1、IL-2、IL-17 水平较治疗前降低,且养阴清肺汤组和吡非尼酮组TGF-β1、IL-2、IL-17 水平低于常规组,养阴清肺汤组TGF-β1、IL-2、IL-17 水平低于吡非尼酮组,差异均有统计学意义(P<0.05)。治疗后,3 组PFSDQ-M 评分均较治疗前降低,且养阴清肺汤组和吡非尼酮组PFSDQ-M 评分低于常规组,养阴清肺汤组PFSDQ-M 评分低于吡非尼酮组,差异均有统计学意义(P<0.05)。养阴清肺汤组和吡非尼酮组不良反应发生率低于常规组(P<0.05),养阴清肺汤组不良反应发生率低于吡非尼酮组(P<0.05)。结论:养阴清肺汤能够显著改善尘肺病患者的肺功能以及肺纤维化,且其对患者的预后较好,安全性高。

    Abstract:

    Abstract:Objective:To observe the effect of Yangyin Qingfei tang on lung function in patients with pneumoconiosis in stable stage and its mechanism of improving lung fibrin. Methods:A total of 70 cases of patients with pneumoconiosis were selected and divided into the routine group,the Yangyin Qingfei tang group and the pirfenidone group according to different treatment methods,with 10,30 and 30 cases in each group respectively. The routine group was treated with conventional inhalation preparations, oxygen inhalation, suppressing cough, resolving sputum and relieving asthma, and the Yangyin Qingfei tang group was additionally treated with Yangyin Qingfei tang based on the routine treatment, and the pirfenidone capsules group was additionally treated with pirfenidone capsules based on routine treatment. Before treatment and after 4 and 16 weeks of treatment,the levels of forced vital capacity(FVC),forced expiratory volume in one second(FEV1) and FEV1/ FVC in the three groups were compared. Before and after treatment,the levels of CD3+,CD4+,CD8+ and CD4+/CD8+ in the peripheral blood,transforming growth factor β1(TGF- β1),interleukin- 2(IL- 2),and interleukin- 17(IL- 17) were detected. The quality of life in the two groups was evaluated by Modified Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ- M), and the incidences of adverse reactions were observed. Results: After 4 and 16 weeks of treatment, the levels of FEV1,FVC and FEV1/FVC in the three groups were gradually increased,and the levels of FEV1,FVC and FEV1/FVC in the Yangyin Qingfei tang group and the pirfenidone group were higher than those in the routine group at the same time period,differences being significant(P<0.05). After treatment,the levels of CD3+,CD4+ and CD4+/CD8+ in the three groups were increased when compared with those before treatment, and CD8 + levels were decreased, the difference being significant(P<0.05). After treatment,the levels of CD3 +,CD4 + and CD4 +/CD8 + in the Yangyin Qingfei tang group and the pirfenidone group were higher than those in the routine group,and the CD8+ levels were lower(P<0.05);the levels of CD3+, CD4+ and CD4+/CD8+ in the Yangyin Qingfei tang group were higher than those in the pirfenidone group,and the CD8+ level was lower(P<0.05). After treatment, the levels of TGF- β1, IL- 2 and IL- 17 in the three groups were decreased when compared with those before treatment,and the levels of TGF-β1,IL-2 and IL-17 in the Yangyin Qingfei tang group and the pirfenidone group were lower than those in the routine group,and the TGF-β1,IL-2 and IL-17 in the Yangyin Qingfei tang group were lower than those in the pirfenidone group,differences being significant(P<0.05). After treatment,the PFSDQM scores in the three groups were decreased when compared with those before treatment,and the PFSDQ-M scores in the Yangyin Qingfei tang group and the pirfenidone group were lower than that in the routine group,and the PFSDQ-M score in the Yangyin Qingfei tang group was lower than that in the pirfenidone group, differences being significant(P<0.05). The incidences of adverse reactions in the Yangyin Qingfei tang group and the pirfenidone group were lower than those in the routine group,and the incidence of adverse reaction in the Yangyin Qingfei tang group was lower than that in the pirfenidone group(P<0.05). Conclusion: Yangyin Qingfei tang can significantly improve lung function and lung fibrin in patients with pneumoconiosis,with good prognosis and high safety.

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范华东,蒋国锋,孙素平,王艳青.养阴清肺汤对稳定期尘肺病患者肺功能的影响及改善肺纤维化的作用机制[J].新中医,2022,54(1):46-50

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  • 在线发布日期: 2022-01-10
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