[1]黄振峰,于会勇,王成祥.清燥救肺汤联合吡非尼酮治疗特发性肺纤维化疗效及对患者支气管肺泡灌洗液胰岛素样生长因子的影响[J].陕西中医,2023,(8):1037-1041.[doi:DOI:10.3969/j.issn.1000-7369.2023.08.009]
　HUANG Zhenfeng,YU Huiyong,WANG Chengxiang.Effect of Qingzao Jiufei decoction combined with pirfenidone on idiopathic pulmonary fibrosis and insulin-like growth factor in patients with bronchoalveolar lavage solution[J].,2023,(8):1037-1041.[doi:DOI:10.3969/j.issn.1000-7369.2023.08.009]
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清燥救肺汤联合吡非尼酮治疗特发性肺纤维化疗效及对患者支气管肺泡灌洗液胰岛素样生长因子的影响
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年8期
页码:
1037-1041
栏目:
临床研究
出版日期:
2023-08-05

文章信息/Info

Title:
Effect of Qingzao Jiufei decoction combined with pirfenidone on idiopathic pulmonary fibrosis and insulin-like growth factor in patients with bronchoalveolar lavage solution
作者:
黄振峰1; 2; 于会勇2; 王成祥2
(1.北京中医药大学,北京 100029; 2.北京中医药大学第三附属医院呼吸科,北京 100029)
Author(s):
HUANG Zhenfeng; YU Huiyong; WANG Chengxiang
(Beijing University of Chinese Medicine,Beijing 100029,China)
关键词:
特发性肺纤维化;  清燥救肺汤;  吡非尼酮;  阴虚肺燥;  支气管肺泡灌洗液胰岛素样生长因子;  肺功能
Keywords:
Idiopathic pulmonary fibrosis;  Qingzao Jiufei decoction;  Pirfenidone;  Yin deficiency lung dryness;  Bronchoalveolar lavage fluid insulin-like growth factor;  Lung function
分类号:
R 563
DOI:
DOI:10.3969/j.issn.1000-7369.2023.08.009
文献标志码:
A
摘要:
目的:探讨清燥救肺汤联合吡非尼酮治疗特发性肺纤维化疗效及对患者肺纤维化指标、支气管肺泡灌洗液胰岛素样生长因子的影响。方法:将96例特发性肺纤维化患者采用随机数字表法分为对照组和观察组,各48例。对照组给予吡非尼酮治疗,观察组则在对照组基础上联用清燥救肺汤。比较两组治疗效果,观察治疗前后两组患者的中医症候积分、肺纤维化指标[层粘蛋白(LN)、透明质酸(HA)和Ⅲ型前胶原(PC Ⅲ)]、支气管肺泡灌洗液胰岛素样生长因子[支气管肺泡灌洗液胰岛素样生长因子Ⅰ(IGF-Ⅰ)、胰岛素样生长因子结合蛋白(IGFBP-4)]水平和肺功能恢复指标[肺一氧化碳弥散量(DLCO)、第一秒用力肺活量(FEV1)和6 min步行实验(6MWD)],并统计两组不良反应发生率。结果:观察组临床治疗总有效率明显高于对照组(P<0.05)。两组治疗后气急喘促、咳吐浊唾、口渴咽干、手足心热和舌红脉虚数症候积分较治疗前显著降低,且观察组低于对照组(均P<0.05)。两组治疗后LN、HA、PC Ⅲ、IGF-Ⅰ和IGFBP-4水平较治疗前显著降低,且观察组治疗后低于对照组(均P<0.05)。两组治疗后DLCO、FEV1、6MWD较治疗前显著升高,且观察组显著优于对照组(均P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论:清燥救肺汤联合吡非尼酮可有效缓解特发性肺纤维化患者肺纤维化程度,降低支气管肺泡灌洗液胰岛素样生长因子水平,提高肺功能,并改善阴虚肺燥症候,提高临床疗效,且未增加不良反应,安全性好。
Abstract:
Objective:To investigate the curative effect of Qingzao Jiufei decoction combined with pirfenidone in the treatment of idiopathic pulmonary fibrosis and the effects on pulmonary fibrosis indexes and insulin-like growth factor of bronchoalveolar lavage fluid.Methods:96 patients with idiopathic pulmonary fibrosis were randomly divided into control group and observation group,48 cases in each group.The control group was given pirfenidone treatment,and the observation group was given Qingzao Jiufei decoction on the basis of the control group.To compare the treatment effect between the two groups,the traditional Chinese medicine symptom scores,pulmonary fibrosis indexes [laminin(LN),hyaluronic acid(HA)and type Ⅲ procollagen(PC Ⅲ)] of the two groups before and after treatment were observed,levels of insulin-like growth factor in bronchoalveolar lavage fluid [insulin-like growth factor Ⅰ(IGF-Ⅰ)and insulin-like growth factor binding protein(IGFBP-4)] and lung function recovery indicators [carbon monoxide dispersion(DLCO),first-second forced vital capacity(FEV1)and 6 min walking test(6MWD)] were compared between the two groups.The incidence of adverse reactions in the two group was analyzed.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).Symptom scores of shortness of breath,cough and turbidness,dry thirst and pharynx,warm hands and feet and red tongue pulse were significantly decreased in both groups after treatment,and the TCM symptom scores of the observation group were significantly lower than those of the control group after treatment(all P<0.05).After treatment,the levels of LN,HA,PC Ⅲ,IGF-Ⅰ and IGFBP-4 in both groups were significantly decreased compared with before treatment,and the above pulmonary fibrosis indexes and insulin-like growth factor levels in bronchoalveolar lavage fluid in the observation group were significantly lower than those in the control group(all P<0.05).The values of DLCO,FEV1 and 6MWD in the two groups were significantly higher after treatment than before,and the above indexes of lung function recovery in the observation group were significantly better than those in the control group after treatment(all P<0.05).There was no statistically significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Qingzao Jiufei decoction combined with pirfenidone can effectively relieve the degree of pulmonary fibrosis in patients with idiopathic pulmonary fibrosis,reduce the level of insulin-like growth factor in bronchoalveolar irrigation fluid,improve lung function and the syndrome of lung dryness,and improve clinical efficacy.It has good safety without increasing adverse reactions.

参考文献/References:

[1] Heukels P,Moor CC,Vonder TJH,et al.Inflammation and immunity in IPF pathogenesis and treatment[J].Respir Med,2019,147(2):79-91.
[2] 魏胜全,薛 华,王惠霞,等.罗红霉素联合N-乙酰半胱氨酸治疗慢性阻塞性肺疾病合并肺间质纤维化疗效及对患者肺功能的影响[J].陕西医学杂志,2020,49(5):611-614.
[3] 朱晓燕,徐晓涵,翟所迪.吡非尼酮治疗特发性肺纤维化疗效与安全性的系统评价[J].临床药物治疗杂志,2020,18(9):22-26.
[4] Behr J,Gunther A,Bonella F,et al.S2K guideline for diagnosis of idiopathic pulmonary fibrosis[J].Respiration,2021,100(3):238-271.
[5] 王紫娟.肺纤方治疗IPF肺肾亏虚痰瘀阻络证患者CT评分及生活质量观察[D].北京:北京中医药大学,2017.
[6] 胡运勤.屏风生脉散联合强的松对气阴两虚型特发性肺纤维化患者疗效及T细胞亚群的影响[J].陕西中医,2017,38(7):889-890.
[7] 中华医学会呼吸病学分会间质性肺疾病学组.特发性肺纤维化诊断和治疗中国专家共识[J].中华结核和呼吸杂志,2016,39(6):427-432.
[8] 刘春明,张 洪,李一鸣.Fleischner学会关于特发性肺纤维化诊断标准的白皮书解读[J].国际医学放射学杂志,2018,41(6):653-657.
[9] 陈灏珠,林果为,王吉耀.实用内科学[M].14版.北京:人民卫生出版社,2013:1775-1782.
[10] 李建生,王至婉,春 柳,等.特发性肺纤维化中医证候诊断标准(2019版)[J].中医杂志,2020,61(18):1653-1656.
[11] 中华医学会呼吸病学分会.特发性肺(间质)纤维化诊断和治疗指南(草案)[J].现代实用医学,2003,15(2):129-130.
[12] 国家食品药品监督管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:50-65.
[13] 冯欣丽,庄 盼,刘军权.特发性肺纤维化的发病机制及药物治疗进展[J].中国医药导报,2021,18(29):45-48.
[14] Ruwanpura SM,Thomas BJ,Bardin PG.Pirfenidone:Molecular mechanisms and potential clinical applications in lung disease[J].Am J Respir Cell Mol Biol,2020,62(4):413-422.
[15] 薛 寒,周贤梅.140例特发性肺纤维化患者中医证型分布及相关因素分析[J].山东中医杂志,2022,41(1):18-22.
[16] 乔 虎,全立欣,付子佳,等.从肺损络伤探讨特发性肺纤维化的发病机制与治疗[J].中医药学报,2023,51(3):48-50.
[17] 刘晓敏,孙慧莹,王永福,等.HA、ColⅣ、LN和PⅢNP-P在结缔组织病合并间质性肺病病情评估中的意义[J].天津医药,2021,49(6):617-621.
[18] 吴 倩,孔灵菲,李振华,等.IGF-Ⅰ、IGFBP-4和IGFBP-5在特发性肺纤维化患者支气管肺泡灌洗液和血清中的表达及意义[J].中国医科大学学报,2016,45(3):255-259,263.
[19] 吴振起,韩冬阳,王贵帮,等.清燥救肺汤“润燥”作用的分子机制[J].中国实验方剂学杂志,2018,24(11):92-98.
[20] 向仕友,张金红,舒孟仙,等.中医益气活血散结法治疗特发性肺纤维化疗效及对肺功能、生活质量的影响[J].现代中西医结合杂志,2021,30(33):3715-3719.
[21] 许建秦,李 婷,祁海燕,等.基于中医传承辅助平台的名老中医米烈汉教授治疗肺痿用药规律分析[J].陕西中医,2020,41(2):254-257.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(82074389); 北京市中医药科技发展资金资助项目(JCZX-2020-02)
更新日期/Last Update: 2023-08-10