| 毛标兵.补气升阳汤联合常规对症治疗Ⅲ期矽肺病肺肾气虚证临床研究[J].浙江中西医结合杂志,2025,35(10): |
| 补气升阳汤联合常规对症治疗Ⅲ期矽肺病肺肾气虚证临床研究 |
| Clinical study on the combination of Bu Qi Sheng Yang Tang and conventional symptomatic treatment for stage III silicosis with lung and kidney qi deficiency syndrome |
| 投稿时间：2024-12-19 修订日期：2025-08-14 |
| DOI： |
| 中文关键词: 矽肺病 Ⅲ期 补气升阳汤 肺肾气虚证 肺功能 炎症反应 肺纤维化 |
| 英文关键词:Silicosis Phase III Tonifying Qi and Boosting Yang Decoction Deficiency syndrome of lung and kidney qi Pulmonary function Inflammatory response pulmonary fibrosis |
| 基金项目: |
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| 摘要点击次数: 94 |
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| 中文摘要: |
| 目的 观察补气升阳汤联合常规对症治疗Ⅲ期矽肺病肺肾气虚证的临床疗效。方法 采取前瞻性对照研究方法,按随机数字表法将浙江省医疗健康集团长兴医院收治的78例Ⅲ期矽肺病肺肾气虚证患者分为研究组与对照组(各39例),最终研究组完成试验37例(剔除2例),对照组完成试验36例(剔除3例)。对照组给予常规对症治疗,研究组在对照组基础上给予补气升阳汤治疗,治疗12周后比较2组临床疗效、中医证候积分、呼吸困难严重程度、肺功能指标、炎症反应及肺纤维化指标水平。结果 治疗12周后,研究组总有效率86.49%优于对照组66.67%(P＜0.05)；2组中医证候积分、呼吸困难严重程度[博格评分(Borg)量表、医学研究委员会呼吸困难问卷(mMRC)]评分均低于治疗前(P＜0.05),研究组上述3项评分均低于对照组(P＜0.05)；2组肺功能指标[第1秒用力呼气量( FEV1)、用力肺活量(FVC)、第1秒用力呼气量/用力肺活量比值(FEV1/FVC)、肺一氧化碳弥散量(DLCO)值]均高于治疗前(P＜0.05),研究组上述4项指标水平高于对照组(P＜0.05)；2组血清炎症指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]水平均低于治疗前(P＜0.05),研究组上述3项指标水平均低于对照组(P＜0.05)；2组肺纤维化指标[Ⅰ型前胶原羧基末端前肽(PⅠCP)、Ⅲ型前胶原肽(PⅢP)、Ⅳ型胶原(Ⅳ-C)]水平均低于治疗前(P＜0.05),研究组上述3项指标水平低于对照组(P＜0.05)。结论 以补气升阳汤联合常规对症治疗治疗Ⅲ期矽肺病肺肾气虚证疗效显效,可有效缓解患者中医症状及呼吸困难程度,提高患者肺功能,减轻炎症反应,改善肺纤维指标,进而延缓肺纤维化的进展。 |
| 英文摘要: |
| Objective:To observe the clinical efficacy of Bu Qi Sheng Yang Tang combined with conventional symptomatic treatment for stage III silicosis with lung and kidney qi deficiency syndrome. Methods: A prospective controlled study was conducted, and 78 patients with stage III silicosis and lung kidney qi deficiency syndrome admitted to Changxing Hospital of Zhejiang Medical and Health Group were randomly divided into a study group and a control group (39 cases each) using a random number table method. The study group completed the experiment with 37 cases (excluding 2 cases), while the control group completed the experiment with 36 cases (excluding 3 cases). The control group received routine symptomatic treatment, while the study group received Bu Qi Sheng Yang Tang treatment on the basis of the control group. After 12 weeks of treatment, the clinical efficacy, TCM syndrome score, severity of respiratory distress, lung function indicators, inflammatory response, and pulmonary fibrosis indicators were compared between the two groups. Results:After 12 weeks of treatment, the total effective rate of the study group was 86.49%, which was better than the control group"s 66.67% (P<0.05); The scores of two groups of traditional Chinese medicine syndrome scores and the severity of respiratory distress [Borg score scale, Medical Research Council respiratory distress questionnaire (mMRC)] were lower than before treatment (P<0.05), and the scores of the three items in the study group were lower than those in the control group (P<0.05); Two sets of lung function indicators, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory volume/forced vital capacity ratio in one second (FEV1/FVC), and diffusion volume of carbon monoxide (DLCO), were all higher than before treatment (P<0.05). The levels of these four indicators in the study group were higher than those in the control group (P<0.05); The levels of two serum inflammatory markers [C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8)] were lower than before treatment (P<0.05), and the levels of the three markers in the study group were lower than those in the control group (P<0.05); The levels of two pulmonary fibrosis indicators [type I procollagen carboxy terminal propeptide (P Ⅰ CP), type III procollagen peptide (P Ⅲ P), and type IV collagen (Ⅳ - C)] were lower than before treatment (P<0.05), and the levels of the three indicators in the study group were lower than those in the control group (P<0.05). Conclusion: The combination of Bu Qi Sheng Yang Tang and conventional symptomatic treatment is effective in treating stage III silicosis with lung and kidney qi deficiency syndrome. It can effectively alleviate patients" traditional Chinese medicine symptoms and respiratory distress, improve their lung function, alleviate inflammatory reactions, improve lung fiber indicators, and thus delay the progression of pulmonary fibrosis. |
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