益气养阴活血方治疗肺纤维化患者疗效及对患者炎性因子和肺功能的影响

于国强 庞立健 付东升 石绍顺 李明飞 李丁蕾

摘要 目的：探討益气养阴活血方治疗肺纤维化患者的疗效及对患者炎性因子和肺功能影响。方法：选取2014年12月至2016年12月辽宁中医药大学附属第二医院收治的肺纤维化患者94例，按照随机表法分为观察组与对照组，各47例。对照组采用西医治疗，观察组在对照组基础上联合益气养阴活血方治疗。2组疗程均为3个月。结果：观察组总有效率（89.36%）高于对照组（70.21%）（P<0.05）;2组治疗后呼吸困难、咳嗽、啰音评分降低（P<0.05）;观察组治疗后呼吸困难、咳嗽、啰音评分低于对照组（P<0.05）;2组治疗后白介素-6（IL-6）、转化生长因子-β1（TGF-β1）和肿瘤坏死因子-α（TNF-α）降低（P<0.05）;观察组治疗后IL-6、TGF-β1和TNF-α低于对照组（P<0.05）;2组治疗后FVC、FEV1和DLco增加（P<0.05）;观察组治疗后用力肺活量（FVC）、一秒用力呼气容积（FEV1）和单次呼吸法一氧化碳弥散（Dlco）高于对照组（P<0.05）;2组均未出现明显不良反应。结论：益气养阴活血方治疗肺纤维化患者疗效显著，可降低炎性因子IL-6、TGF-β1和TNF-α水平，及改善患者肺功能。

关键词 益气养阴活血方;肺纤维化;疗效;白介素-6;转化生长因子-β1;肿瘤坏死因子-α;用力肺活量;一秒用力呼气容积;单次呼吸法一氧化碳弥散

Efficacy of Yiqi Yangyin Huoxue Fang on Patients with Pulmonary Fibrosis and Effects

on Inflammatory Factors and Pulmonary Function

Yu Guoqiang1， Pang Lijian2， Fu Dongsheng1， Shi Shaoshun1， Li Mingfei1， Li Dinglei1

（1 Department of Respiratory Medicine， Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine，

Shenyang 110034， China; 2 Department of Respiratory Medicine， Affiliated Hospital of Liaoning University

of Traditional Chinese Medicine， Shenyang 110032， China）

Abstract Objective：To study the curative effect of Yiqi Yangyin Huoxue Fang on pulmonary fibrosis and its influence on inflammatory factors and pulmonary function. Methods：A total of 94 patients with pulmonary fibrosis treated in our hospital from December 2014 to December 2016 were randomly divided into the observation group （47 cases） and the control group （47 cases）. The control group was treated with western medicine， and the observation group was treated with Yiqi Yangyin Huoxue Fang on the basis of the control group. The two groups were treated for 3 months. Results：The total effective rate of the observation group （89.36%） was higher than that of the control group （70.21%） （P<0.05）; Cough， breathing difficulties and the two groups after treatment were lower rales （observation group： t=22.5430， 24.0091， 21.9675， the control group： t=14.0037， 14.9906， 15.1712， P<0.05）; respiratory difficulties， cough， rales in the observation group after treatment were lower than control group （t=20.2334， 10.8108， 12.9694， P<0.05）; IL-6， TGF-β1 and TNF-α decreased in two groups after treatment （observation group： t=25.4017， 16.6851， 24.3335， the control group： t=10.7510， 9.7017， 12.1940， P<0.05）; the observation group after treatment IL-6， TGF-β1 and TNF-α lower than that of the control group （t=14.8318， 13.2045， 13.2847， P<0.05）. The two groups after treatment FVC， FEV1 and DLco increased （observation group： t=12.4157， 14.2608， 11.5487， the control group： t=7.5293， 8.5027， 5.9400， P<0.05） and the observation group after treatment FVC， FEV1 and DLco was higher than the control group （t=6.1000， 5.9271， 5.2539， P<0.05）. There were no obvious adverse reactions in the two groups. Conclusion：Yiqi Yangyin Huoxue Fang has significant curative effect on pulmonary fibrosis， can reduce the levels of inflammatory factors IL-6， TGF-β1 and TNF-α， and improve the lung function of patients， which has important research significance.

Key Words Yiqi Yangyin Huoxue Fang; Pulmonary fibrosis; Curative effect; Interleukin-6， Transforming growth factor-β1; Tumor necrosis factor-α; Forced vital capacity; Forced expiratory volume in one second; Carbon monoxide dispersion by single breath method

中图分类号：R289.5;R563文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.03.026

肺纤维化主要是多种弥漫性肺间质疾病的共同结局，按照病因分为2大类，分别为特发性和继发性[1]。随着近年来人们不良生活习惯及生存环境的改变，肺纤维化发病率呈不断上升趋势，严重影响人们身心健康和生命质量[2]。现代医学认为，各种造成肺部炎性损伤的因素均会引起肺纤维化，且呈进行性加重，肺功能丧失，肺组织结构变化，使得氧不能进入血液，从而造成缺氧、丧失劳动力、酸中毒，晚期则会致使患者出现心力衰竭、呼吸衰竭[3-5]。目前，西医治疗肺纤维化尚无特效药物，且效果并不十分理想。近年来随着中医药的不断发展，用于肺纤维化治疗取得良好疗效[6-8]。本研究探讨益气养阴活血方治疗肺纤维化患者的疗效及对患者炎性因子和肺功能的影响。

1 资料与方法

1.1 一般资料 选取2014年12月至2016年12月期间收治的肺纤维化患者94例，依据按照随机表法分为观察组与对照组，每组47例。……