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目的探讨肺痿冲剂方配合大剂量N-乙酰半胱氨酸二联治疗特发性肺间质纤维化临床效果。方法选取本院2010年2月~2012年2月收治特发性肺间质纤维化患者130例,采用随机数字表法分为对照组和观察组,每组各65例;其中对照组患者采用常规激素疗法;观察组患者在则采用肺痿冲剂方配合大剂量N-乙酰半胱氨酸二联疗法;比较两组患者临床治疗总有效率,胸部高分辨CT(HRCT)改变阳性率,治疗前后中医症候积分及肺功能指标等。结果观察组患者临床治疗总有效率明显高于对照组,组间比较差异有统计学意义(P<0.05);观察组患者HRCT检查网格影及斑片影改变阳性率均明显低于对照组,组间比较差异有统计学意义(P<0.05);但两组患者毛玻璃影改变阳性率明显高于对照组,组间比较差异无统计学意义(P>0.05);经治疗后两组患者中医症候积分较治疗前均显著改善,且观察组患者中医症候积分改善程度较对照组更为明显,组间比较差异有统计学意义(P<0.05);对照组与观察组患者治疗前TLC、FVC及FEV1/FVC等肺功能指标组间比较差异无统计学意义(P>0.05);观察组患者TLC、FVC指标均较对照组显著改善,组间比较差异有统计学意义(P<0.05)。结论肺痿冲剂方配合大剂量N-乙酰半胱氨酸二联治疗特发性肺间质纤维化与激素治疗相比可有效缓解临床症状、体征,改善肺功能,具有临床应用价值。
Objective To investigate the clinical effects of Feiran granule combined with high-dose N-acetylcysteine in the treatment of idiopathic pulmonary fibrosis. Methods A total of 130 patients with idiopathic pulmonary fibrosis were selected from February 2010 to February 2012 in our hospital and divided into control group and observation group with 65 cases in each group by random number table. Conventional hormone therapy; observation group patients were treated with Feiran Granules with high-dose N-acetyl cysteine dual therapy; clinical efficacy of the two groups were compared, chest high resolution CT (HRCT) to change the positive rate of treatment Before and after the TCM symptom score and lung function index. Results The total effective rate of clinical treatment in observation group was significantly higher than that in control group, with significant difference between the two groups (P <0.05). The positive rates of HRCT mesh and patch changes in observation group were significantly lower than those in control group (P <0.05). However, the positive rates of gross glass changes in the two groups were significantly higher than those in the control group, with no significant difference between the two groups (P> 0.05). After treatment, the two groups of patients TCM symptom scores were significantly improved compared with those before treatment, and the degree of improvement of TCM symptom scores in observation group was more obvious than that in control group (P <0.05). Before treatment, TLC, FVC and FEV1 / FVC showed no significant difference between the two groups (P> 0.05). The TLC and FVC indexes of the observation group were significantly improved compared with the control group, the difference was statistically significant (P <0.05) . Conclusion Feizhen granule combined with high-dose N-acetylcysteine in the treatment of idiopathic pulmonary fibrosis compared with hormone therapy can effectively alleviate the clinical symptoms and signs, improve lung function, with clinical value.