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[目的]观察补益肺肾活血方联合西药治疗特发性肺间质纤维化(IPF)疗效。[方法]使用随机平行对照方法,将77例门诊患者按随机数字表法分为两组。均按国内常规治疗,并发肺部感染抗生素控制感染,低氧血症吸氧。对照组38例强的松、抗氧化剂。治疗组39例补益肺肾活血方(太子参、麦冬各15g,黄芪40g,山萸肉、浙贝、当归、川芎、赤芍、鳖甲各15g,等),1剂/d,水煎300mL,口服100mL/次,3次/d;西药治疗同对照组。连续治疗12周为1疗程。观测临床症状、生化指标、血气分析、肺功能(用力肺活量-FVC、肺一氧化碳弥散量-DLCO、动脉氧分压-PaO2)、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效3例,有效22例,无效10例,总有效率71.42%;对照组显效1例,有效12例,无效22例,总有效率37.14%;治疗组临床疗效优于对照组(P<0.05)。中医证候疗效治疗组临床控制1例,显效5例,有效21例,无效8例,总有效率77.24%;对照组临床控制1例,显效1例,有效12例,无效21例,总有效率40.00%;治疗组中医证候疗效优于对照组(P<0.05)。治疗组FVC、DLCO、PaO2均明显改善(P<0.05);对照组DLCO明显改善(P<0.05),FVC、PaO2无显著变化(P>0.05);FVC、DLCO改善治疗组优于对照组(P<0.05),PaO2改善两组无显著差异(P>0.05)。[结论]补益肺肾活血方联合西药治疗特发性肺间质纤维化(IPF),疗效满意,无明显副作用,值得推广。
[Objective] To observe the effect of Tonifying the Lung, Kidney and Activating Blood Circulation combined with western medicine on the treatment of idiopathic pulmonary interstitial fibrosis (IPF). [Methods] Using randomized parallel method, 77 outpatients were divided into two groups according to random number table. According to the routine treatment of domestic, complicated by pulmonary infection with antibiotics to control infection, hypoxemia oxygen. Control group 38 cases of prednisone, anti-oxidants. The treatment group, 39 cases of replenishing Yifendishenhuixue (heterophylla, Ophiopogon japonicus 15g, Astragalus 40g, cornus, Zhejiang Pui, Angelica, Chuanxiong, red peony root, turtle shell each 15g, etc.), 1 / d, decoction 300mL, oral 100mL / times, 3 times / d; western medicine treatment with the control group. Continuous treatment for 12 weeks for a course of treatment. Clinical symptoms, biochemical indicators, blood gas analysis, pulmonary function (forced vital capacity-VC, diffuse pulmonary carbon monoxide-DCO, arterial partial pressure of oxygen-PaO2), adverse reactions were observed. Treatment of a course of treatment to determine the efficacy. [Results] Three cases were effective in the treatment group, 22 cases were effective, 10 cases were ineffective and the total effective rate was 71.42%. In the control group, 1 case was markedly effective, 12 cases effective and 22 cases ineffective. The total effective rate was 37.14% Group (P <0.05). TCM Syndromes curative effect of treatment group 1 cases of clinical control, effective in 5 cases, effective in 21 cases, ineffective in 8 cases, the total effective rate was 77.24%; clinical control in 1 case, markedly effective in 1 case, effective in 12 cases, ineffective in 21 cases, Efficiency 40.00%; Therapeutic effect of TCM syndrome is better than that of control group (P <0.05). DLCO and PaO2 in the treatment group were significantly improved (P <0.05); DLCO in the control group was significantly improved (P <0.05), FVC and PaO2 did not change significantly (P> 0.05); FVC, DLCO improved treatment group than the control group P <0.05), PaO2 improved no significant difference between the two groups (P> 0.05). [Conclusion] The treatment of idiopathic pulmonary interstitial fibrosis (IPF) with Tonifying the Lung, Kidney and Activating Blood Circulation combined with western medicine has satisfactory curative effect and no obvious side effects and is worth popularizing.