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目的:探讨中西医结合治疗对类风湿性关节炎(RA)并发肺间质纤维化患者肺功能和血气指标的影响。方法:选取RA并发肺间质纤维化患者60例,并依据治疗方式不同分为治疗组(n=30)和对照组(n=30),对照组采用强的松治疗;治疗组在对照组的基础上加用活血化瘀、补益脾肾方治疗,1周为1个疗程,两组均连续治疗4个疗程。统计并比较两组患者临床疗效;检测并比较两组患者治疗前后肺功能、血气指标及ESR、CRP、RF水平变化。结果:治疗组总有效率为93.33%,显著高于对照组的73.33%(P<0.05);治疗后两组FEV1、FVC、FEV1/FVC均较治疗前显著上升(P<0.05或P<0.01),且治疗组显著高于对照组(P<0.05或P<0.01);治疗后两组Pa O2和Sa O2水平均较治疗前显著上升,Pa CO2水平较治疗前显著下降(P<0.01),且组间差异显著(P<0.05或P<0.01);治疗后两组RF、ESR和CRP均显著低于治疗前(P<0.05或P<0.01),且治疗组显著低于对照组(P<0.05或P<0.01)。结论:中西医结合治疗RA并发肺间质纤维化疗效确切,可有效缓解临床体征,并能改善患者肺功能和血气指标水平,降低ESR、CRP、RF水平。
Objective: To investigate the effect of integrated traditional Chinese and western medicine on pulmonary function and blood gas index in patients with rheumatoid arthritis (RA) complicated with pulmonary fibrosis. Methods: Sixty patients with RA complicated with pulmonary fibrosis were selected and divided into treatment group (n = 30) and control group (n = 30) according to different treatment methods. The control group was treated with prednisone. In the control group Based on the plus blood circulation, replenishing spleen and kidney treatment, 1 week for a course of treatment, two groups were treated for 4 courses. The clinical efficacy of the two groups were statistically compared and compared. The changes of pulmonary function, blood gas index, ESR, CRP and RF before and after treatment were detected and compared between the two groups. Results: The total effective rate of the treatment group was 93.33%, which was significantly higher than that of the control group (73.33%, P <0.05). After treatment, the FEV1, FVC and FEV1 / FVC of the two groups increased significantly ), And the treatment group was significantly higher than the control group (P <0.05 or P <0.01); After treatment PaO2 and Sa O2 levels were significantly increased compared with before treatment, Pa CO2 levels were significantly lower than before treatment (P <0.01) (P <0.05 or P <0.01). After treatment, the levels of RF, ESR and CRP in the two groups were significantly lower than those before treatment (P <0.05 or P <0.01), and the treatment group was significantly lower than the control group P <0.05 or P <0.01). Conclusion: Integrative treatment of RA with pulmonary fibrosis is effective and effective in relieving clinical signs, improving pulmonary function and blood gas indexes and decreasing ESR, CRP and RF.