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[目的 ]病人按国家“八·五”课题《矽肺治疗措施及效果评价研究》的汉防己甲素和克矽平联合治疗矽肺的方案治疗 2年后 ,停药 1年 ,继续进行治疗并观察远期疗效。 [方法 ]根据 3 0例矽肺病人胸片的读片结果分成全量复治组 (简称全量组 ) 6例 ,维持量组 (简称维量组 ) 6例 ,继续停药观察组 (简称停药组 ) 7例和对照组 11例。全量组 :以汉防己甲素 2 0 0mg/d ,每周服药 6d ;1%克矽平 14 4ml在纤维支气管镜直视下滴注 ,每年滴注一次。维量组 :汉防己甲素 3 0 0mg/周 ,每周一分 3次口服。停药组和对照组 :口服安慰剂 4片 ,每周一口服。每 3个月为一疗程 ,停药 1个月再进行下一疗程 ,共进行 6个疗程 (2年 )的继续治疗观察。 [结果 ]全量组和维量组的症状好转率较停药组和对照组高 ,尤其是呼吸困难症状。X线胸片全量组有明显好转病例 2例 ,有进展的病例也较其他组少。好转病例仍集中在过去接触高浓度矽尘的病例。停药后病变出现反跳的经继续用药 ,可以好转。不良反应较轻。 [结论 ]汉防己甲素和克矽平联合用药治疗矽肺可提高疗效 ,降低不良反应
[Objective] According to the national “eight · five” project “silicosis treatment measures and the effect of evaluation of” tetrandrine and Ke Si-ping combination treatment of silicosis two years after treatment, withdrawal for 1 year, continue to treat and observe Long-term efficacy. [Methods] According to the results of reading the chest radiographs of 30 patients with silicosis, the patients were divided into six groups: the total rehabilitative group (referred to as the full dose group), the maintenance dose group (abbreviated as the dimension group), and the discontinuation observation group ) In 7 cases and control group in 11 cases. The total amount of the group: tetrandrine 200 mg / d, weekly medication 6d; 1% grams of silicon 14 4ml in the bronchoscopy direct infusion, drip once a year. Dimension group: tetrandrine 300mg / week, three times a week orally. Drug-withdrawal group and control group: oral placebo 4 tablets, oral once a week. Every 3 months for a course of treatment, withdrawal 1 month and then the next course of treatment, a total of 6 courses (2 years) continued treatment. [Results] The symptom improvement rate of the total dose group and the dimension group was higher than that of the withdrawal group and the control group, especially the dyspnea symptom. X-ray chest full of patients with significant improvement in 2 cases, there are fewer cases of progress than other groups. Improvement cases are still concentrated in the past contact with high concentrations of silica dust cases. After stopping the rebound of the disease appears to continue medication, can be improved. Adverse reactions are mild. [Conclusion] Combination of tetrandrine and g-Si-Ping treatment of silicosis can improve the curative effect and reduce adverse reactions