摘要
目的观察通痹颗粒治疗类风湿关节炎相关肺间质病变(RA-ILD)的临床疗效及对转化生长因子-β1(TGF-β1)和Ⅱ型肺泡表细胞表面抗原(KL-6)的影响。方法60例患者随机分为A、B组,每组30例,B组口服甲泼尼龙片,20 mg/次,1次/d,起效后逐渐减量;联合环磷酰胺片口服,100 mg/次,1次/d。A组在B组的基础上加用通痹颗粒冲服,6g/次,2次/d。以3个月为1个疗程,2个疗程后比较2组治疗前后的症状、体征变化;血清学血沉(ESR)、C反应蛋白(CRP)、TGF-β1及KL-6变化;肺功能检查,包括肺总量(TCL)、用力肺活量(FVC)、第1秒用力呼气量(FEV1)和最大分钟通气量(MVV)的变化;放射学肺部HRCT评分变化及有无不良反应。结果治疗后2组患者症状、体征均有改善,A组的总有效率优于B组(P<0.05);治疗后2组患者ESR、CRP和DSA28均较治疗前明显改善(P<0.01),A组的指标好转情况优于B组(P<0.05);治疗后2组患者TCL、FVC、FEV1、MVV及肺部HRCT积分均较治疗前有不同程度改善(P<0.01),A组TCL、FVC及肺部HRCT积分好转情况优于B组(P<0.05);治疗后2组患者血清TGF-β1、KL-6均较治疗前明显改善(P<0.01),A组的好转情况优于B组(P<0.05),且无明显不良反应。结论在西医规范治疗的基础上,联合使用通痹颗粒可有效缓解患者的症状、体征,改善炎症活动度,提高肺部功能,其机制可能是通过调节TGF-β1、KL-6等纤维因子实现的。
Objective To investigate the clinical efficacy of Tongbi granule in treatment of rheumatoid arthritis-related pulmonary interstitial lesions(RA-ILD)and its effects on transforming growth factor-β1(TGF-β1)and typeⅡalveolar cell surface antigen(KL-6).Methods A total of 60 patients with RA-ILD were randomly divided into group A and group B,with 30 cases in each group.The patients in group B were treated by oral methylprednisolone tablets,20mg once,once a day,gradually reducing dosage,combined with oral cyclophosphamide tablets,100mg once,once a day,however,the patients in group A,on the basis of group B,were treated by Tongbi granules,6g once,teice a day,with 3 months as a treatment course for two courses.After treatment,the symptoms and signs,and the changes of serum ESR,CRP,TGF-β1 and KL-6,pulmonary function indexes including total lung volume(TCL),forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),and maximum minute ventilation(MVV),and the changes of radiological HRCT scores as well as adverse reactions were observed and compared between the two groups.Results After treatment,the symptoms and signs were improved in both groups.The total effective rate was 83.3%in group A,which was significantly better than that(73.3%)in group B(P<0.05).After treatment,the ESR,CRP and DSA28 were significantly improved in both groups,as compared with those bfore treatment(P<0.01),moreover,the improvement degree in group A was superior to that in group B(P<0.05).After treatment,the scores of TCL,FVC,FEV1,MVV and lung HRCT were were significantly improved in both groups,as compared with those bfore treatment(P<0.01),moreover,the improvement degree in group A was superior to that in group B(P<0.05).After treatment,the serum TGF-β1 and KL-6 were were significantly improved in both groups,as compared with those bfore treatment(P<0.01),moreover,the improvement degree in group A was superior to that in group B(P<0.05).In addition no obvious adverse reactions were found in group A.Conclusion On the basis of wester
作者
肖铁铮
徐英
XIAO Tiezheng;XU Ying(Department of Pharmacy,The Second Hospital of Chaoyang City,Liaoning,Chaoyang 122000,China)
出处
《河北医药》
CAS
2020年第10期1537-1540,共4页
Hebei Medical Journal
