糖皮质激素联合雷公藤多苷治疗结缔组织病相关间质性肺疾病的临床观察

目的:观察糖皮质激素联合雷公藤多苷治疗结缔组织病相关间质性肺疾病(connective tissue disease-related interstitial lung disease,CTD-ILD)临床疗效。方法:纳入CTD-ILD患者74例,随机分为激素组和联合组,每组37例。激素组患者采用糖皮质激素治疗,联合组患者采用糖皮质激素联合雷公藤多苷片治疗,观察周期为6个月。评价两组患者的临床疗效,比较两组患者的CT影像学评分、肺功能指标及不良反应发生情况。结果:治疗后,联合组患者的总有效率为67.5%,激素组为40.5%,联合组疗效优于激素组(P0.05);两组患者的喘息、憋气、咳嗽、Velcro啰音积分均降低(P0.05),且联合组患者的各项积分均低于激素组(P0.05);两组患者的CT影像学积分均显著降低(P0.05),且联合组患者的CT影像学积分低于激素组(P0.05);两组患者的肺总量(TLC)、CO弥散量(DLCO)、动脉血氧分压(PaO_2)水平均显著升高(P0.05),且联合组患者的TLC、DLCO、PaO_2水平高于激素组(P0.05)。治疗过程中,两组患者的不良反应发生情况比较,差异无统计学意义(P0.05)。结论:糖皮质激素联合雷公藤多苷治疗CTDILD能够提高治疗效果,且安全性较好。

Clinical Observation on Glucocorticoids Combined with Tripterygium Glycosides in the Treatment of CTD-ILD

  Objective:To observe the clinical effect of glucocorticoids combined with tripterygium glycosides in treating patients with connective tissue disease-related interstitial lung disease (CTD-ILD).   Methods: Seventy-four patients with CTD-ILD were selected and randomly divided into the hormone group and the combination group with 37 cases in each group. The patients in the hormone group were treated with glucocorticoids and the patients in the combination group were treated with glucocorticoids and tripterygium glycosides, with a course of 6 months. The clinical effect was evaluated and the CT imaging scores, the levels of pulmonary function indexes and the incidence of adverse reactions were compared.   Results: After treatment, the total effective rates of the combination group and the hormone group were 67.5% and 40.5% respectively, and the effect of the combination group was better than that of the hormone group (P<0.05); the scores of pant, suffocation, cough and Velcro rale in both groups were decreased (P<0.05), and all scores of the combination group were lower than those of the hormone group (P<0.05); the CT imaging scores in both groups were obviously decreased (P<0.05), and the CT imaging scores of the combination group were lower than those of the hormone group (P<0.05); the levels of total lung capacity(TLC), diffusing capacity of CO(DLCO), arterial partial pressure of oxygen(PaO₂) in both groups were significantly increased (P<0.05), and the levels of TLC, DLCO and PaO₂ in the combination group were higher than those in the hormone group (P<0.05). In the course of treatment, there was no statistical difference between the two groups on the incidence of adverse reactions (P>0.05).   Conclusion: Glucocorticoids combined with tripterygium glycosides can enhance the clinical effect in the treatment of CTD-ILD with good safety.