益气养阴汤联合西药治疗特发性肺纤维化缓解期临床研究

目的：观察益气养阴汤联合西药治疗特发性肺纤维化（IPF） 缓解期的临床疗效。方法：采用随机数字表法将66 例IPF 缓解期患者分为试验组、对照组各33 例。对照组给予常规西药治疗，试验组给予益气养阴汤联合西药治疗，2 组连续治疗2 个月。比较2 组治疗前后中医证候积分、高分辨率CT（HRCT） 半定量评分、肺功能指标［用力肺活量（FVC）、第1 秒用力呼气容积（FEV1）、最大呼气峰流速（PEF）、肺总量（TLC）］、动脉血二氧化碳分压（PaCO2）、动脉血氧分压（PaO2），评估2 组临床疗效及不良反应发生情况。结果：试验过程中，试验组剔除2 例，完成研究31 例；对照组剔除3 例，完成研究30 例。治疗后，试验组总有效率为90.32%，高于对照组70.00%（P＜0.05）。2 组治疗后中医证候积分、HRCT 半定量评分、PaCO2水平均治疗前降低（P＜0.05），PaO2 水平均升高（P＜0.05）；试验组治疗后中医证候积分、HRCT 半定量评分、PaCO2 水平低于对照组（P＜0.05），PaO2 水平高于对照组（P＜0.05）。2 组治疗后FVC、FEV1、PEF、TLC水平均高于治疗前（P＜0.05），且试验组治疗后肺功能指标均高于对照组（P＜0.05）。试验组、对照组不良反应发生率分别为9.68%、13.33%，2 组比较，差异无统计学意义（P＞0.05）。结论：益气养阴汤联合西药治疗IPF 缓解期疗效确切，能改善患者肺功能，缓解肺纤维化，安全性较高。

Clinical Study on Yiqi Yangyin Decoction Combined with Western Medicine forIdiopathic Pulmonary Fibrosis in Remission Stage

Abstract：Objective：To observe the clinical effect of the therapy of Yiqi Yangyin Decoction combinedwith western medicine on idiopathic pulmonary fibrosis (IPF) in remission stage. Methods ： A total of66 patients with IPF in remission stage were divided into the trial group and the control group according tothe random number table method， with 33 cases in each group. The control group was given routinewestern medicine for treatment，and the trial group was treated with Yiqi Yangyin Decoction combined withwestern medicine. The two groups were treated for two months. The traditional Chinese medicine (TCM)syndrome scores， the semi-quantitative scores of high resolution CT (HRCT)， indexes of lung function，including forced vital capacity (FVC)，forced expiratory volume in one second (FEV1)，peak expiratory flow(PEF) and total lung capacity (TLC)，partial pressure of carbon dioxide (PaCO2) in arterial blood，and partial pressure of oxygen (PaO2) in arterial blood were compared before and after treatment between the twogroups； the clinical effects and incidence of adverse reactions in both groups were evaluated. Results：During the trial， 2 cases dropped off in the trial group， and finally 31 cases were included； 3 casesdropped off in the control group， and finally 30 cases were included. After treatment， the total effectiverate was 90.32% in the trial group， higher than that of 70.00% in the control group (P＜0.05). Aftertreatment， the TCM scores， HRCT semi-quantitative scores and PaCO2 levels in the two groups weredecreased when compared with those before treatment (P＜0.05)，and the PaO2 levels were increased (P＜0.05). After treatment，the TCM syndrome score，HRCT semi-quantitative scores and PaCO2 level in thetrial group were lower than those in the control group (P＜0.05)，and the PaO2 level was higher than that inthe control group (P＜0.05). After treatment， the levels of FVC， FEV1， PEF and TLC in the two groupswere higher than those before treatment (P＜0.05)，and the above levels in the trial group were higher thanthose in the control group (P＜0.05). The incidence of adverse reactions was respectively 9.68% and13.33% in the trial group and the control group， there being no significance in the difference (P＞0.05).Conclusion：The therapy of Yiqi Yangyin Decoction combined with western medicine has a definite curativeeffect on IPF in remission stage， which can improve the lung function of patients and mitigate the lungfibrosis with good safety.