肺痿冲剂治疗肺间质纤维化疗效观察及对肿瘤标记物CA 19-9的影响

摘要

Objective:To observe the curative effect of the Feiwei medicinal instant granules on pulmonary interstitial fibrosis and effect on tumor markers of CA19-9.Methods:One hundred and twenty patients with pulmonary interstitial fibrosis were randomly divided into treatment group (n=61)and control group (n=59),and all of them were given fundamental treatment.Patients in the treatment group also received oral administration of Feiwei medicinal instant granules for consumptive lung disease twice a day,100ml a time.Patients in the control group were given oral administration of prednisone once a day,30mg each time.After 2 months of treatment,a series of chan-ges of the two groups before and after the treatment,including:TCM score,dyspnea scores,six-minutes walking test,TLC,FVC,FEV1 , FEV1/FVC,DLCO and tumor markers of CA19-9 were observed.Results:The total effective rates of TCMsyndrome in treatment group and control group were respectively 61.7% and 34.8%,and there was significant difference between the two groups.In the treatment group,TCM score,dyspnea scores,six-minutes walking test,TLC,FEV1 ,and tumor markers of CA19 -9 were improved obviously(P<0.05 or P<0.01).In the control group,the part of TCMscore,dyspnea scores were relatively improved,too(P<0.05).However,the treatment group was superior to control group in the improvement of TCM syndromes,dyspnea scores,six-minutes walking test,FVC and tumor markers of CA19-9.Conclusion:Feiwei medicinal instant granules can effectively relieve the symptoms of dyspnea in patients with pulmonary interstitial fibrosis,increase exercise tolerance,enhance the TLC,FEV1 in lung function,and bring patients more satisfac-tion.The medicinal instant granules may inhibit apoptosis of epithelial cells of IPF and abnormal proliferation.%目的：观察肺痿冲剂治疗肺间质纤维化的临床疗效及对肿瘤标记物CA19-9的影响。方法：将120例肺间质纤维化患者随机分为治疗组61例、对照组59例，2组患者均进行基础治疗，治疗组同时给予肺痿冲剂方每次100 mL，每日2次口服；对照组给予泼尼松每次30 mg，每日1次口服。治疗2个月后评价2组患者中医证候疗效及患者满意度，并观察2组患者治疗前后中医证候积分、呼吸困难评分、6分钟步行试验、肺功能[包括肺总量（TLC）、用力肺活量（FVC）、一秒用力呼气容积（FEV1）、FEV1/FVC、一氧化碳弥散量（DLCO）]及肿瘤标记物 CA19-9的变化。结果：治疗组与对照组中医证候总有效率分别为62.3％、32.2％，2组比较差异有统计学意义（P＜0.01）。治疗后治疗组中医证候积分、呼吸困难评分、6分钟步行试验、肺功能TLC、FEV1及肿瘤标记物CA19-9均较治疗前改善（P＜0.05或P＜0.01）；对照组中医证候部分指标积分、呼吸困难评分较治疗前改善（P＜0.05或P＜0.01），但肺功能FVC反而较治疗前恶化（P＜0.05）。治疗后治疗组与对照组比较，中医证候部分指标积分、生活质量部分指标评分、6分钟步行试验、肺功能FVC及肿瘤标记物CA19-9差异有统计学意义（P＜0.05或P＜0.01），治疗组疗效优于对照组。结论：肺痿冲剂方治疗肺间质纤维化可减轻患者呼吸困难症状，改善患者生活质量、肺功能。并提示了肺痿冲剂可能有抑制IPF上皮细胞的凋亡及异常增生的作用。