CAJ | 학술논문

目的观察汉防己甲素与苦参碱注射液联合应用治疗矽肺的临床疗效.方法 63例矽肺患者随机分为治疗组(33例)和对照组(30例),两组均常规给予抗炎、止咳、平喘等治疗,治疗组同时给予汉防己甲素和苦参碱注射液,汉防己甲素100 mg,每日2次,3个月为1疗程,休息1个月开始下一个疗程,共4个疗程；苦参碱注射液150 mg,每日1次,每月连用15d,3个月为1疗程,休息1个月开始下一个疗程,共2个疗程.观察临床症状、肺通气功能、血清超氧化物歧化酶(SOD)、X线胸片影像的变化.结果与治疗前比较,治疗后胸闷、胸痛、气急等呼吸道症状明显改善,差异有统计学意义(P＜0.05).治疗组治疗后SOD活力明显高于治疗前及对照组,差异有统计学意义(P＜0.05).治疗组治疗后FVC、FEV1.0明显高于对照组及治疗前,差异有统计学意义(P＜0.05)；X线胸片治疗组有5例(其中Ⅱ期4例、Ⅲ期1例,均属快进型)矽肺小阴影较治疗前缩小,略有变淡,边缘较治疗前清晰,总体密集度较治疗前有所降低；12例肺纹理明显减少、清晰.结论汉防己甲素与苦参碱注射液联合应用对矽肺有一定治疗效果.
목적 관찰한방기갑소여고삼감주사액연합응용치료석폐적림상료효.방법 63례석폐환자수궤분위치료조(33례)화대조조(30례),량조균상규급여항염、지해、평천등치료,치료조동시급여한방기갑소화고삼감주사액,한방기갑소100 mg,매일2차,3개월위1료정,휴식1개월개시하일개료정,공4개료정；고삼감주사액150 mg,매일1차,매월련용15d,3개월위1료정,휴식1개월개시하일개료정,공2개료정.관찰림상증상、폐통기공능、혈청초양화물기화매(SOD)、X선흉편영상적변화.결과 여치료전비교,치료후흉민、흉통、기급등호흡도증상명현개선,차이유통계학의의(P＜0.05).치료조치료후SOD활력명현고우치료전급대조조,차이유통계학의의(P＜0.05).치료조치료후FVC、FEV1.0명현고우대조조급치료전,차이유통계학의의(P＜0.05)；X선흉편치료조유5례(기중Ⅱ기4례、Ⅲ기1례,균속쾌진형)석폐소음영교치료전축소,략유변담,변연교치료전청석,총체밀집도교치료전유소강저；12례폐문리명현감소、청석.결론 한방기갑소여고삼감주사액연합응용대석폐유일정치료효과.
Objective To observe the therapeutic efficacy of tetrandrine tablets combined with matrine injection in the treatment of silicosis.Methods Sixty-three patients with silicosis were randomly divided into treatment group (n =33) and control group (n =30).Both groups received anti-inflammatory,cough-relieving,and anti-asthmatic treatment.Meanwhile,the treatment group was given tetrandrine tablets (100 mg bid) and matrine injection (150 mg qd).There were 4 courses oftetrandrine treatment (each course =3 months),with one-month intervals among them.Matrine injection was used for 15 consecutive days in each month.There were 2 courses of matrine treatment (each course =3 months),with a one-month interval in between.The clinical symptoms,pulmonary function,serum superoxide dismutase (SOD) activity,and chest X-ray images were observed before and after treatment.Results After treatment,chest distress,chest pain,shortness of breath,and other respiratory symptoms were relieved significantly (P＜0.05).The treatment group showed significantly higher SOD activity than before treatment and the control group (P＜0.05) and significantly higher forced vital capacity and forced expiratory volume in one second than before treatment and the control group (P＜0.05).After treatment,5 patients (4 stage Ⅱ cases and 1 stage Ⅲ case,all in rapidly progressive forms) in the treatment group showed smaller,lighter,and clearer shadows with decreased overall intensity on chest X-ray; 12 patients showed significantly fewer and clearer lung markings on chest X-ray.Conclusion Tetrandrine tablets combined with matrine injection have some therapeutic effect on silicosis.