实用医学杂志 ›› 2020, Vol. 36 ›› Issue (20): 2856-2860.doi: 10.3969/j.issn.1006⁃5725.2020.20.023

• 新技术新方法 • 上一篇    下一篇

小剂量糖皮质激素、N⁃乙酰半胱氨酸联合有氧抗阻肺康复疗法治疗特发性肺纤维化的临床疗效及对相关炎症介质表达的影响

戴勇1 曾崎冈1 段晨霞1 徐飞龙2 魏成功1   

  1. 1广东省中西医结合医院呼吸内科(广东佛山528200);2 广州中医药大学(广州510006)
  • 出版日期:2020-10-20 发布日期:2020-10-25
  • 基金资助:
    广东省医学科学技术研究基金项目(编号:B2017018)

Clinical observation of idiopathic pulmonary fibross treating with pulmonary rehabilitation combined with N⁃acetyl cysteine

DAI Yong*,ZENG Qigang,DUAN Chenxia,XU Feilong,WEI Chenggong   

  1. *Guangdong TCM and Western Medicine Hospital,Foshan 528200,China
  • Online:2020-10-20 Published:2020-10-25

摘要:

目的 探讨小剂量糖皮质激素、N⁃乙酰半胱氨酸(Nac)联合有氧抗阻肺康复治疗对特发性肺纤维化(IPF)患者临床疗效及对相关炎症介质表达的影响。方法 将72例IPF患者随机分为治疗组与对照组各36 例,在进行肺康复治疗的同时,治疗组给予小剂量糖皮质激素泼尼松片、Nac 持续口服6 个月。对两组患者的临床疗效、肺功能变化情况、生活质量评估(MMRC、CAT)以及炎症介质表达差异进行分析比较。结果 治疗前两组患者第1秒用力呼气容积(FEV1)、MMRC、CAT评分以及炎症介质表达均无显著差异,治疗6 个月后比较发现,治疗组临床有效率明显高于对照组(P < 0.05),MMRC、CAT 评分均优于对照组(P < 0.05)。治疗后两组患者白细胞介素⁃8(IL⁃8)、肿瘤坏死因子(TNF⁃α)差异明显(P < 0.05)。结论 IPF患者,应用小剂量糖皮质激素、Nac联合有氧抗阻肺康复治疗效果显著,可降低炎症因子释放,提高患者生活质量,临床上值得推广。

关键词: 糖皮质激素, N?乙酰半胱氨酸, 有氧抗阻肺康复疗法, 特发性肺纤维化, 炎症因子

Abstract:

Objective Observing clinical efficacy and the changes in inflammatory response mediatorswith idiopathic pulmonary fibross(IPF)after treating with pulmonary rehabilitation combined with N⁃acetyl cysteine(Nac)and low dose of glucocorticoid. Methods 72 IPF patients were randomly divided into two groups. 36 patientsin conventional therapy group was given symbicort turbuhaler combined with low dose of glucocorticoid and Nac as thebasic treatment. 36 patients in treating group was treated with pulmonary rehabilitation on the basis of conventionaltherapy. The clinical efficacy,the influence on pulmonary function and quality of life,and the inflammatory responsemediators of these two groups were observed. Results The clinic effective rates of conventional therapy group,treating group were 77.8% and 94.4% individually,which had a statistical significance(P < 0.05). Symptom scor⁃ing,quality of living evaluation,pulmonary function index(FEV1、FVC)and changes of inflammatory factorswere improved in treating group compared with that in conventional therapy group(P < 0.05). Conclusion IPFpatients treating with pulmonary rehabilitation combined with Nac showed significantly improvement in clinical effi⁃cacy,pulmonary function and quality of life,which also decreasing inflammatory factors expression and restorescorticosteroid responses in IPF.

Key words: low dose of glucocorticoid, N?acetyl cysteine, aerobic anti?obstructive lung rehabilitation therapy, idiopathic pulmonary fibross, inflammatory factors