摘要
目的:间质性肺疾病为呼吸系统常见病、难治病之一,严重危害着人类的健康,在一定程度上影响了患者的生存质量。本病起病隐匿,易反复发作,治愈率低,其共同特征包括弥漫性肺泡炎、肺实质炎症和肺间质纤维化,其中间质性肺纤维化临床最为多见,常发。本病发病机制与免疫有一定的关系,而糖皮质激素可抑制炎症和免疫过程,所以现代医学常采用糖皮质激素做为基础用药,拟定多种治疗方案,临床观察表明近期有效,远期疗效不理想,甚至易产生毒副作用。本课题通过对六味地黄汤加减干预间质性肺疾病激素减量过程(肺肾阴虚型)的相关临床研究,证明六味地黄汤加减不仅能改善激素减量过程中肺肾阴虚症状,也可以改善间质性肺疾病的其他临床症状,可延缓间质性肺疾病病情进展,减少应用激素后引起的不良反应,从而发挥中医药优势,为中西医结合治疗本病提高临床疗效提供新思路。
方法:本课题对确诊为间质性肺疾病激素治疗减量过程中出现肺肾阴虚症状的60例中老年患者,随机分为治疗组(30例)和对照组(30例)。两组均为肾上腺皮质激素强的松片治疗(0.5mg/kg.d口服4周;然后0.25mg/kg.d口服8周;继之减量至0.125mg/kg.d或隔日0. 25mg/kg.d口服,激素治疗应持续6个月以上)减量过程中,治疗组配合六味地黄汤加减口服治疗;对照组配合阿奇霉素分散剂0.5/d口服治疗。评价60例患者激素减量过程中肺肾阴虚症状及间质性肺疾病其他症状、体征用药前后改善情况,并进行比较。
结果:治疗组在间质性肺疾病激素减量过程中肺肾阴虚症状及间质性肺疾病其他症状、体征方面改善显著优于对照组。总体疗效结果对比,治疗组总有效率96.67%,对照组总有效率56.67%。两组总有效率比较有极显著性差异(P〈0.01)。
结论:治疗组肾上腺糖皮质激素(强的松片)配合六味地黄汤加减口服治疗中老年间质性肺疾病激素减量过程中肺肾阴虚症状及间质性肺疾病其他症状、体征显著优于对照组肾上腺糖皮质激素(强的松片)配合阿奇霉素分散剂口服治疗,减轻患者痛苦,改善患者的全身症状,有较好的近期和远期疗效。
Purpose:Interstitial lung disease is difficult to cure Lung Disease, frequent occurrence, one serious threat to human health, to some extent, affect the quality of survival. The disease cause hidden and easy to frequent a cure for cancer low and common feature, including extensive Lung small dip, lung essence of the inflammation and lung stroma hardening, including physical between lung hardening for general, the most popular and frequently. the occurrence of the immune system and there, and massive cortical hormones can sugar the inflammation process, and suppress immune, So modern medical often used sugar to massive cortical hormone application, at present based in spite of various treatment, the recent, but the effects are not ideal, and even produced second effects. this issue is through the six taste the soup with a reduction in the stroma of lung disease hormones reduce the amounts ( the process of the lungs, the type of the relevant ) and clinical research, proved six taste the soup with a minus can not only improve the hormone reduce the amounts process of invigorating the kidney and the virtual type, can also improve the quality of the lung disease clinical symptoms and other, To delay the stroma of lung disease, and reduce the use of steroids is the cause of reaction to their advantage, there is a combination of chinese medicine to cure this disease improve the clinical effect to provide new ideas.
Methods: This subject is treated for a physical lung disease ( the hormone treatment ) of the elderly patients, into the treatment of 30 cases and (30 in the case of the application. therapy) cut the sugar massive cortical hormones 25mg kg of 3 d with six taste the soup with a reduced by treatment ; cut the sugar in the application of the massive cortical hormones 25mg kg of 3 d in the arch of the mildewed 0.5 d oral treatment. the patient get between 60 and quality of lung disease symptoms.
Results: Treatment between the lungs set in physical disease symptoms and signs of improvement. overall outperform in the curative effect as a result, the effective treatment groups 96.67%, the total availability 56.67%. the two groups of the total availability is a significant gender difference (p<0.01).
Conclusion: Treatment of the glands used on a massive cortical hormones 3.25mg/kg.d with six of the soup with a reduced by treatment of lung disease among the old quality of the application of the kidney outperform cut the sugar massive cortical hormones 25mg kg of 3 d in the arch of the mildewed 0.5 d oral treatment, relieve the patient pain is, improvement of symptoms. all have good effects. immediate .
引文
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