目的 研究漢防己甲素片聯(lián)合吡非尼酮膠囊治療肺間質(zhì)纖維化的療效。方法 選取2017年8月-2019年8月來鄭州大學(xué)附屬鄭州中心醫(yī)院治療的80例肺間質(zhì)纖維化患者為研究對象，所有患者隨機(jī)分為對照組和治療組，每組各40例。對照組患者口服吡非尼酮膠囊，200 mg/次，在兩周時間內(nèi)每次增加200 mg最后達(dá)到每次維持劑量為600 mg/次，3次/d。治療組在對照組基礎(chǔ)上口服漢防己甲素片，2片/次，3次/d。兩組患者持續(xù)治療2個月。觀察兩組的臨床療效，比較兩組臨床癥狀緩解時間、肺功能指標(biāo)、血清轉(zhuǎn)化生長因子-β（TGF-β1）、血管內(nèi)皮生長因子（VEGF）、胰島素生長因子-I（IGF-I）、Ⅲ型膠原（Ⅲ-C）、Ⅳ型膠原（Ⅳ-C）、透明質(zhì)酸（HA）水平。結(jié)果 治療后，治療組總有效率95.00%，顯著高于對照組的77.50%（P<0.05）。治療后，治療組胸憋、喘息、氣短、咳嗽、咳痰等癥狀緩解時間明顯短于對照組（P<0.05）。治療后，兩組患者最大呼氣流量（PEF）、用力肺活量（FVC）、一秒用力呼氣容積（FEV1）水平顯著升高（P<0.05），且治療組患者PEF、FVC、FEV1水平升高較多（P<0.05）。治療后，兩組TGF-β₁、VEGF、IGF-I水平顯著降低（P<0.05）；并且治療組TGF-β₁、VEGF、IGF-I水平降低較多（P<0.05）。治療后，兩組Ⅲ-C、Ⅳ-C、HA水平顯著降低（P<0.05）；并且治療組Ⅲ-C、Ⅳ-C、HA水平降低較多（P<0.05）。結(jié)論 漢防己甲素片聯(lián)合吡非尼酮膠囊治療肺間質(zhì)纖維化具有較好的治療效果，能夠改善患者肺功能，縮短臨床癥狀緩解時間，調(diào)節(jié)血清炎性因子水平，安全性較高，值得在臨床上推廣應(yīng)用。

Objective To study the efficacy of Tetrandrine Tablets combined with Pirfenidone Capsules in treatment of pulmonary interstitial fibrosis. Methods Patients (80 cases) with pulmonary interstitial fibrosis in Zhengzhou Central Hospital Affiliated to Zhengzhou University from August 2017 to August 2019 were randomly divided into two groups, and each group had 40 cases. Patients in the control group were po administered with Pirfenidone Capsules, 200 mg/time, increased 200 mg each time in two weeks, and finally reached the maintenance dose of 600 mg/time, three times daily. Patients in the treatment group were po administered with Tetrandrine Tablets on the basis of the control group, 2 tablets/time, three times daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and clinical symptom relief time, pulmonary function, the levels of TGF-β₁, VEGF, IGF-I, Ⅲ-C, Ⅳ-C, and HA in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95%, which was significantly higher than 77.50% of the control group (P<0.05). After treatment, the remission times of chest holding, wheezing, shortness of breath, cough, expectoration and other symptoms in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, PEF, FVC, and FEV1 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the PEF, FVC, and FEV1 in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of TGF-β₁, VEGF, and IGF-I in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the levels of TGF-β₁, VEGF and IGF-I in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of Ⅲ-C, Ⅳ-C and HA in two groups were significantly decreased (P<0.05). And the levels of Ⅲ-C, Ⅳ-C and HA in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Tetrandrine Tablets combined with Pirfenidone Capsules has clinical curative effect in treatment of pulmonary interstitial fibrosis, can improve the lung function, reduce the time of clinical symptom relief, and regulate the level of serum inflammatory factors, with good safety, which is worthy of clinical application.

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