目的 分析探討在西醫(yī)治療基礎上，清咳平喘顆粒單用及與六君子湯聯(lián)用治療塵肺病的臨床療效。方法 將2022年1月—2023年12月山東第一醫(yī)科大學附屬職業(yè)病醫(yī)院收治的138例氣虛質塵肺病患者按隨機數字表分為對照組、清咳平喘顆粒（清咳）組、清咳平喘顆粒＋六君子湯聯(lián)合組，每組各46例。對照組以西醫(yī)綜合治療，清咳組在西醫(yī)基礎治療的基礎上，加用清咳平喘顆粒治療，聯(lián)合組在清咳組治療的基礎上聯(lián)合六君子湯治療。對比3組臨床療效、中醫(yī)證候、肺功能水平[用力肺活量（ FVC）、最大呼氣中期流量（ MMEF）、第一秒用力呼氣容積占用力肺活量百分比（ FEV1/FVC）]、疾病康復指標[血氧飽和度（ SpO₂）、慢性阻塞性肺病疾病評分（ CAT）、急性發(fā)作次數]、呼出氣一氧化氮（ FeNO）、降鈣素原、治療安全性。結果 清咳組、聯(lián)合組總有效率均高于對照組（ P＜0.05），均能顯著降低中醫(yī)證候積分，提高SpO₂水平，降低CAT評分、急性發(fā)作次數、FeNO及降鈣素原水平（ P＜0.05）。其中聯(lián)合組在改善患者神疲乏力、氣短懶言狀態(tài)，提升肺功能水平，促進疾病康復指標恢復，降低降鈣素原方面顯著強于清咳組（ P＜0.05）。3組不良反應發(fā)生率比較無差異性（ P＞0.05）。結論 在西醫(yī)基礎治療的基礎上，清咳平喘顆粒治療塵肺病有良好效果，能顯著提升治療有效率，減輕中醫(yī)證候程度，提高肺功能水平，促進疾病的康復狀態(tài)，提高血氧飽和度，降低CAT評分，減少急性發(fā)作次數，減輕炎癥水平，安全性好，可推薦用于塵肺病的治療。在此基礎上，聯(lián)合使用六君子湯，可進一步提升其治療效果。

Objective To analyze and explore the clinical efficacy of Qingke Pingchuan Granules alone and in combination with Liujunzi Decoction and western medicine treatment for pneumoconiosis. Methods A total of 138 patients with pneumoconiosis admitted to Shandong Occupational Disease Hospital from January 2022 to December 2023 were divided into control group, Qingke Pingchuan Granules (Qingke) group, and Qingke Pingchuan Granules + Liujunzi Decoction (combination) group, with 46 patients in each group. The control group received comprehensive treatment with western medicine, the Qingke group received treatment with Qingke Pingchuan Granules in addition to basic western medicine treatment, and the combination group received treatment with Liujunzi Decoction in addition to the Qingke group treatment. The clinical efficacy, traditional Chinese medicine syndromes, and lung function levels (FVC, MMEF and FEV1/FVC), disease rehabilitation indicators (SpO₂, CAT score, number of acute attacks), FeNO, procalcitonin, and treatment safety were compared. Results The total effective rates of the Qingke group and the combination group were higher than those of the control group (P < 0.05), all significantly reduced traditional Chinese medicine syndrome scores, increased SpO₂, decreased CAT scores, acute attack frequency, FeNO, and procalcitonin levels (P < 0.05). The combined group showed significantly stronger effects than the Qingke group in improving patients' fatigue, shortness of breath, and laziness, enhancing lung function levels, promoting disease recovery indicators, and reducing procalcitonin levels (P < 0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P < 0.05). Conclusion On the basis of basic western medicine treatment, Qingke Pingchuan Granules have good effects in treating pneumoconiosis, significantly improving treatment efficiency, reducing the degree of traditional Chinese medicine syndrome, improving lung function level, promoting disease recovery status, increasing blood oxygen saturation, reducing CAT score, reducing the number of acute attacks, reducing inflammation level, and good safety. It can be recommended for the treatment of pneumoconiosis. On this basis, the combined use of Liujunzi Decoction can further enhance its therapeutic effect.

R974

山東省中醫(yī)藥科技項目（M-2023340）；山東省中醫(yī)藥發(fā)展科技計劃項目（2015-327）