目的 探討肺寧顆粒聯(lián)合乙酰半胱氨酸泡騰片治療特發(fā)性肺間質(zhì)纖維化的臨床療效。方法 選取2021年4月—2023年12月邢臺(tái)市人民醫(yī)院收治的特發(fā)性肺間質(zhì)纖維化患者108例，按隨機(jī)數(shù)字表法將患者分為對(duì)照組和治療組，每組各54例。對(duì)照組口服乙酰半胱氨酸泡騰片，0.6 g/次，2次/d。在對(duì)照組基礎(chǔ)上，治療組口服肺寧顆粒，1袋/次，3次/d。兩組患者療程為3個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者肺功能指標(biāo)和血?dú)夥治觯? min步行距離（6MWD）和圣喬治呼吸問(wèn)卷（SGRQ）評(píng)分，血清基質(zhì)金屬蛋白酶-9（MMP-9）、轉(zhuǎn)化生長(zhǎng)因子-β1（TGF-β1）、纖溶酶原激活劑抑制劑-1（PAI-1）和白細(xì)胞介素-13（IL-13）水平。結(jié)果 治療后，治療組患者總有效率明顯高于對(duì)照組（92.59% vs 77.78%，P＜0.05）。治療后，兩組一氧化碳彌散量（DLCO）、肺總量（TLC）、潮氣量（VC）、動(dòng)脈氧分壓（pO₂）和動(dòng)脈血氧飽和度（SaO₂）水平明顯高于組內(nèi)治療前（P＜0.05），且治療組這些指標(biāo)水平顯著高于對(duì)照組（P＜0.05）。治療后，兩組6MWD比治療前顯著增加，而SGRQ評(píng)分顯著減少（P＜0.05），且治療組6MWD、SGRQ評(píng)分明顯好于對(duì)照組（P＜0.05）。治療后，兩組患者血清MMP-9、TGF-β1、PAI-1、IL-13水平均低于同組治療前（P＜0.05），且治療后治療組患者血清因子水平明顯低于對(duì)照組（P＜0.05）。結(jié)論 采用肺寧顆粒聯(lián)合乙酰半胱氨酸泡騰片治療特發(fā)性肺間質(zhì)纖維化，安全性較好，能有效抑制機(jī)體炎癥狀態(tài)及肺纖維化，恢復(fù)患者肺功能、呼吸功能及運(yùn)動(dòng)耐力，利于患者生活質(zhì)量的改善。

Objective To investigate the clinical efficacy of Feining Granules combined with acetylcysteine in treatment of idiopathic pulmonary interstitial fibrosis.Methods Patients (108 cases) with idiopathic pulmonary interstitial fibrosis in Xingtai People′s Hospital from April 2021 to December 2023 were divided into control and treatment group according to random number table method, and each group had 54 cases. Patients in the control group were po administered with Acetylcysteine Effervescent Tablets, 0.6 g/time, twice daily. Patients in the treatment group were po administered with Feining Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical evaluations were evaluated, and the lung function indicators and blood gas analysis, 6MWD and SGRQ scores, serum MMP-9, TGF-β1, PAI-1, and IL-13 levels in two groups before and after treatment were compared.Results After treatment, the clinical total effective rate in the treatment group was significantly higher than that in the control group (92.59% vs 77.78%, P < 0.05). After treatment, the levels of DLCO, TLC, VC, pO₂ and SaO₂ in two groups were significantly higher than those before treatment in the two groups (P < 0.05), and the levels of these indicators in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, 6MWD in two groups were significantly increased compared with before treatment, while SGRQ score was significantly decreased (P < 0.05), and the score in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the serum levels of MMP-9, TGF-β1, PAI-1, and IL-13 in two groups were lower than those before treatment in the same group (P < 0.05), and the serum factor levels in the treatment group were significantly lower than those in the control group (P < 0.05).Conclusion The treatment of idiopathic pulmonary interstitial fibrosis with Feining Granules combined with Acetylcysteine Effervescent Tablets has good safety, can effectively inhibit the inflammatory state and pulmonary fibrosis of the body, restore the patient's lung function, respiratory function and exercise endurance, and improve the patient′s quality of life.

R974

邢臺(tái)市科學(xué)技術(shù)委員會(huì)醫(yī)學(xué)創(chuàng)新研究專項(xiàng)（20Y115668）