论著
目的 探讨复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期患者的疗效。方法 选取张掖市第二人民医院2020年1月—2023年10月收治的128例特发性肺间质纤维化急性加重期患者,应用随机数字表法分为两组,每组各64例。对照组采取泼尼松治疗,观察组采取复方甘草口服液联合泼尼松治疗。对比其临床疗效,治疗前后血清肺纤维化指标及炎症因子水平,最后对比其不良反应发生率。结果 观察组总有效率93.75%,高于对照组的79.69%(χ2=5.490,P=0.019);治疗前两组层黏连蛋白(LN)、Ⅲ型前胶原肽(PC-Ⅲ)、透明质酸(HA)对比差异无统计学意义(P>0.05),治疗后两组患者LN、PC-Ⅲ、HA均降低,观察组[(89.25±7.61)μg/L;(68.33±7.68)mg/L;(81.53±8.54)μg/L]低于对照组[(96.17±8.34)μg/L;(75.68±8.25)mg/L;(95.68±9.25)μg/L],对比差异有统计学意义(t1=4.903,P1<0.001;t2=5.217,P2<0.001;t3=8.992,P3<0.001);治疗前两组患者肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、IL-10、转化生长因子(TGF-β1)对比差异无统计学意义(P>0.05),治疗后两组TNF-α、IL-4、IL-10、TGF-β1水平降低,观察组[(61.94±8.24)ng/L;(4.43±1.17)ng/mL;(65.49±13.24)g/L;(114.73±13.12)pg/mL]低于对照组[(75.52±9.43)ng/L;(6.31±1.28)ng/mL;(79.27±9.38)g/L;(147.76±15.46)pg/mL],对比差异有统计学意义(t1=8.675,P1<0.001;t2=8.673,P2<0.001;t3=6.794,P3<0.001;t4=13.032,P4<0.001);两组不良反应发生率对比差异无统计学意义(7.81% vs 6.25%,χ2=0.120,P=0.730)。结论 复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期疗效显著,可辅助延缓患者肺纤维化发展进程,减轻机体炎症反应,安全性较高。
Objective To investigate the efficacy of compound licorice oral liquid combined with prednisone in patients with acute exacerbations of idiopathic pulmonary interstitial fibrosis. Methods A total of 128 patients with acute exacerbation of idiopathic pulmonary interstitial fibrosis admitted to Zhangye Second People's Hospital from January 2020 to October 2023 were divided into two groups by random number table method,with 64 patients in each group.The control group received prednisone treatment,while the observation group received compound licorice oral liquid combined with prednisone treatment.Compare its clinical efficacy,serum pulmonary fibrosis indicators and inflammatory factor levels before and after treatment,and finally compare its incidence of adverse reactions. Results The total response rate in the observation group was 93.75%,which was higher than the 79.69% in the control group(χ2=5.490,P=0.019).There was no difference between the two groups of LN,PC-III,and HA(P>0.05),LN,PC-III and HA were decreased in both groups,while the observation group[(89.25±7.61)μg/L;(68.33±7.68)mg/L;(81.53±8.54)μg/L] was lower than the control group[(96.17±8.34)μg/L;(75.68±8.25)mg/L;(95.68±9.25)μg/L],the contrast difference was statistically significant(t1=4.903,P1<0.001;t2=5.217,P2<0.001;t3=8.992,P3<0.001).There was no difference in TNF-α,IL-4,IL-10,and TGF-β1 between the two groups before treatment(P>0.05),lower levels of TNF-α,IL-4,IL-10,and TGF-β1 in the two patient groups after treatment,the observation group[(61.94±8.24)ng/L;(4.43±1.17)ng/mL;(65.49±13.24)g/L;(114.73±13.12)pg/mL] was lower than the control group[(75.52±9.43)ng/L;(6.31±1.28)ng/mL;(79.27±9.38)g/L;(147.76±15.46)pg/mL],the contrast difference was statistically significant(t1=8.675,P1<0.001;t2=8.673,P2<0.001;t3=6.794,P3<0.001;t4=13.032,P4<0.001).There was no difference in the incidence of adverse effects between the two groups(7.81% vs 6.25%,χ2=120,P=0.730). Conclusions The combination of compound licorice oral liquid and prednisone has a significant therapeutic effect on the acute exacerbation of idiopathic pulmonary interstitial fibrosis.It can assist in delaying the progression of pulmonary fibrosis in patients,reducing the body's inflammatory response,and has high safety.
临床诊疗
目的 探讨吗替麦考酚酯联合泼尼松治疗儿童紫癜性肾炎的临床疗效。方法 将2016年2月—2018年2月在广州开发区医院儿科和广州市第一人民医院儿科收治的36例紫癜性肾炎肾病综合征型患者根据治疗分为联合组和对照组,每组18例。联合组采用吗替麦考酚酯和泼尼松治疗,对照组采用泼尼松治疗。比较两组患儿治疗前后血肌酐(Scr)、总胆固醇(Chol)、24 h 尿蛋白定量、血白蛋白(ALB) 。结果 联合组治疗效果优于对照组,差异有统计学意义(Z=-2.461,P < 0.05) ; 联合组治疗后24 h尿蛋白定量下降,血肌酐(Scr)降低,总胆固醇(Chol)下降和血白蛋白(ALB)升高,两组实验室指标差异有统计学意义(P< 0.05) 。结论 吗替麦考酚酯联合泼尼松治疗紫癜性肾炎治疗效果明确,可以降低血肌酐和胆固醇,改善尿蛋白水平,提升血白蛋白浓度,治疗效果明显,能有效控制病情,在临床上值得推广应用。