Efficacy of Qingfei Huayu Decoction combined with pirfenidone on progressive fibrosing interstitial lung disease associated with rheumatoid arthritis of lung heat and blood stasis syndrome type
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Efficacy of Qingfei Huayu Decoction combined with pirfenidone on progressive fibrosing interstitial lung disease associated with rheumatoid arthritis of lung heat and blood stasis syndrome type
Shanghai Journal of Traditional Chinese MedicineVol. 56, Issue 9, Pages: 58-63(2022)
YAO Jinghui,WANG Yunchao,ZHAO Zhehong,et al.Efficacy of Qingfei Huayu Decoction combined with pirfenidone on progressive fibrosing interstitial lung disease associated with rheumatoid arthritis of lung heat and blood stasis syndrome type[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(9):58-63.
YAO Jinghui,WANG Yunchao,ZHAO Zhehong,et al.Efficacy of Qingfei Huayu Decoction combined with pirfenidone on progressive fibrosing interstitial lung disease associated with rheumatoid arthritis of lung heat and blood stasis syndrome type[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(9):58-63. DOI: 10.16305/j.1007-1334.2022.2205075.
Efficacy of Qingfei Huayu Decoction combined with pirfenidone on progressive fibrosing interstitial lung disease associated with rheumatoid arthritis of lung heat and blood stasis syndrome type
Objective,2,To observe the efficacy of Qingfei Huayu Decoction combined with pirfenidone in the treatment of progressive fibrosing interstitial lung disease (PF-ILD) associated with rheumatoid arthritis of lung in heat and blood stasis syndrome type.,Methods,2,Seventy-three patients with rheumatoid arthritis-related PF-ILD were randomly divided into the control group (,n,=37) and the traditional Chinese medicine(TCM) group (,n,=36). The control group was treated with conventional western medicine plus pirfenidone for rheumatoid arthritis, and the TCM group was treated with Qingfei Huayu Decoction on the basis of the control group. After treatment for 6 months, the clinical efficacy, forced vital capacity (FVC), decreased forced vital capacity (ΔFVC), lung HRCT semi-quantitative score, TCM score, erythrocyte sedimentation rate (ESR), disease activity score (DAS28-ESR), serum KL-6, TGF-β1 levels, maximum dose of pirfenidone and adverse reactions were compared between the two groups.,Results,2,① During the trial, 3 cases dropped out in the TCM group, 4 cases dropped out in the control group, 66 cases finally completed the trial, and 33 cases in each group. ② The total effective rate of the TCM group was 51.52%, and the total effective rate of the control group was 36.36%. There was significant difference in the overall efficacy between the two groups (,P,<,0.05).After treatment, the effective rate of TCM was 69.70% in the TCM group and 33.33% in the control group, and there was significant difference between the two groups (,P,<,0.05). ③ After treatment, the FVC in the control group and the TCM group was lower than that before treatment (,P,<,0.05).The FVC in the TCM group was higher than that in the control group (,P,<,0.05).The ΔFVC was lower in the TCM group than in the control group (,P,<,0.05). ④ There was no significant difference in lung HRCT semiquantitative score in the two groups before and after treatment (,P,>,0.05). The TCM score of the two groups was lower than that before treatment (,P,<,0.05).The TCM score of the TCM group was lower than that of the control group (,P,<,0.05). ⑤After treatment, the ESR、DAS28-ESR scores、KL-6 and TGF-β1 in the control group and the TCM group were lower than those before treatment (,P,<,0.05); The ESR、DAS28-ESR scores、KL-6 and TGF-β1 in the TCM group were lower than those in the control group ,(P,<,0.05). ⑥There was no statistically significant difference in the maximum dose of pirfenidone used between the two groups (,P,>,0.05).,Conclusions,2,Qingfei Huayu Decoction combined with pirfenidone has a satisfactory therapeutic effect on rheumatoid arthritis-related PF-ILD. Compared with western medicine, Qingfei Huayu Decoction can improve the TCM syndrome of patients better and delay the decline of measured FVC, and the mechanism may be related to the down-regulation of serum TGF-β1 expression level.
关键词
类风湿关节炎间质性肺病肺纤维化清肺化瘀方中医药疗法临床试验
Keywords
rheumatoid arthritisinterstitial lung diseasepulmonary fibrosisQingfei Huayu Decoctiontherapy of traditional Chinese medicineclinic trial
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