【摘要】 目的　研究矽肺抗纤维化治疗的远期疗效。方法　对“八五”攻关课题“矽肺治疗措施及效果评价研究”(简称“八五”)中的 10 0例矽肺治疗病例 ,停药 2年后 ,根据病情分别采用汉防己甲素 (汉甲素 ) +羟基磷酸哌喹 (羟哌 )、汉甲素 +克矽平、柠檬酸铝 (柠铝 ) +羟哌进行全量复治、小剂量治疗和继续停药 3种临床方案观察 2年。对照组仍为“八五”对照组的 5 0例矽肺病例。结果　咳嗽、咯痰的治疗有效率各治疗组均高于对照组 ;胸痛及呼吸困难的治疗有效率“汉甲素 +克矽平”的全量组也高于对照组。临床症状综合评价显示 ,无论经“八五”治疗后停药观察或“九五”攻关课题“联合用药治疗矽肺效果及综合评价方法研究”(简称“九五”)进行复治的病例 ,绝大部分均病情稳定 ,各治疗方案均没有出现病情加重病例。“八五”治疗病例停药 2年后 ,X线胸片病变形态都有进展 ,好转率降为 0 ;再经 2年治疗 ,X线胸片疗效观察结果 :(1)“汉甲素 +羟哌”全量组的好转率升至 2 3.8% ,进展率由停药后的 71.4%降至 42 .9% ;维持量组好转率为4.8% ,进展率由 14.3%降至 9.5 % ;观察组的好转率稳定为 4.6 %。 (2 )“汉甲素 +克矽平”全量组的好转率升至 33.3% ,进展率由 6 6 .7%降至 33.3% ;维持量组稳定率由 83.3%降至 5 0 .0 % ,?更多还原

【Abstract】 Objective To investigate long term therapeutic effect of combined anti fibrosis drugs on silicosis. Methods 100 cases of silicosis,who were treated with the combined anti fibrosis drugs:tetrandrine(TD)+quinolyl piperazine hydroxyl phosphate(QOHP),TD+poly 2 vinyl pyridine nitrogen oxide(PVNO),QOHP+aluminium citrate(ALC)and stopped the treatment for two years,were divided into three groups:re treated group with the same dosage of drugs as before,maintained group with a lower dosage and observed(not treated)group.The control consisted of 50 silicosis patients in previous study. Results In all treated groups,cough and expectoration were getting better than that in control group.Chest pain and dyspnea also showed improvement in TD+PVNO re treated group.The evaluation by summing up all clinical symptoms indicated that the condition of patients in most of the treated and observed groups were stable and no case was getting worse.Concerning the changes of chest X ray films,over the two years after the previous treatment,the images of fibrosis in X ray films in all cases were aggravated,the improving rate was 0.With the two years treatment again,the results of X ray films were as follows:by using TD+QOHP,the improving rate was 23.8% and the aggravating rate went down from 71.4% to 42.9% in re treated group,4.8% and from 14.3% to 9.5% respectively in maintained group,the improving rate was not changed( 4.6% ) in observed group;by using TD+PVNO,the improving rate reached 33.3% and the aggravating rate decreased from 66.7% to 33.3% in re treated group,the stability rate went down from 83.3% to 50.0% and the aggravating rate went up from 16.7% to 50.0% in maintained group,71.4% of cases showed no change in observed group;by using ALC+QOHP,the improving rate was 5.9% and aggravating rate went down from 11.8% to 0. Conclusion The treatment of silicosis with combined anti fibrosis drugs showed a certain long term therapeutic effect.Repeated treatment and maintained treatment with a lower dosage were suggested for most patients according to their condition.更多还原