摘要目的 观察汉防己甲素与乙酰半胱氨酸泡腾片联合应用治疗矽肺的临床疗效.方法 96例矽肺患者随机分为治疗组(49例)和对照组(47例),2组均常规给予抗炎、止咳、平喘等治疗,治疗组同时给予汉防己甲素和乙酰半胱氨酸泡腾片,汉防己甲素口服,2次/d,每次100 mg,服用6d,停用1d,3个月为1疗程,休息1个月开始下一个疗程,共4个疗程.乙酰半胱氨酸泡腾片2次/d,每次600mg,连用12d,为1疗程,起初2个月,每月1个疗程,后每隔2个月1疗程,共4个疗程.观察临床症状、肺通气功能、血清超氧化物歧化酶(SOD)、X线胸片影像的变化.结果 与对照组比较,治疗组治疗后咳嗽、咳痰、胸闷、胸痛、呼吸困难的好转率明显升高,差异有统计学意义(P＜0.05).与对照组[(70.466±20.261) U/ml]和治疗前[(68.182±21.414) U/ml]比较,治疗组治疗后SOD水平[(77.389±21.315) U/ml]升高,用力肺活量(FVC)、1秒用力呼气量(FEV1.0)增高,差异有统计学意义(P＜0.05).治疗组8例X线胸片矽肺影像好转.结论 汉防己甲素与乙酰半胱氨酸联合应用对矽肺有一定治疗效果,在目前矽肺尚无特效药物的情况下,不失为一种有效的矽肺治疗药物.

abstractsObjective To observe the clinical efficacy of tetrandrine combined with acetylcysteine effervescent tablets in the treatment of silicosis.Methods A total of 96 patients with silicosis were randomly divided into treatment group (49 cases) and control group (47 cases).Both groups were given routine therapy including anti-inflammatory,antitussive,and antiasthmatic drugs,and the patients in treatment group were given tetrandrine combined with acetylcysteine effervescent tablets at the same time.Tetrandrine (100 mg) was orally administrated twice a day,and there was a one-day interval between every 6 days' continuous administration; totally,there were four courses of treatment,with 3 months for each course,and there was a onemonth break between each course.Acetylcysteine effervescent tablets (600 mg) were taken twice a day; each course of treatment was 12 days,and there were four courses; for the first two months,there was one course per month,and then one course every other two months for the rest of time.Clinical symptoms,pulmonary ventilation function,serum superoxide dismutase (SOD) and changes in X-ray findings were observed.Results After treatment,the treatment group had significantly increased rates of improvements in cough,expectoration,chest congestion and pain,and dyspnea compared with the control group (P＜0.05).Compared with the control group (serum SOD level:70.466±20.261 U/ml) and the treatment group before therapy (serum SOD level:68.182±21.414 U/ml),the treatment group after therapy had significantly increased serum SOD level (77.389±21.315 U/ml),forced vital capacity,and forced expiratory volume in one second (P＜0.05).Eight patients in treatment group showed improvement in the chest X-ray findings of silicosis.Conclusion The combination of tetrandrine and acetylcysteine effervescent tablets show some effect in the treatment of silicosis.It can be an effective option for treating silicosis as there are no other specific remedies.