目的 觀察鹽酸氨溴索聯(lián)合吡非尼酮治療肺間質(zhì)纖維化的臨床療效。方法 選擇2020年9月—2024年1月在天津市泰達(dá)醫(yī)院治療的特發(fā)性肺間質(zhì)纖維化患者80例，按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各40例。對(duì)照組患者口服吡非尼酮片，200 mg/次，3次/d，兩周內(nèi)每次增加0.2 g，增加至每次0.6 g，此后維持在每次0.6 g。治療組在對(duì)照組基礎(chǔ)上口服鹽酸氨溴索片，30 mg/次，3次/d。兩組患者治療3個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者腫瘤壞死因子-α（TNF-α）、骨橋蛋白、白細(xì)胞介素-13（IL-13）、趨化因子配體14（CXCL14）、脂質(zhì)過氧化物（LPO）、谷胱甘肽過氧化物酶（GSH-Px）、過氧化氫酶（CAT）、血管細(xì)胞黏附分子-1（VCAM-1）、胰島素生長(zhǎng)因子I（IGF-I）、層黏連蛋白（LN）、肺總量（TLC）、動(dòng)脈血氧飽和度（SaO₂）、最大呼氣中段流量（MMF）和肺一氧化碳彌散量（DLCO）水平，及特發(fā)性肺纖維化患者生活質(zhì)量量表（ATAQ-IPF）和圣喬治呼吸問卷（SGRQ）評(píng)分。結(jié)果 治療后，治療組總有效率為97.50%，明顯高于對(duì)照組總有效率（80.00%），兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組TNF-α、骨橋蛋白、IL-13、CXCL14、LPO、VCAM-1、IGF-Ⅰ、LN水平較治療前降低，而GSH-Px、CAT、TLC、SaO₂、MMF、DLCO水平較治療前明顯升高（P＜0.05），且治療組這些指標(biāo)水平較對(duì)照組明顯好轉(zhuǎn)（P＜0.05）。治療后，兩組患者SGRQ評(píng)分較治療前增加，而ATAQ-IPF評(píng)分較治療前降低（P＜0.05），且治療組SGRQ和ATAQ-IPF評(píng)分較對(duì)照組明顯好轉(zhuǎn)（P＜0.05）。結(jié)論 鹽酸氨溴索聯(lián)合吡非尼酮治療肺間質(zhì)纖維化，可減少氧化應(yīng)激及炎癥損傷，減少肺纖維化，改善呼吸狀態(tài)，提升肺功能、臨床療效及生活質(zhì)量。

Objective To observe the clinical effect of ambroxol hydrochloride combined with pirfenidone in treatment of pulmonary interstitial fibrosis. Methods Patients (80 cases) with pulmonary interstitial fibrosis in Tianjin Teda Hospital from September 2020 to January 2024 were divided into control and treatment group by random number table method, and each group had 40 cases. Patients in the control group were po administered with Pirfenidone Tablets, 200 mg/time, three times daily, increase by 0.2 g each time within 2 weeks until 0.6 g/time. Patients in the treatment group were po administered with Ambroxol Hydrochloride Talets on the basis of the control group, 30 mg/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical evaluations were evaluated, the levels of TNF-α, osteopontin, IL-13, CXCL14, LPO, GSH-Px, CAT, VCAM-1, IGF-Ⅰ, LN, TLC, SaO₂, MMF and DLCO, and the scores of ATAQ-IPF and SGRQ in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 97.50%, which was significantly higher than that in the control group (80.00%), and the difference between the two groups was statistically significant (P < 0.05). After treatment, the levels of TNF-α, osteopontin, IL-13, CXCL14, LPO, VCAM-1, IGF-I, and LN in two groups were significantly decreased compared with before treatment, while the levels of GSH-Px, CAT, TLC, SaO₂, MMF, and DLCO were significantly increased compared with before treatment (P < 0.05), and the levels of these indicators in the treatment group were significantly improved compared with the control group (P < 0.05). After treatment, the SGRQ scores of patients in two groups were increased compared with before treatment, while the ATAQ-IPF scores were decreased (P < 0.05). The SGRQ and ATAQ-IPF scores in the treatment group were significantly improved compared with the control group (P < 0.05). Conclusion Ambroxol hydrochloride combined with pirfenidone in treatment of pulmonary interstitial fibrosis can reduce oxidative stress and inflammatory damage, reduce pulmonary fibrosis, improve respiratory status, and enhance lung function, clinical efficacy and quality of life.

R974