Jiang Ning, Li Jing
Objective Observe the efficacy and safety of pirfenidone after pulmonary rehabilitation treatment in patients with CPEF. Methods This article is a prospective study, with cases included from January 2020 to May 2023. The study subjects were 80 patients with CPEF. The enrolled patients were randomly divided into a conventional group (40 cases) and an experimental group (40 cases) using computer randomization. The conventional group received routine lung rehabilitation treatment, while the experimental group received combination therapy with pirfenidone. The inflammatory cytokines, pulmonary fibrosis progression, pulmonary arterial blood gas indicators, and lung function improvement of the two groups of patients were compared, And medication safety. Results Before treatment, the inflammatory indicators of the two groups of patients were similar (P>0.05); After treatment, the TGF of the experimental group-β 1. MMP-9, TNF-α The levels of (125.35±20.61) ng/L, (30.41±5.16) ng/ml, and (3.36±0.27) ng/L were lower than those of the conventional group [(140.33±20.36) ng/L, (33.49±5.33) ng/ml, and (4.41±1.26) ng/L] (P<0.05). Before treatment, the progression of pulmonary fibrosis in both groups of patients was similar (P>0.05); After treatment, the ICAM-1, HA, and Ashcroft scores of the experimental group were (105.44±20.13) pg/ml, (25.44±5.17) ng/ml, and (3.46 ±0.25) points, respectively, which were lower than those of the conventional group [(120.36±20.14) pg/ml, (28.66±5.34) ng/ml, and (4.77±1.14) points] (P<0.05). Before treatment, the pulmonary arterial blood gas indicators of the two groups of patients were similar (P>0.05); After treatment, the PaO2 of the experimental group was (85.25±10.31) mmHg, which was higher than that of the conventional group (80.33±10.22) mmHg; PaCO2 was (40.35±10.27) mmHg, lower than the conventional group (45.77±10.34) mmHg (P<0.05). Before treatment, the lung function of the two groups of patients was similar (P>0.05); After treatment, the FEV1, FVC, and PEF of the experimental group were (60.24±10.11)%, (2.54±0.26) L, and (488.75±50.61) L/min, respectively, which were higher than those of the conventional group [(54.41±10.23)%, (2.03±0.43) L, and (440.24±50.13) L/min] (P<0.05). Under different treatment regimens, the incidence of drug-related side effects in the experimental group was 15.00% (6/40), which was similar to 10.00% (4/40) in the conventional group (P>0.05). Conclusion Pifenidone can inhibit inflammatory factors and pulmonary fibrosis progression in CPEF patients, and has a positive effect on improving their pulmonary arterial blood gas indicators and promoting pulmonary function recovery; The combined use of this drug did not significantly increase the risk of drug-related side effects, and its safety was relatively high.