[Research on the therapeutic effects of drugs on patients with pneumoconiosis in China].
Objective:To review the clinical research on the main drugs which are used to treat pneumoconiosis in China, evaluate and analyze the efficacy, and give the suggestions on the study of pneumoconiosis treatment.Methods:The data of researches on the therapeutic effects of eight main drugs on patients with pneumoconiosis in China were retrieved from CNKI and Wanfang database before Jan. 1, 2016 including polyvinylpyridine, tetrandrine, piperaquine phosphate, hydroxypiperaquine phosphate, aluminium citrate, Xinin, Xifeining and N-acetyl cysteine (NAC) after consulting the related project files on the clinical treatment on the patients with pneumoconiosis, and a systematic analysis was made on the random control test (RCT) which conformed to the quality criteria in terms of five indices such as the improvement rate of respiratory system symptoms such as cough, expectoration, chest pain and dyspnea, the decrease of the respiratory system infection rate, the changes in FEV1.0% (forced expired volume in one second to forced vital capacity ratio) (ΔFEV1.0%) , index of stability and improvement rate of chest X-ray, and adverse reactions as well as the summary of descriptive efficacy.Results:Nine RCTs in the 15 papers were included; 2 097 patients with pneumoconiosis were included with 1215 in the treatment group and 882 in the control group. The medication modes were divided into four categories, monotherapy (such as polyvinylpyridine, hydroxypiperaquine phosphate, Xifeining and Xinin) , combination of tetrandrine with other drugs, hydroxypiperaquine phosphate and aluminium citrate, and lung lavage (added medications) ; the analysis indicated that the patients in the treatment group were obviously superior to those in the control group in terms of the improvement rate of respiratory system symptoms, the decrease rate of the respiratory tract infection, ΔFEV1.0%, the improvement rate of shadows as indicated in the X-ray chest film and the index of stability (P<0.01) ; after the mean values of the control group were deducted, the improvement rate of symptoms of the respiratory system within the treatment period of the patients with pneumoconiosis increased by 34.6% (95%CI32.9%, 36.3%) in average, the mean value of the decrease in the respiratory tract infection rate was 26.0% (95%CI24.0%, 28.0%) , the mean value of ΔFEV1.0% was 4.08 (95%CI3.56, 4.60) , the improvement rate in X-ray chest film increased by 8.80% (95%CI8.55%, 9.05%) in average, and the index of stability in the X-ray chest film increased by 10.6% (95%CI9.18%, 12.0%) ; one-way analysis of variance indicated the presence of statistical difference in terms of efficacy of four categories of medication modes (Fthe improvement rate of symptoms of the respiratory system=482.2,P<0.01;Fthe decrease in the respiratory tract infection rate=72.01,P<0.01;FΔFEV1.0%=246.6,P<0.01;Fthe index of stability in the X-ray chest film=212.9,P<0.01; Fthe improvement rate of X-ray chest film=466.6,P<0.01) .Conclusion:Drugs such as polyvinylpyridine, tetrandrine, hydroxypiperaquine phosphate, aluminium citrate, Xinin, Xifeining and NAC have some efficacy in the treatment of pneumoconiosis. It is suggested that, in accordance with the mechanism of pneumosilicosis onset and the action mechanism of drugs and on the basis of the research on the traditional drugs, the latest clinical study results and the management experiences on the idiopathic pulmonary interstitial fibrosis be constantly traced and borrowed to strengthen the research on the drugs which are used to treat the pneumoconiosis and the patient health management.
National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
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D000111:Acetylcysteine / Q000627:therapeutic use*; D044182:Benzylisoquinolines / Q000627:therapeutic use*; D018893:Bronchoalveolar Lavage; D002681:China; D005541:Forced Expiratory Volume; D006801:Humans; D011009:Pneumoconiosis / Q000188:drug therapy*; D011658:Pulmonary Fibrosis; D011804:Quinolines / Q000627:therapeutic use*; D012106:Research; D012141:Respiratory Tract Infections; D016896:Treatment Outcome; D014962:X-Ray Film; D010879:Piperazines
D000111:Acetylcysteine; D044182:Benzylisoquinolines; D011804:Quinolines; C009438:tetrandrine; C030684:hydroxypiperaquine; C034759:piperaquine; D010879:Piperazines