中国实用内科杂志2026，Vol.46Issue(5)：389-397,9.DOI:10.19538/j.nk2026050108
综合性肺康复联合汉防己甲素对尘肺病患者免疫调节及康复效果的影响研究
Study on the effect of comprehensive pulmonary rehabilitation combined with tetrandrine on immunomodulation and rehabilitation outcomes in patients with pneumoconiosis
摘要
Abstract
Objective To investigate whether integrating comprehensive pulmonary rehabilitation with tetrandrine improves pulmonary function and exercise capacity in pneumoconiosis patients by restoring the immune microenvironment.Methods A total of 153 pneumoconiosis patients were selected from three medical institutions—the Wuhai Occupational Disease Prevention(51 patients)and Treatment Hospital,the Dayu Mingde Hospital of Ganzhou(55 patients),and the Ganzhou Mingde Occupational Disease Hospital(47 patients),who received treatment from November 2024 to October 2025.Among these patients,147 patients(49、52、46 patients)completed the 12-week trial with complete data records,and they were divided into three groups by random number table method:the control group(49 patients),Trial Group 1(50 patients)and Trial Group 2(48 patients).The intervention lasted 12 weeks.The 6-minute walk distance(6MWD)and pulmonary function tests(PFT)of the three groups were recorded before and after intervention to evaluate the clinical effects.Flow cytometry was utilized to detect peripheral blood lymphocyte subsets and cytokine levels to assess immunomodulatory responses.Spearman's correlation analysis was applied to explore the associations between immunological markers and rehabilitation outcomes.Results Following the 12-week intervention,both Trial Groups 1 and 2 exhibited substantially higher measurements than the control group across multiple parameters:6MWD,forced expiratory volume in one second(FEV1),FEV1/FVC ratio,CD3+,CD4+,CD8+,CD16+,CD19+,CD4+/CD8+ratio,IL-4,IL-10,and IFN-γ(all P＜0.05),while IL-2,IL-6,IL-17,and TNF-α were lower than the control group(all P＜0.05).Inter-group comparison revealed that Trial Group 2 achieved more significant improvements in 6MWD,FEV1,CD19+,and IL-6 than Trial Group 1(all P＜0.01,0.001).Positive associations existed between FEV1,CD4+,CD4+/CD8+ratio and 6MWD,CD16+,CD19+,IL-4,IL-10(r=0.43-0.62).Negative correlations were observed between IL-2 and FEV1,CD4+,CD19+,CD4+/CD8+ratio,CD 16+NK cells,and FEV1/FVC ratio;similarly,CD4+/CD8+ratio correlated negatively with IL-17(r=-0.62--0.44).All the aforementioned correlations were statistically significant(P＜0.001).Conclusion The integration of comprehensive pulmonary rehabilitation with tetrandrine can significantly improve the exercise capacity and pulmonary function of pneumoconiosis patients through the restoration of immunological homeostasis and the targeted suppression of pro-fibrotic factors.关键词
尘肺病/肺康复/淋巴细胞亚群/细胞因子/免疫调节/康复效果Key words
pneumoconiosis/pulmonary rehabilitation/lymphocyte subset/cytokines/immunomodulation/rehabilitation outcomes分类
医药卫生引用本文复制引用
孙雪梅,杨忠东,李祥有,钟家银,侯博文,高丽妮,侯晨悦,刘美睿,李宝平,沈福海,孙治平,李倩倩,崔海峰,王春喜,王健祥,曹青春..综合性肺康复联合汉防己甲素对尘肺病患者免疫调节及康复效果的影响研究[J].中国实用内科杂志,2026,46(5):389-397,9.基金项目
国家卫生健康委员会尘肺病重点实验室2023年度开放课题(2020-PT320-005) （2020-PT320-005）
