目的 分析探讨在西医治疗基础上，清咳平喘颗粒单用及与六君子汤联用治疗尘肺病的临床疗效。方法 将2022年1月—2023年12月山东第一医科大学附属职业病医院收治的138例气虚质尘肺病患者按随机数字表分为对照组、清咳平喘颗粒（清咳）组、清咳平喘颗粒＋六君子汤联合组，每组各46例。对照组以西医综合治疗，清咳组在西医基础治疗的基础上，加用清咳平喘颗粒治疗，联合组在清咳组治疗的基础上联合六君子汤治疗。对比3组临床疗效、中医证候、肺功能水平[用力肺活量（ FVC）、最大呼气中期流量（ MMEF）、第一秒用力呼气容积占用力肺活量百分比（ FEV1/FVC）]、疾病康复指标[血氧饱和度（ SpO₂）、慢性阻塞性肺病疾病评分（ CAT）、急性发作次数]、呼出气一氧化氮（ FeNO）、降钙素原、治疗安全性。结果 清咳组、联合组总有效率均高于对照组（ P＜0.05），均能显著降低中医证候积分，提高SpO₂水平，降低CAT评分、急性发作次数、FeNO及降钙素原水平（ P＜0.05）。其中联合组在改善患者神疲乏力、气短懒言状态，提升肺功能水平，促进疾病康复指标恢复，降低降钙素原方面显著强于清咳组（ P＜0.05）。3组不良反应发生率比较无差异性（ P＞0.05）。结论 在西医基础治疗的基础上，清咳平喘颗粒治疗尘肺病有良好效果，能显著提升治疗有效率，减轻中医证候程度，提高肺功能水平，促进疾病的康复状态，提高血氧饱和度，降低CAT评分，减少急性发作次数，减轻炎症水平，安全性好，可推荐用于尘肺病的治疗。在此基础上，联合使用六君子汤，可进一步提升其治疗效果。

Objective To analyze and explore the clinical efficacy of Qingke Pingchuan Granules alone and in combination with Liujunzi Decoction and western medicine treatment for pneumoconiosis. Methods A total of 138 patients with pneumoconiosis admitted to Shandong Occupational Disease Hospital from January 2022 to December 2023 were divided into control group, Qingke Pingchuan Granules (Qingke) group, and Qingke Pingchuan Granules + Liujunzi Decoction (combination) group, with 46 patients in each group. The control group received comprehensive treatment with western medicine, the Qingke group received treatment with Qingke Pingchuan Granules in addition to basic western medicine treatment, and the combination group received treatment with Liujunzi Decoction in addition to the Qingke group treatment. The clinical efficacy, traditional Chinese medicine syndromes, and lung function levels (FVC, MMEF and FEV1/FVC), disease rehabilitation indicators (SpO₂, CAT score, number of acute attacks), FeNO, procalcitonin, and treatment safety were compared. Results The total effective rates of the Qingke group and the combination group were higher than those of the control group (P < 0.05), all significantly reduced traditional Chinese medicine syndrome scores, increased SpO₂, decreased CAT scores, acute attack frequency, FeNO, and procalcitonin levels (P < 0.05). The combined group showed significantly stronger effects than the Qingke group in improving patients' fatigue, shortness of breath, and laziness, enhancing lung function levels, promoting disease recovery indicators, and reducing procalcitonin levels (P < 0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P < 0.05). Conclusion On the basis of basic western medicine treatment, Qingke Pingchuan Granules have good effects in treating pneumoconiosis, significantly improving treatment efficiency, reducing the degree of traditional Chinese medicine syndrome, improving lung function level, promoting disease recovery status, increasing blood oxygen saturation, reducing CAT score, reducing the number of acute attacks, reducing inflammation level, and good safety. It can be recommended for the treatment of pneumoconiosis. On this basis, the combined use of Liujunzi Decoction can further enhance its therapeutic effect.

R974

山东省中医药科技项目（M-2023340）；山东省中医药发展科技计划项目（2015-327）