目的 观察吡非尼酮胶囊联合乙酰半胱氨酸颗粒治疗特发性肺间质纤维化的临床疗效。方法 选取2016年1月—2018年3月成都市中西医结合医院收治的特发性肺间质纤维化患者67例为研究对象，根据随机数字表法随机分为对照组（32例）和治疗组（35例）。对照组饭后口服乙酰半胱氨酸颗粒，0.2 g/次，3次/d。治疗组在对照组的基础上口服吡非尼酮胶囊，初始用量200 mg/次，两周后调整为400 mg/次，3周后调整为600 mg/次，3次/d。两组均持续治疗4个月。观察两组临床疗效，比较治疗前后高分辨率CT（HRCT）改变阳性率，肺功能指标和肺纤维化指标。结果 治疗后，对照组和治疗组的总有效率分别为71.88%、88.57%，两组比较差异具有统计学意义（P<0.05）。治疗后，对照组网格影阳性率显著降低，治疗组网格影、斑片影阳性率均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗组网格影、斑片影阳性率显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者最大呼气流量（PEF）、用力肺活量（FVC）、一秒用力呼气容积（FEV₁）水平均显著升高，同组治疗前后比较差异具有统计学意义（P<0.05），且治疗后治疗组肺功能指标显著高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者Ⅲ型胶原（Ⅲ-C）、IV型胶原（Ⅳ-C）、透明质酸（HA）水平均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗组肺功能指标显著低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 吡非尼酮胶囊联合乙酰半胱氨酸颗粒治疗特发性肺间质纤维化疗效显著，能明显改善肺功能和肺纤维化指标，安全性高，具有一定的临床推广应用价值。

Objective To observe the clinical efficacy of Pirfenidone Capsules combined with Acetylcysteine Granules in treatment of idiopathic pulmonary interstitial fibrosis. Methods Patients (67 cases) with idiopathic pulmonary interstitial fibrosis in Chengdu Integrated TCM & Western Medicine Hospital from January 2016 to March 2018 were randomly divided into control (32 cases) and treatment (35 cases) groups. Patients in the control group were po administered with Acetylcysteine Granules after meals, 0.2 g/time, three times daily Patients in the treatment group were po administered with Pirfenidone Capsules on the basis of the control group, starting dosage 200 mg/time, after treatment for 2 weeks, dosage changed to 400 mg/time, and after treatment for 3 weeks, dosage changed to 600 mg/time, three times daily. Patients in two groups were treated for 4 months. After treatment, the clinical efficacy was evaluated, and the changes of HRCT positive rate, lung function indexes, and lung fibrosis indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 71.88% and 88.57%, respectively, and there was difference between two groups (P < 0.05). After treatment, the positive rate of grid shadow in the control group was significantly decreased,and the positive rate of grid and patchy shadows in the treatment group were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the changes of HRCT positive rate in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, PEF, FVC, and FEV₁ in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And lung function indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05).After treatment, Ⅲ-C, Ⅳ-C, and HAin two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And lung fibrosis indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Pirfenidone Capsules combined with Acetylcysteine Granules has clinical curative effect in treatment of idiopathic pulmonary interstitial fibrosis, and can significantly improve lung function and lung function indexes,with good safety, which has a certain clinical application value.