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OA

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.