Fangfang Wang1, Baohong Xiao1, Xuepeng Huang2, Jianxin Du1, Wei Cheng1, Jinfeng Li1, Weihua Yan3 and Wencheng Yu1*
1Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, China 2Department of Respiratory and Critical Care Medicine, People's Hospital of Rizhao Lanshan, China 3Department of Pathology, The Affiliated Hospital of Qingdao University, ChinaFulltext PDF
Objective: The aim of this study was to explore the efficacy of Xuefu Zhuyu decoction in treating autoimmune PAP (aPAP) and its underlying mechanism. Methods: 12 aPAP patients from January 2012 to February 2018 were enrolled. According to the different therapies, they were divided into two groups: Whole Lung Lavage (WLL) group and Xuefu Zhuyu Decoction (XFZYD) group. The results of multiple clinical tests and examination were used as data sources. Results: Compared with the standard baseline of CT, the percentage of affected lung parenchyma in WLL group and XFZYD group were 69.28 ± 10.25 and 67.55 ± 8.44, respectively. Both groups decreased gradually over time, reaching the lowest at the 24th month, but XFZYD group was significantly lower than the WLL group since the 3rd month after baseline. The improvements of the Partial Alveolar-arterial Oxygen gradient (P(A-a)O2) and the Partial arterial pressure of Oxygen (PaO2) were consistent with the reduction of the affected lung on CT images. In XFZYD group, the forced vital capacity (FVC) % and carbon monoxide diffusing capacity (DLCO) % were markedly improved after 3-month treatment. The contents of Lactate Dehydrogenase (LDH), Carcino Embryonic Antigen (CEA) and Neuron Specific Enolase (NSE) in serum were significantly decreasing in the two different treatment groups. Serum Total Cholesterol (TC) in the XFZYD group gradually decreased over time, reaching the lowest value at 24 months, while serum High- Density Lipoprotein Cholesterol (HDL-C) had the opposite trend. There was no difference of Low- Density Lipoprotein Cholesterol (LDL-C) and Triglyceride (TG) between the WLL and XFZYD group, and Alanine Amino Transferase (ALT) and Aspartate Aminotransferase (AST) of XFZYD group maintained at normal levels. Conclusion: XFZYD might be an effective and safe method for the treatment of aPAP, and it can ameliorate the symptom of aPAP and reduce the level of serum cholesterol.
Autoimmune pulmonary alveolar proteinosis; Whole lung lavage; Xuefu Zhuyu decoction; Therapy
Wang F, Xiao B, Huang X, Du J, Cheng W, Li J, et al. Xuefu Zhuyu Decoction: A Safety Tactics to Lessening Cholesterol and Improving the Treatment Effect of the Autoimmune Alveolar Proteinosis. Ann Clin Case Rep. 2021; 6: 2056..