To observe the effect of Yangyin Runfei Qingzao Decoction combined with pirfenidone on patients with idiopathic pulmonary interstitial fibrosis.

A total of 100 patients with idiopathic pulmonary fibrosis were selected from Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province. They were enrolled from September 2020 to September 2023. They were grouped by random number table method. 50 patients in pirfenidone group (1 case dropped, 49 cases eventually included) were given pirfenidone capsule treatment, and 50 patients in the combined Chinese medicine group (1 case dropped, 1 case excluded, 48 cases eventually included) were given pirfenidone capsule treatment. The pirfenidone group was treated with Yangyin Runfei Qingzao Decoction at the same time. After treatment, the clinical efficacy of the two groups was compared, the 6 min walking distance (6MWT) was measured before and after treatment, and the patients were evaluated with St. George's Respiratory Questionnaire (SGRQ) and idiopathic pulmonary fibrosis Patient Quality of Life Scale (ATAQ-IPF). The levels of total lung volume (TLC), arterial oxygen saturation (SaO₂), maximum mid-expiratory flow (MMF), and pulmonary carbon monoxide dispersion (DLco) were measured. Serum levels of IGFBP-5, CYFRA21-1, osteopontin, fibroblast growth factor (FGF -21), chemokine ligand 14 (CXCL14), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), CD4⁺and CD8⁺ were detected.

The total effective rate of Chinese medicine combined group was higher than that of pirfenidone group (P <0.05). The expression levels of 6MWT, SGRQ score, TLC, SaO₂, FGF -21, MMF, GSH-Px, DLCO and CD4⁺ in Chinese medicine combined group were higher than those in pirfenidone group (P < 0.05). ATAQ-IPF score, CD8⁺, CXCL14, MDA, IGFBP-5, Cyfra21-1 and osteopontin expression in the Chinese medicine group were lower than those in pirfenidone group (P < 0.05).

The combination therapy of Yangyin Runfei Qingzao Decoction and pirfenidone in patients with idiopathic pulmonary fibrosis can reduce inflammation and oxidative injury, improve immune function, alleviate pulmonary fibrosis, and enhance patients' quality of life, exercise tolerance, and clinical efficacy.