快速进展型特发性炎症性肌病继发间质性肺疾病的中西医临床特征分析

张宗学; 王玉光; 郭丽娅; 刘锡曈; 王亚南; 孟广松

doi:10.16025/j.1674-1307.2025.08.004

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快速进展型特发性炎症性肌病继发间质性肺疾病的中西医临床特征分析

专题——间质性肺疾病的中西医结合诊疗 | 更新时间：2025-10-10

- 快速进展型特发性炎症性肌病继发间质性肺疾病的中西医临床特征分析
- TCM and Western medicine clinical characteristics of rapidly progressing idiopathic inflammatory myopathy with interstitial lung disease
- 北京中医药 2025年44卷第8期页码：967-970
- 作者机构：
  
  首都医科大学附属北京中医医院呼吸科，北京 100010
- 作者简介：
  
  张宗学，男，43岁，博士，副主任医师。研究方向：间质性肺疾病、肺部感染、呼吸衰竭等呼吸系统疾病的中西医诊疗。
  孟广松，E-mail：zhongyi360@163.com
- 基金信息：
  
  国家中医药管理局科技司中医药循证能力建设项目;高层次公共卫生技术人才培养建设项目计划（学科带头人-01-16）
- DOI：10.16025/j.1674-1307.2025.08.004
  中图分类号：
- 收稿日期：2025-04-15，
  
  纸质出版日期：2025-08-25
- 稿件说明：
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张宗学，王玉光，郭丽娅，等.快速进展型特发性炎症性肌病继发间质性肺疾病的中西医临床特征分析［J］.北京中医药，2025，44（8）：967-970.

ZHANG Zongzue,WANG Yuguang,GUO Liya,et al.TCM and Western medicine clinical characteristics of rapidly progressing idiopathic inflammatory myopathy with interstitial lung disease[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(08):967-970.
张宗学，王玉光，郭丽娅，等.快速进展型特发性炎症性肌病继发间质性肺疾病的中西医临床特征分析［J］.北京中医药，2025，44（8）：967-970. DOI： 10.16025/j.1674-1307.2025.08.004.

ZHANG Zongzue,WANG Yuguang,GUO Liya,et al.TCM and Western medicine clinical characteristics of rapidly progressing idiopathic inflammatory myopathy with interstitial lung disease[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(08):967-970. DOI： 10.16025/j.1674-1307.2025.08.004.

摘要

目的

分析快速进展型特发性炎症性肌病继发间质性肺疾病（idiopathic inflammatory myopathy associated interstitial lung disease，IIM-ILD）的中西医临床特征。

方法

本研究采用回顾性病例对照研究，选取首都医科大学附属北京中医医院2016年1月―2023年1月诊断为快速进展型IIM-ILD患者36例，收集和分析包括人口学信息、病程、临床表现或并发症、实验室检查结果、影像学资料、中医证候特点及短期预后等数据。选择稳定期IIM-ILD患者作为对照组，根据年龄和性别按1∶2的比例匹配病例资料。归纳总结快速进展型IIM-ILD患者的中医证候特点，评估短期预后不良的危险因素。

结果

快速进展型IIM-ILD患者的中医辨证分型实证以湿热蕴肺，湿热内蕴、扰及营血及肺气痹阻为主，虚证表现中喘脱占比最高。抗MDA5抗体阳性（

=0.008）是快速进展IIM-ILD患者短期预后不良的危险因素。

结论

抗MDA5抗体阳性是快速进展型IIM-ILD患者短期预后不良的危险因素，与较高死亡率相关。

Abstract

Objective

To analyze the clinical characteristics of rapidly progressing idiopathic inflammatory myopathy associated with interstitial lung disease （IIM-ILD） from both traditional Chinese medicine （TCM） and Western medicine perspectives.

Methods

This retrospective case-control study included 36 patients diagnosed with rapidly progressing IIM-ILD at Beijing Hospital of Traditional Chinese Medicine， Capital Medical University， from January 2016 to January 2023. Data collected and analyzed included demographic information， disease course， clinical manifestations or complications， laboratory test results， imaging findings， TCM syndrome characteristics， and short-term prognosis. Stable IIM-ILD patients were selected as the control group， matched by age and sex in a 1：2 ratio. The TCM syndrome characteristics of rapidly progressing IIM-ILD were summarized， and risk factors for poor short-term prognosis were evaluated.

Results

In TCM syndrome differentiation， the excess syndromes of rapidly progressing IIM-ILD were mainly characterized by dampness-heat accumulation in the lungs， dampness-heat retention， disturbance of nutrient blood， and obstruction of lung

. Among deficiency syndromes， asthma collapse accounted for the highest proportion. Positive anti-MDA5 antibody （

=0.008） was identified as a risk factor for poor short-term prognosis in patients with rapidly progressing IIM-ILD.

Conclusion

Rapidly progressing IIM-ILD is characterized by a lower oxygenation index and higher ferritin levels. Positive anti-MDA5 antibody is a risk factor for poor short-term prognosis. In TCM syndrome differentiation of rapidly progressing IIM-ILD， dampness-heat accumulation in the lungs is the predominant excess syndrome， while asthma collapse is the most frequent deficiency syndrome.

关键词

Keywords

references

DALAKAS MC . Pathogenesis and therapies of immune-mediated myopathies [J ] . Autoimmun Rev , 2012 , 11 ( 3 ): 203 - 206 .

SCHMIDT J . Current classification and management of inflammatory myopathies [J ] . J Neuromuscul Dis , 2018 , 5 ( 2 ): 109 - 129 .

BARBA T , FORT R , COTTIN V , et al . Treatment of idiopathic inflammatory myositis associated interstitial lung disease: a systematic review and meta-analysis [J ] . Autoimmun Rev , 2019 , 18 ( 2 ): 113 - 122 .

FATHI M , DASTMALCHI M , RASMUSSEN E , et al . Interstitial lung disease,a common manifestation of newly diagnosed polymyositis and dermatomyositis [J ] . Ann Rheum Dis , 2004 , 63 ( 3 ): 297 - 301 .

COTTIN V , THIVOLET-BÉJUI F , REYNAUD-GAUBERT M , et al . Interstitial lung disease in amyopathic dermatomyositis,dermatomyositis and polymyositis [J ] . Eur Respir J , 2003 , 22 ( 2 ): 245 - 250 .

KOGA T , FUJIKAWA K , HORAI Y , et al . The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM [J ] . Rheumatology(Oxford) , 2012 , 51 ( 7 ): 1278 - 1284 .

DALAKAS MC . Autoimmune muscular pathologies [J ] . Neurol Sci , 2005 （ S1 ）: 7 - 8 .

GONO T , KAWAGUCHI Y , SATOH T , et al . Clinical manifestation and prognostic factor in anti-melanoma differentiation-associated gene 5 antibody-associated interstitial lung disease as a complication of dermatomyositis [J ] . Rheumatology (Oxford) , 2010 , 49 ( 9 ): 1713 - 1719 .

程绍恩 . 中医证候诊断治疗学 [M ] . 北京 : 北京科学技术出版社 , 1993 .

KAWASUMI H , GONO T , KAWAGUCHI Y , et al . IL-6,IL-8,and IL-10 are associated with hyperferritinemia in rapidly progressive interstitial lung disease with polymyositis/dermatomyositis [J ] . Biomed Res Int , 2014 : 815245 .

SCHNABEL A . Interstitial lung disease in polymyositis/dermatomyositis [J ] . Z Rheumatol , 2013 , 72 ( 3 ): 220 - 226 .

SATO S , KUWANA M , FUJITA T , et al . Anti-CADM-140/MDA5 autoantibody titer correlates with disease activity and predicts disease outcome in patients with dermatomyositis and rapidly progressive interstitial lung disease [J ] . Mod Rheumatol , 2013 , 23 ( 3 ): 496 - 502 .

郭丽娅，焦以庆，王亚南，等 . 王玉光从肺痹、肺痿、喘脱三期论治间质性肺疾病经验 [J ] . 北京中医药， 2023 , 42 ( 12 ): 1313 - 1316 ．

李川，高扬 . 李国勤辨治特发性肺纤维化经验 [J ] . 北京中医药， 2022 ， 41 ( 2 )： 145 - 149 ．

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