Clinical efficacy and quality of life effect of acetylcysteine plus pirfenidone in patients with pulmonary fibrosis

Objective: To study the clinical efficacy of acetylcysteine combined with pirfenidone in patients with pul-monary fibrosis (PF). Methods: A total of 114 PF patients admitted from January 2018 to January 2019 were retro-spectively analyzed. Among them, 64 patients treated with acetylcysteine combined with pirfenidone were classi-fied into a research group, and the other 50 treated with acetylcysteine combined with budesonide were assigned into a control group. The clinical efficacy and total effectiveness rate of the two groups were compared after 6 months of therapy. The quality of life (QoL) in the two groups before and after treatment was evaluatedusing Asthma Therapy Assessment Questionnaire for idiopathic pulmonary fibrosis patients (ATAQ-IPF). The 2-year survival of the two groups was compared. Additionally, the incidence of adverse reactions was compared between the two groups. The changes in forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), inflammatory factors, and PF markers were compared between the two groups before and after therapy. Results: There were no significant dif-ferences in clinical efficacy or total effectiveness rate (all P > 0.05), serum IL-4, INF gamma or IL-6 expression (all P > 0.05), as well as FEV1 and FVC levels (all P > 0.05) after therapy between two groups. After therapy, the research group showed significantly lower PCIII and HA levels, lower ATAQ-IPF scores, and lower total incidence of adverse reactions than the control group (all P < 0.05). In addition, a higher 2-year survival rate was observed in the research group than in the control group (P=0.025). Conclusion: Acetylcysteine combined with pirfenidone can reduce adverse reactions and improve the QoL and survival time of patients.