六君子汤加减治疗慢性阻塞性肺疾病的疗效观察

Clinical efficacy of additive LiuJunZi decoction in treatment of chronic obstructive pneumonia

目的探讨六君子汤加减治疗肺脾两虚型慢性阻塞性肺疾病(chronic obstructive pneumonia,COPD)稳定期的疗效。方法选择杭州市余杭区第一人民医院门诊符合肺脾两虚型慢阻肺稳定期患者58例,用随机数字表法随机分为治疗组和对照组,每组29例,2组均给予沙美特罗替卡松粉吸入剂吸入,在此基础上,治疗组给予六君子汤加减口服,疗程为3个月,观察患者临床体征和症状改善情况,比较肺功能、痰液指标以及1年内急性发作比例。结果 2组患者经不同治疗方案后,治疗组总有效率为93.1%,明显优于对照组的总有效率65.5%(P<0.05)。2组治疗后FEV1和FEV1/FVC均有提高(P<0.05),治疗组上述肺功能指标提高明显优于对照组(P<0.05)。2组HDACs活性、TNF-α及IL-8水平均有改善(P<0.05),治疗组明显优于对照组(P<0.05)。治疗组急性发作2例(6.9%),对照组急性发作7例(24.1%),差异无统计学意义。结论六君子汤加减治疗肺脾两虚型慢阻肺稳定期临床疗效确切,可明显改善患者临床症状以及实验室指标,控制病情发展,提高患者生存质量。

Objective To investigate clinical efficacy of additive LiuJunZi decoction in treatment of patients with chronic obstructive pneumonia （ COPD） of both lung and spleen deficiency in stable phase.Methods A total of 58 patients with deficiency of both lung and spleen type stable COPD patients were randomly divided into treatment group and control group by a random number table, 29 cases in each group, patients in two groups were treated with salmeterol and fluticasone propionate powder for inhalation.On this basis, the treatment group were given additive Liujunzi Decoction, orally, with 3 months treatment.The clinical signs and symptoms of patients, pulmonary function, index of sputumand acute attack proportion in a year were observed and compared.Results After different treatment, total efficiency was 93.1% in treatment group, which was obviously higher than 65.5%in control group （P〈0.05）.After treatment, the values of FEV1 and FEV1/FVC improved compared with before treatment, and the above indexes of treatment group significantly improved compared with control group （P〈0.05）.The HDACs activety, levels of TNF-αand IL-8 mproved compared with before treatment, and the above indexes of treatment group significantly improved compared with control group （P〈0.05）.The acute attack was two cases in treatment group（6.9%）, seven cases in control group（24.1%）, but the difference had no statistically significant.Conclusion The additive Liujunzi decoction in the treatment of both lung and spleen deficiency type chronic obstructive pulmonary disease （ COPD） in stable phase has exact clinical curative effect, can significantly improve clinical symptoms and laboratory indexes, control the progression of the disease, and improve life quality of the patients.