宽胸理肺汤合三子养亲汤对老年慢性阻塞性肺疾病急性加重期肺功能和血清炎症因子的影响

The Effects of Kuanxiong Lifei Decoction Combined with Sanzi Yangqin Decoction on Pulmonary Function and serum Inflammatory Cytokines in Elderly Patients with Acute Exacerbation of Chronic Pulmonary Disease

目的观察宽胸理肺汤合三子养亲汤治疗老年慢性阻塞性肺疾病急性加重期痰浊壅肺证的临床疗效及其对肺功能、血清炎症因子超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的影响。方法将患者按照随机数字表法分为宽胸理肺合三子养亲汤组39例,宽胸理肺汤组38例,三子养亲汤组40例。各组均在基础治疗的基础上给予相应中药治疗。7 d为1疗程,观察3组临床疗效及治疗前后肺功能、血清hs-CRP、IL-6和TNF-α改善情况。结果 1)宽胸理肺汤合三子养亲汤组疗效优于宽胸理肺汤组与三子养亲汤组(P<0.01或P<0.05),宽胸理肺汤组亦优于三子养亲汤组(P<0.01)。2)宽胸理肺合三子养亲汤组能有效改善患者第1秒用力呼气量(FEV1)后预计值的百分比与FEV1与用力肺活量(FVC)的比值,明显优于宽胸理肺汤组或三子养亲汤组(P<0.05或P<0.01),宽胸胸理肺汤组与三子养亲汤组比较差异无统计学意义(P>0.05)。3)治疗后宽胸理肺合三子养亲汤组能显著降低血清hs-CRP、IL-6和TNF-α水平,与宽胸理肺汤组或三子养亲汤组差异有统计学意义(P<0.05或P<0.01),宽胸理肺汤组和三子养亲汤组差异有统计学意义(P<0.01)。结论在西药基础上合用宽胸理肺汤与三子养亲汤,能有效抑制全身炎症反应,降低血清炎症因子水平,改善肺功能,从而改善慢性阻塞性肺疾病急性加重期痰浊壅肺证患者的临床症状体征。

Objective： To evaluate the clinical efficacy of Kuanxiong lifei Decoction combined with Sanzi yangqin Decoction （KXLFD-SZYQD） in treating elderly patients with acute exacerbation of chronic pulmonary disease（AECOPD） in turbid phlegm obstructing lung syndrome,and to observe its effects on the lung function and serum level of in inflammatory cytokines in such cases. Methods： Patients were randomly divided into three groups： 39 cases in KXLFD-SZYQD group,38 cases in Kuanxiong lifei Decoction （KXLFD） group,and 40 cases in Sanzi yangqin Decoction（SZYQD） group. The therapeutic course were 7 days. The clinical therapeutic effects, pulmonary function and serum hs-CRP,IL-6,TNF-ct results were observed before and after treatment period. Results： 1 ）The eltective rates were higher in KXLFD-SZYQD group, showing statistically significant differences than the other two groups （P〈O.05 ,P〈0.01 ）. There were also significant differences between KXLFD group and SZYQD group（P〈 0.01 ）. 2）FEVI% pred and FEV1/FVC% were better improved in KXLFD-SZYQD group than the other two groups after treatment （P〈 0.05 ,P〈 0.01 ）. There was no statistically significant difference between KXLFD group and SZYQD group （P〉 0.05）. （3）Serum hs-CRP, IL-6 ,TNF-a level statistically significantly de- creased than the other two groups after treatment （P 〈 0.05 ,P〈0.01 ）. There was statistically significant difference between KXLFD group and SZYQD group （P〈 0.01）. Conclusion： KXLFD-SZYQD combined with western medicine therapy shows a definitely clinical effectiveness in the treatment of elderly patients with AECOPD in turbid phlegm obstructing lung syndrome, and its mechanical function may be related to decreasing serum inflam- mation level and improving lung function in such cases.