中药雾化吸入治疗稳定期重度慢性阻塞性肺疾病临床对照研究

Effects of Chinese herb inhalation on the treatment of severe chronic obstructive pulmonary diseases in stable phase: a controlled clinical study

目的观察中药雾化吸入治疗稳定期重度慢性阻塞性肺疾病临床疗效。方法将131例稳定期重度慢性阻塞性肺疾病患者随机分为2组。对照组52例予西医常规治疗,治疗组79例在对照组治疗基础上加用补肺益肾方中药雾化吸入治疗。2组均1个月为1个疗程,2个疗程后统计疗效,并观察2组治疗前后肺功能、免疫功能、血清炎症因子的变化及临床疗效,以问卷调查方式统计患者生活质量。结果 2组临床疗效比较差异无统计学意义(P>0.05),疗效相当。2组治疗后第1 s用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC均改善(P<0.05),且治疗组改善优于对照组(P<0.05)。2组治疗后免疫功能指标免疫球蛋白(Ig)A、Ig G、Ig M水平均明显提高(P<0.05),治疗组治疗后提高优于对照组(P<0.05)。2组治疗后白细胞介素6(IL-6)、IL-8、肿瘤坏死因子(TNF-α)及超敏C反应蛋白(hs-CRP)水平均较本组治疗前降低(P<0.05),IL-10水平升高(P<0.05),且2组治疗后组间比较差异有统计意义(P<0.05)。治疗组治疗后SGRQ问卷呼吸症状、活动能力、疾病影响评分均降低(P<0.05),且治疗组各项评分均低于对照组(P<0.05)。结论中药雾化吸入可改善稳定期重度慢性阻塞性肺疾病患者肺功能,可有效控制气道炎症反应,改善免疫功能,提高患者生活质量。

Objective To observe the clinical effect of Chinese herb inhalation on the treatment of severe chronic obstructive pulmonary diseases（ COPD） in stable phase. Methods 131 severe COPD patients in stable phase were randomly divided into two groups. 52 patients in control group were treated by western routine treatment.79 patients in treatment group were treated by Chinese herb inhalation of tonifying lung and kidney formula on the basis of control group treatment. The course was one month in two groups. The therapeutic effect was evaluated after two courses,and the changes of pulmonary function,immunologic function and serum inflammatory factors before and after treatment were observed in two groups. The quality of life was evaluated by questionnaire survey. Results There was no statistical different on clinical effect between two groups（ P〉0. 05） that had equivalent effect. The forced expiratory volume 1 second（ FEV1）,forced expiratory volume（ FVC） and FEV1 / FVC ratio after treatment were improved（ P〈0. 05）,and the improvement in treatment group was superior to that in control group（ P〈0. 05）. The levels of Ig A,Ig G and Ig M after treatment were obviously increased in two groups（ P〈0. 05）,and the increase in treatment group was superior to that in control group（ P〈0. 05）. The levels of interleukin- 6（ IL- 6）,IL- 8,tumor necrosis factor α（ TNF- α） and hyper- sensitive C- reactive protein（ hs- CRP） after treatment were decreased in two groups（ P〈0. 05）,and the IL- 10 was increased（ P〈0. 05）,there was statistical different between two groups（ P〈0. 05）. The scores of respiratory symptom,mobility and sickness influence of St Georges respiratory questionnaire（ SGRQ） after treatment were decreased in treatment group（ P〈0. 05）,and the scores of all items in treatment group were lower than those in control group（ P〈0. 05）. Conclusion Chinese herb inhalation can improve the pulmonary function in sever COPD patients with stable phase, effectively control airway inflammatory response,improve the immune function and the life quality of the patients.