清肺补肾化瘀法联合西医对COPD患者肺功能及锁链素水平的影响

Effect of Qingfei Bushen Huayu method combined with western medicine on lung function and desmosine level in patients with COPD

目的:探讨清肺补肾化瘀法联合西医治疗对慢性阻塞性肺疾病(COPD)患者肺功能及锁链素水平的影响。方法:选取94例急性加重期的痰热肾虚证COPD患者为研究对象,随机数字表法分为联合组和对照组各47例。对照组予以西药疗法,联合组予以西药联合自拟清肺补肾化瘀方,均持续治疗14d。对比两组受试者治疗前后肺功能指标(FEV1、FEV1/FVC)、血气指标PaCO2、PaO2、症状积分及血清锁链素水平变化情况,记录其临床疗效差异。结果:治疗2周后,联合组治疗总有效率显著高于对照组(P<0.05)。两组FEV1/FVC、FEV1等肺功能指标及PaO2水平均较治疗前显著升高,且联合组大于对照组(P<0.05);症状评分、血清锁链素水平及PaCO2水平则较治疗前显著降低,且联合组小于对照组(P<0.05)。结论:将西药联合清肺补肾化瘀汤口服方案应用于急性加重期的痰热肾虚证COPD患者临床治疗中,对缓解其相关症状、促进肺功能恢复、调节锁链素及血气指标水平等具有积极影响。

Objective：To explore the effect of Qingfei Bushen Huayu method combined with western medicine on lung function and desmosine level in patients with COPD.Methods：Ninety-four patients with phlegm-heat kidney-deficiency of COPD in exacerbation period were randomized into combined group and control group.The control group was treated with western medicine while the combined group was treated with western medicine combined with self-designed Qingfei Bushen Huayu Decoction.Both groups were treated for 14 days.Lung function indexes（FEV1,FEV1/FVC,gas parameters PaCO2,PaO2）,symptom scores and changes of serum desmosine levels were compared between the two groups before and after the treatment.The differences in clinical efficacy were recorded.Results：After 2weeks of treatment,the total effective rate of combined group was significantly higher than control group（P〈0.05）.FEV1/FVC,FEV1 and other lung function indexes,PaO2 levels in both groups were significantly higher than those before treatment,and the indexes in combined group were higher than control group（P〈0.05）while symptom scores,serum desmosine levels and PaCO2 levels were significantly lower,and combined group lower than the control group（P〈0.05）.Conclusion：Application of Qingfei Bushen Huayu method in clinical treatment of patients with phlegm-heat kidney-deficiency of COPD in exacerbation period has positive effect on alleviating related symptoms,promoting lung function recovery,regulating desmosine and blood-gas parameters.