健脾化痰方治疗肺脾两虚型慢性阻塞性肺疾病临床疗效及对气道炎症影响评价

Clinicaleffect of invigorating spleen and eliminating phlegm therapy on chronic obstructive pulmonary disease with deficiency of lung and spleen and the evaluation its influence on airway inflammation

目的探讨健脾化痰方治疗肺脾两虚型慢性阻塞性肺疾病(COPD)稳定期的临床疗效和对患者气道炎症的影响。方法选取肺脾两虚型COPD稳定期轻中度患者60例,随机分为观察组和对照组,各30例。对照组给予信必可都保治疗,观察组给予健脾化痰方治疗,疗程均为4周。观察2组治疗前后BODE指数(BMI、肺功能、MMRC呼吸困难评分、6MWT)评分、COPD生活质量圣乔治呼吸系统问卷调查(SGRQ)评分、诱导痰中炎症细胞因子(IL-6、IL-8、TNF-α)变化和临床疗效。结果观察组总有效率81.8%,对照组为62.5%,差异有统计学意义(P<0.05)。治疗后2组的BODE积分和SGRQ问卷评分均有降低,观察组低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后痰上清液IL-6、IL-8、TNF-α水平均低于治疗前,差异有统计学意义(P<0.05);对照组治疗后痰上清液IL-8水平低于治疗前,差异有统计学意义(P<0.05);治疗后2组间IL-6、IL-8、TNF-α水平差异均有统计学意义(P<0.05)。结论健脾化痰方治疗肺脾两虚型COPD临床疗效较好,对气道炎症具有一定的抑制作用。

Objective To study the clinical effect of invigorating spleen and eliminating phlegm therapy on the stable stage of chronic obstructive pulmonary disease （COPD） with deficiency of both lung and spleen and its influence on the airway inflammation. Methods 60 patients with COPD of deficiency of lung and spleen in the stable condition were selected and randomized into the observation group and the control group of 30 each. The control group received inhalant of Budesonide and Formoterol. The observation group used invigorating spleen and resolving phlegm formula. Both groups were treated for 4 weeks. The changes of BODE （ BMI, lung function, MMRC, 6MWT ）, SGRQ, sputum induction of inflammatory cytokines （IL-6, IL-8, TNF-α） of COPD of two group before and after the treatment and the clinical effect were observed. Results The total effective rate in the observation group was 81.8%, which of the control group was 62. 5%, the difference was statistically significant （P 〈 0. 05 ） . BODE scores and SGRQ scores of two groups after the treatment were lower than that before the treatment, and the difference was statistically significant （ P 〈 0. 05 ） . The sputum induction of inflammatory cytokines （IL-6, TNF-α ） of the observation group after the treatment were lower than that before the treatment （ P 〈 0. 05 ）, sputum supernatant on IL-8 levels of the control group are lower than that before the treatment, and the difference was statistically significant （ P 〈 0. 05 ） ; the difference of levels of IL-6, IL-8 and TNF-αbetween the two groups after the treatment had statistical significance （ P 〈 0. 05 ） . Conclusion Invigorating spleen and eliminating phlegm recipe has better clinical effect in the treatment of lung and spleen deficiency of COPD, and has a certain inhibitory effect on airway inflammation.