三子养亲汤加味对慢性阻塞性肺疾病稳定期患者疗效、活动耐力及气道黏液高分泌的影响

The Effect of Modified Sanzi Yangqin Tang on Efficacy,Activity Tolerance and Airway Mucus Hypersecretion in Patients with Chronic Obstructive Pulmonary Disease at Stable Stage

目的:观察三子养亲汤加味对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者的临床疗效、活动耐力及气道黏液高分泌的影响。方法:90例COPD稳定期患者随机分为对照组和观察组各45例。对照组患者给予常规西医治疗,包括氨茶碱缓释片和沙丁胺醇气雾剂等;观察组在对照组治疗基础上联用三子养亲汤加味治疗,2周为1个疗程,连续治疗3个疗程。治疗后,比较两组患者活动耐力、中医证候评分、肺功能[用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(the first second force expiratory volume,FEV1)和FEV1%]、血清炎性因子[白细胞介素-8(interleukin-8,IL-8)、IL-10和中性粒细胞弹性蛋白酶(neutrophil elastase,NE)]的含量,并评价疗效。结果:治疗后,两组患者FEV1和FEV1%均升高,其中观察组FEV1高于对照组,差异有统计学意义(P<0.05);治疗后,两组患者6分钟步行距离(6-minutes walk desease,6-MWD)均增加,观察组6-MWD高于对照组(P<0.05);治疗后,两组患者IL-8和IL-10均下降,且观察组低于对照组(P<0.05);观察组NE明显下降,且低于对照组(P<0.05);治疗后,两组患者中医证候评分均降低,且观察组评分低于对照组(P<0.05);观察组有效率为93.33%,对照组有效率为77.78%,两组有效率比较,差异有统计学意义(P<0.05)。结论:三子养亲汤加味治疗稳定期COPD疗效显著,可以明显提高患者活动耐力,改善患者肺功能,并减少气道黏液的分泌,其机制可能是抑制IL-8、IL-10和NE,从而减少气道炎症。

Objective： To observe the effect of modified Sanzi Yangqin Tang on efficacy,activity tolerance and airway mucus hypersecretion in patients with chronic obstructive pulmonary disease（ COPD） at stable stage. Methods： 90 patients with stable COPD were randomly divided into the control group（ n = 45） and the observation group（ n = 45）. Patients in control group were given routine western medicine,including aminophylline sustained-release tablets and salbutamol aerosol. Patients in the observation group were treated with modified Sanzi Yangqin Tang on the basis of control group,2 weeks as a course of treatment,and 3 consecutive courses of treatment. After treatment,compared the activity endurance,TCM syndrome score and pulmonary function including forced vital capacity（ FVC）,and the first second force expiratory volume（ FEV1）,and FEV1%,and serum inflammatory factor content including interleukin-8（ IL-8）,IL-10 and neutrophil elastase（ NE） between the two groups,and evaluated the efficacy.Results： After treatment,the two groups of patients with FEV1 and FEV1% were elevated,in which FEV1 in the observation group was higher than the control group（ P〈 0. 05）; 6-minute walking distance（ 6-MWD） increased in both groups,and 6-MWD in the observation group was higher than that in the control group（ P 〈0. 05）. After treatment,IL-8 and IL-10 decreased in the two groups,and the observation group was lower than the control group（ P 〈0. 05）; NE in the observation group was significantly lower than that in the control group（ P 〈0. 05）. After treatment,the scores of TCM syndromes decreased in both groups,and the score of observation group was lower than that of the control group（ P 〈0. 05）. The effective rate was 93. 33% in the observation group and 77. 78% in the control group,and the difference was statistically significant（ P 〈0. 05）. Conclusion： Sanzi Yangqin Tang has a remarkable curative effect on COPD patients,which can obviously improve the patient＇s activity endurance,improve the pulmonary function,and reduce the secretion of airway mucus. The mechanism may be to reduce airway inflammation by inhibiting IL-8,IL-10 and NE.