补肾益肺化纤方治疗慢性阻塞性肺疾病稳定期合并肺纤维化疗效及对患者肺功能及生活质量的影响

Clinical Efficacy of Bushen Yifei Huaxian Decoction on Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Fibrosis and Its Effect on Lung Function,Inflammatory Mediator and Quality of Life

目的：探讨补肾益肺化纤方对慢性阻塞性肺疾病稳定期（chronic obstructive pulmonary disease,COPD）合并肺纤维化（pulmonary fibrosis,PF）患者肺功能及生活质量的影响。方法：2014年5月至2016年7月河北省中医院共收治146例COPD-PF患者,以该批患者为研究对象,随机数字表法分为治疗组与对照组,各73例。对照组患者给予沙美特罗替卡松粉吸入剂,治疗组在此基础上加用补肾益肺化纤方,连续治疗3个月后,比较对两组患者的临床疗效,肺功能,肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）,白细胞介素-6（interleukin-6,IL-6）水平及生活质量。结果：治疗组患者总有效率为93.15%,对照组为82.19%,治疗组优于对照组（χ^2=16.412,P〈0.05）;与本组治疗前比较,治疗后两组COPD-PF患者血清中TNF-α,IL-6水平明显降低;治疗组明显低于对照组（P〈0.05）;经治疗,两组COPD-PF患者第1秒用力呼气容积（forced expiratory volume in one second,FEV1）,用力肺活量（forced vital capacity,FVC）水平均明显升高,治疗组明显高于对照组（P〈0.05）;经治疗,治疗组患者在症状、活动能力及疾病影响、总积分均明显优于对照组（P〈0.05）。结论：补肾益肺化纤方治疗COPD-PF疗效显著,可以明显降低COPD-PF患者血清TNF-α,IL-6的水平,改善患者肺功能及生活质量。

Objective： To study the clinical efficacy of Bushen Yifei Huaxian decoction on lung function,inflammatory mediator and quality of life in patients with chronic obstructive pulmonary disease(COPD）complicated with pulmonary fibrosis(PF）. Method： The study selected 146 cases of patients with COPD-PF treated in Hebei Province Hospital of Traditional Chinese Medicine from May 2014 to July 2016. They were divided into two groups according to the random number table,with 73 cases in each group. Patients in the control group were treated with Salmeterol assigned powder inhaler,while the clinical group was also given Bushen Yifei Huaxian decoction in addition to the therapy of control group. Then the efficacy,lung function,inflammatory mediator and quality of life were compared after 3 months of treatment. Result： Compared with 82. 19% in control group,the total effective rate of the clinical group was 93. 15%. There was a significant increase(χ^2= 16. 412,P〈0. 05）.Compared with before treatment,tumor necrosis factor-α(TNF-α） and interleukin-6(IL-6） of two groups decreased after treatment(P〈0. 05）. Compared with control group,the values of TNF-α and IL-6 in patients of the clinical group were lower after treatment(P〈0. 05）. Compared with before treatment,forced expiratory volume in one second(FEV1） and forced vital capacity(FVC） of the two groups after treatment increased(P〈0. 05）. Compared with control group,the values of FEV1 and FVC in patients of the clinical group were higher after treatment(P〈0. 05）. After treatment,scores of symptom,activity ability,disease influence and total scores in treatment group were lower than those in control group. There was a significant increase(P〈0. 05）.Conclusion： Bushen Yifei Huaxian decoction is very effective in treating COPD-PF. It can significantly lower inflammatory mediators,and improve lung function and quality of life.