金咳息胶囊联合班布特罗治疗老年慢性阻塞性肺疾病缓解期的临床研究

Clinical study on Jinkexi Capsules combined with bambuterol in treatment of remission stage of chronic obstruction pulmonary diseases in elderly patient

目的探讨金咳息胶囊联合盐酸班布特罗片治疗老年慢性阻塞性肺疾病缓解期的临床疗效。方法选取2015年1月—2017年5月在重庆市红十字会医院(江北区人民医院)呼吸内科接受治疗的老年慢性阻塞性肺疾病缓解期患者94例为研究对象,采用随机数字表法将所有患者分为对照组和治疗组,每组各47例。对照组于睡前口服盐酸班布特罗片,初始剂量为1片/次,1次/d,治疗1周后可增加到2片/次,1次/d。治疗组在对照组基础上口服金咳息胶囊,5粒/次,3次/d。两组患者均连续治疗12周。观察两组的临床疗效,比较两组的肺功能、生活质量和血清炎性因子。结果治疗后,对照组和治疗组的总有效率分别为72.34%、91.49%,两组比较差异有统计学意义(P<0.05)。治疗后,两组第1秒用力呼气容积(FEV1)、呼气峰流速值(PEF)、用力肺活量(FVC)均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组肺功能指标明显高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组活动受限评分、疾病影响评分、呼吸症状评分和总评分均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组生活质量评分明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清白细胞介素-8(IL-8)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平明显降低,α1-抗胰蛋白酶(α1-AT)水平明显增高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组血清炎性因子的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论金咳息胶囊联合盐酸班布特罗片治疗老年慢性阻塞性肺疾病缓解期具有较好的临床疗效,能明显改善患者的肺功能,提升生活质量,降低炎症反应,具有一定的临床推广应用价值。

Objective To investigate the clinical effects of Jinkexi Capsules combined with Bambuterol Hydrochloride Tablets in treatment of remission stage of chronic obstruction pulmonary diseases in elderly patient. Methods Elderly patients（94 cases） with remission stage of chronic obstruction pulmonary diseases in Department of Respiratory Medicine of Hospital of Chongqing Red Cross Society（Jiangbei District People＇s Hospital） from January 2015 to May 2017 were randomly divided into control and treatment groups, and each group had 47 cases. Patients in the control group were po administered with Bambuterol Hydrochloride Tablets before bedtime, starting dosage 1 tablet/time, once daily, and after treatment for 1 week, dosage changed to 2 tablets/time, once daily. Patients in the treatment group were po administered with Jinkexi Capsules on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated, and lung function, quality of life, and serum inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 72.34% and 91.49%, respectively, and there was difference between two groups（P〈0.05）. After treatment, FEV1, PEF, and FVC in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And lung function indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, activity limited scores, disease impact scores, respiratory symptom scores, and total scores in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the quality of life indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, the levels of IL-8, IL-6, and TNF-α in two groups were significantly decreased, but the levels of α1-AT in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And serum inflammatory factor indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Jinkexi Capsules combined with Bambuterol Hydrochloride Tablets has clinical curative effects in treatment of remission stage of chronic obstruction pulmonary diseases in elderly patient, can improve lung function, promote quality of life, reduce inflammatory reaction, which has a certain clinical application value.