肺康方联合西药治疗慢性阻塞性肺疾病稳定期肺脾气虚证临床观察

Clinical Observation of Feikang Prescription Combined with Western Medicine for Syndrome of Qi Deficiency of Spleen and Lung in the Stable Stage of Chronic Obstructive Pulmonary Disease

目的:观察肺康方联合西药治疗慢性阻塞性肺疾病(COPD)稳定期肺脾气虚证的临床疗效。方法:将符合纳入标准的患者随机分为肺康组及对照组。肺康组予肺康方与噻托溴铵粉吸入剂治疗,对照组以噻托溴铵粉吸入剂治疗,2组疗程均为3月,观察2组中医证候积分、简化圣乔治呼吸问卷(SGRQ)、6 min步行距离(6MWD)及诱导痰中白细胞介素(IL)-1β、肿瘤坏死因子-α(TNF-α)、IL-6、IL-17表达的变化情况。结果:治疗后,肺康组各项症状积分与治疗前比较,差异均有统计学意义(P<0.05);对照组仅是咳嗽、咯痰、喘息积分与治疗前比较,差异有统计学意义(P<0.05),其余指标均无明显变化。除了咳嗽、喘息积分外,2组其余症状积分治疗前后差值比较,差异均有统计学意义(P<0.05)。2组简化SGRQ症状部分评分、活动部分评分、疾病影响部分评分及总分均较治疗前下降(P<0.05);肺康组症状部分、活动部分评分治疗前后差值均高于对照组(P<0.05)。肺康组6MWD较治疗前增加(P<0.05),肺康组治疗前后差值高于对照组(P<0.05)。2组诱导痰中IL-1β、TNF-α、IL-6及IL-17水平均较治疗前下降(P<0.05);肺康组TNF-α、IL-17水平治疗前后差值均高于对照组(P<0.05)。结论:肺康方联合西药治疗能明显改善COPD稳定期肺脾气虚证患者的临床症状,提高患者的生存质量,并降低患者诱导痰中炎症因子IL-1β、TNF-α、IL-6及IL-17的水平,考虑其发挥临床疗效的作用机制可能与减少气道炎症因子,从而减轻气道炎症反应有关。

Objective： To observe the clinical effect of Feikang prescription combined with western medicine for syndrome of qi deficiency of spleen and lung in the stable stage of Chronic Obstructive Pulnonary Disease（COPD）. Methods：Divided patients who met the inclusion criteria into the Feikang group and the control group randomly. The Feikang group was given Feikang prescription and tiotropium bromide inhalation powder for treatment, while the control group received tiotropium bromide inhalation powder for treatment. The treatment for both groups lasted for 3 months. Observed the changes of scores of Chinese medicine syndromes,simplified St George＇s respiratory questionnaire（SGRQ）, 6-min walk distance（6 MWD） and expression of interleukin（IL）-1β, tumour necrosis factor（TNF-α）,IL-6 and IL-17 in the induced sputum in both groups. Results：After treatment,comparing each symptom score in the Feikang group with that before treatment, there were significant differences being found（P〈0.05）; comparing the scores of cough,expectoration and wheezing in the control group with those before treatment, there was significant difference being found（P〈0.05）,and there was no significant differences being found in the other indexes. Except the scores of cough and wheezing, comparing the value differences of the other symptom scores in both groups before and after treatment,there were significant differences being found（P〈0.05）. Simplified SGRQ symptom scores,activity scores,scores of disease influence and the total scores in both groups were lower than those before treatment（P〈0.05）;the value differences of SGRQ symptom scores and activity scores in the Feikang group before and after treatment were all higher than those in the control group（P〈0.05）. 6 MWD in the Feikang group was increased when comparing with that before treatment（P〈0.05）, and the value difference in the Feikang group before and after treatment was higher than that in the control group（P〈0.05）. the levels of IL-1β,TNF-α,IL-6 and IL-17 in the induced sputum of both groups were lower than those before treatment（P〈0.05）; the value differences of levels of TNF-α and IL-17 in the Feikang group before and aftertreatment were both higher than those in the control group（P〈0.05）. Conclusion：Feikang prescription combined with western medicine can significantly improve the clinical symptoms of patients with syndrome of qi deficiency of spleen and lung in the stable stage of COPD,enhance the quality of life,and decrease the levels of inflammatory factors including IL-1β,TNF-α,IL-6 and IL-17 in the induced sputum of patients. It is considered that the functional mechanism of its clinical effect may be related to reducing inflammatory factors in airway so as to relieve the inflammatory reactions in airway.