胸腺肽联合活血化瘀方治疗老年AECOPD的效果研究

Therapeutic effects of thymosin combined with Huoxuehuayu prescription in adjuvant treatment of AECOPD in the elderly

目的观察胸腺肽联合活血化瘀方辅助治疗急性加重期老年慢性阻塞性肺疾病(AECOPD)的效果及安全性。方法选取2016年2月至2017年1月收治的240例AECOPD患者,随机分为观察组130例和对照组110例。对照组予常规治疗,包括吸氧、扩张血管、祛痰及抗感染等治疗,疗程10 d;观察组在对照组治疗基础上,加用胸腺肽联合活血化瘀方治疗,疗程10 d。观察比较2组治疗效果,治疗前后第1秒用力呼气容积(FEVl)与第1秒用力呼气容积占预计值的百分比(FEVl%),CD_3^+、CD_4^+、CD_8^+及CD_4^+/CD_8^+,用药安全性及住院时间。结果 1个疗程治疗后,观察组患者治疗总有效率为93.08%,显著高于对照组的78.18%,差异有统计学意义(P<0.05)。2组患者FEVl和FEVl%均明显高于治疗前,差异有统计学意义(P<0.05);且观察组治疗后FEVl和FEVl%均明显高于对照组,差异有统计学意义(P<0.05)。与治疗前比较,治疗后观察组CD_3^+、CD_4^+、CD_4^+/CD_8^+显著升高,CD_8^+显著降低,差异均有统计学意义(P<0.05);CD_4^+、CD_4^+/CD_8^+对照组显著升高(P<0.05)。治疗后,观察组CD_4^+明显高于对照组,CD_8^+及CD_4^+/CD_8^+明显低于对照组,差异有统计学意义(P<0.05)。2组均无明显不良反应发生,过敏、皮疹、恶心呕吐、肝功能损害发生率比较差异无统计学意义(P>0.05)。观察组患者住院时间[(12.1±2.3)d]明显短于对照组的[(18.3±3.5)d],差异有统计学意义(P<0.05)。结论胸腺肽联合活血化瘀方辅治可提高老年AECOPD患者常规治疗的效果,改善患者肺功能和免疫功能,并可缩短治疗时间,且无明显药物不良反应,值得临床推广应用。

Objective To observe the therapeutic effects and safety of thymosin combined with thymosin combined with Huoxuehuayu prescription in adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease（ AECOPD） in elderly patients. Methods A total of 240 elderly patients with AECOPD who were admitted and treated in our hospital from February 2016 to January 2017 were randomly divided into observation group（ n = 130） and control group（ n =110）. The patients in control group were treated by conventional therapy,which included oxygen absorption,dilation of blood vessels,expectoration and anti-infection treatment,however,the patients in observation group,on the basis of control group,were treated by thymosin combined with Huoxuehuayu prescription,with a treatment course of 10 days for both groups. The therapeutic effects,forced expiratory volume in 1 second（ FEV1） before and after the treatment,the percentage of forced expiratory volume in 1 second of expected value（ FEV1%）,CD3~＋,CD4~＋,CD8~＋,the ratio of CD4~＋ to CD8~＋,drug safety and the length of staying in hospital were observed and compared between the two groups. Results After 1 treatment course,the total effective rate in observation group was 93. 08%,which was significantly higher than that（ 78. 18%） in control group（ P〈0. 05）. After treatment the levels of FEV1 and FEV1% in both groups were significantly higher than those before treatment（ P〈0. 05）,moreover,the levels of FEV1 and FEV1% in observation group were significantly higher than those in control group（ P〈0. 05）. After treatment,the levels of CD3~＋,CD4~＋,CD4~＋/CD8~＋ in observation group were significantly increased,as compared with those before treatment,however the levels of CD8~＋ in observation group were significantly decreased（ P〈0. 05）. After treatment the levels of CD4~＋,CD4~＋/CD8~＋ in control group were significantly increased,as compared with those before treatment（ P〈0. 05）,moreover the levels of CD4~＋ in observation group were significantly higher than those in control group,however the levels of CD8~＋ and CD4~＋/CD8~＋ were significantly lower than those in control group（ P〈0. 05）. No obvious adverse reaction were observed in both groups,and there was no significant difference in the incidence rate of adverse reactions including allergies,rashes,nausea,vomiting and the damage of liver function between two groups（ P〈0. 05）. The length of staying in hospital in observation group [（ 12. 1 ± 2. 3） d]was significantly shorter than that in control group[（ 18. 3 ± 3. 5） d,（ P〈0. 05） ]. Conclusion Thymosin combined with Huoxuehuayu prescription can improve the therapeutic effects on AECOPD in elderly patients,improve the lung function and immune function of patients,shorten the time of treatment,without obvious drug adverse reactions,therefor,which is worthy of clinical application and promotion.