复方丹参滴丸联合多索茶碱治疗慢性阻塞性肺疾病急性加重期的临床研究

Clinical study on Compound Danshen Dropping Pills combined with doxofylline in treatment of acute exacerbation of chronic obstructive pulmonary disease

目的探讨复方丹参滴丸联合多索茶碱片治疗慢性阻塞性肺疾病急性加重期的临床疗效。方法选取2016年1月—2017年6月南阳医学高等专科学校第一附属医院收治的100例慢性阻塞性肺疾病急性加重期患者作为研究对象,根据治疗方式不同将所有患者分为对照组(48例)和治疗组(52例)。对照组口服多索茶碱片,0.2 g/次,2次/d。治疗组在对照组的基础上口服复方丹参滴丸,10丸/次,3次/d。两组患者均连续治疗1个月。观察两组患者的临床疗效,同时比较治疗前后两组患者的QOL评分、肺功能指标、血气指标和炎性指标。结果治疗后,对照组和治疗组的总有效率分别为75.0%、90.4%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者自我照顾能力、行动能力、疼痛或不舒服、日常活动能力、焦虑或抑郁评分均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05)。治疗后,治疗组生活质量(QOL)评分显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者一秒用力呼气容积(FEV_1)、用力肺活量(FVC)和FEV_1/FVC均显著升高,同组治疗前后比较差异具有统计学意义(P<0.05)。治疗后,治疗组肺功能指标显著高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者氧分压(p O_2)显著升高,二氧化碳分压(p CO_2)显著降低,同组治疗前后比较差异具有统计学意义(P<0.05)。治疗后,治疗组血气指标显著优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者的血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05)。治疗后,治疗组炎性因子水平显著低于对照组,两组比较差异具有统计学意义(P<0.05)。结论复方丹参滴丸联合多索茶碱片治疗慢性阻塞性肺疾病急性加重期具有较好的临床疗效,可显著提高患者的生活质量,改善肺功能和炎性水平,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Compound Danshen Dropping Pills combined with Doxofylline Tablets in treatment of acute exacerbation of chronic obstructive pulmonary disease.Methods Patients（100 cases）with acute exacerbation of chronic obstructive pulmonary disease in the First Affiliated Hospital of Nanyang Medical College from January 2016 to June 2017were randomly divided into control（48 cases）and treatment（52 cases）groups according to different treatment methods.Patients in the control group were po administered with Doxofylline Tablets,0.2 g/time,twice daily.Patients in the treatment group were po administered with Compound Danshen Dropping Pills on the basis of the control group,10 pills/time,three times daily.Patients in two groups were treated for 1 month.After treatment,the clinical efficacy was evaluated,and the QOL scores,lung function indexes,blood gas indexes,and inflammatory indexes in two groups before and after treatment were compared.Results After treatment,the clinical efficacy in the control and treatment groups were 75.0%and 90.4%,respectively,and there were differences between two groups（P〈0.05）.After treatment,the self-care ability,mobility,pain or discomfort,daily activity ability,and anxiety or depression scores in two groups were significantly decreased,and the difference was statistically significant in the same group（P〈0.05）.After treatment,the QOL scores 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 FEV1,FVC,and FEV1/FVC in two groups were significantly increased,and the difference was statistically significant in the same group（P〈0.05）.After treatment,the 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,p O2 in two groups were significantly increased,but p CO2 in two groups were significantly decreased,and the difference was statistically significant in the same group（P〈0.05）.After treatment,the blood gas indexes in the treatment group were significantly better than those in the control group,with significant difference between two groups（P〈0.05）.After treatment,the levels of CRP,TNF-α,and IL-6 in two groups were significantly decreased,and the difference was statistically significant in the same group（P〈0.05）.After treatment,the inflammatory indexes in the treatment group were significantly lower than those in the control group,with significant difference between two groups（P〈0.05）.Conclusion Compound Danshen Dropping Pills combined with Doxofylline Tablets has clinical curative effect in treatment of acute exacerbation of chronic obstructive pulmonary disease,can significantly improve the quality of life of patients,improve lung function and inflammatory levels,which has a certain clinical application value.