化痰益肺汤联合氨溴索、沙美特罗丙酸氟替卡松治疗老年慢性阻塞性肺疾病的临床观察

Clinical observation of Huatanyifei decoction combined with ambroxol, salmeterol/fluticasone propionate in treatment of elderly COPD

目的探讨化痰益肺汤联合氨溴索、沙美特罗丙酸氟替卡松对老年慢性阻塞性肺疾病的相关实验室指标的影响,进一步评价中药联合常规西医对症治疗的临床疗效性及安全性。方法选取就诊肺病科的120例诊断为慢性阻塞性肺疾病的老年患者,采用尊重患者治疗意愿的方式分为对照组和研究组,每组60例。对照组给予患者吸氧、纠正酸碱失衡、抗感染、生活方式干预指导的相关对症治疗的基础上,予患者盐酸氨溴索雾化吸入30 min,2次/d,联合沙美特罗丙酸氟替卡松吸入,其中沙美特罗50μg、丙酸氟替卡松500μg,2次/d;研究组在对照组的基础上给予化痰益肺汤联合治疗。2组患者均治疗3个月,观察2组患者的炎性反应因子[白介素-6(IL-6)、白介素^(-1)7(IL^(-1)7)、白介素-23(IL-23)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)]、血气分析结果[p H值、二氧化碳分压(Pa CO_2)、氧分压(Pa O_2)、血氧饱和度(Sa O_2)]、临床疗效、生活质量改善情况以及不良反应发生率的相关情况。结果治疗后2组患者的IL-6、IL^(-1)7、IL-23、TNF-α、CRP、p H值、Pa CO_2、Pa O_2、Sa O_2以及生活质量均较治疗前得到明显改善(P <0. 01);治疗后2组比较,研究组上述指标以及临床疗效改善情况和不良反应发生率均优于对照组(P <0. 05或<0. 01)。结论化痰益肺汤联合氨溴索、沙美特罗丙酸氟替卡松对老年性慢性阻塞性肺疾病患者疾病发展中炎性因子、血气分析结果可起到很好的调控作用,可有效改善患者的生活质量以及临床相关性病理表现,且保证治疗的相关安全性,为个人、家庭及社会的和谐稳步发展提供了相关保障,值得在临床中进一步推广应用。

Objective To investigate the effects of Huatanyifei decoction combined ambroxol,salmeterol/fluticasone propionate on the related laboratory indexes in elderly patients with chronic obstructive pulmonary disease(COPD),and to evaluate the clinical effects and safety of traditional Chinese medicine(TCM)combined conventional western medicine symptomatic treatment.Methods A total of 120 elderly patients with COPD who were treated in our hospital were divided into control group(n=60)and research group(n=60),according to the treatment wills of patients.The patients in control group were treated by oxygen uptaken,correcting acid-base imbalance,anti infection,lifestyle intervention guidance and other related symptomatic treatment.On the basis of that,the patients in control group were given aerosol inhalation of ambroxol hydrochloride 30 min and salmeterol/fluticasone propionate twice a day,the dosage of those were salmeterol 50μg and fluticasone propionate 500μg one time,and twice a day.Moreover on the basis of that in control group,the patients in research group were combined treated with the reducing phlegm and profiting lung soup,with a treatment course of 3 months for both groups.The indexes including inflammatory reaction factors[interleukin-6(IL-6),interleukin-17(IL-17),interleukin-23(IL-23),tumor necrosis factor-α(TNF-α),C reactive protein(CRP)],blood gas analysis results[pH,partial pressure of CO 2(PaCO 2),oxygen partial pressure(PaO 2),oxyhemoglobin saturation(SaO 2)],clinical effects,life quality improvement,and the incidence rate of adverse reactions were observed and compared between the two groups.Results After treatment,the IL-6,IL-17,IL-23,TNF-α,CRP,pH,PaCO 2,PaO 2,SaO 2 and life quality were significantly improved in both groups,as compared with those before treatment(P<0.01).Moreover the improvement degree of above indexes and clinical effects as well as the incidence rate of adverse reactions in research group were superior to those in control group(P<0.05 or P<0.01).Conclusion Huatanyifei decoction combined with ambroxol,salmeterol/fluticasone propionate in treatment of elderly COPD have better regulating effects on inflammation factors,blood gas analysis indexes during progress of disease,which can effectively improve the life quality and clinical related pathology performance of patients,and can guarantee the safety of treatment,therefor,it is worthy of further popularization and application in clinical practice.