补肾化痰、祛瘀通络膏对哮喘-慢阻肺重叠综合征缓解期患者肺功能和血清白三烯B4水平的影响

Effect of Bushen Huatan-Quyu Tongluo ointment on pulmonary function and serum leukotriene B4 level in patients with asthma-COPD overlap syndrome in remission stage

目的观察补肾化痰、祛瘀通络膏对哮喘-慢阻肺重叠综合征(ACOS)缓解期患者肺功能和血清白三烯B4(LTB4)水平的影响。方法将100例ACOS缓解期患者按照随机数字表法分为2组。对照组50例予西医治疗;治疗组50例在对照组治疗基础上加补肾化痰、祛瘀通络膏治疗。2组疗程3个月。观察2组治疗前后哮喘控制测试(ACT)评分及慢阻肺症状测试(CAT)评分变化,肺功能指标第1s用力呼气容积占预计值百分比(FEV1%)、FEV1/用力肺活量(FVC)、呼气高峰流量(PEFR)变化,LTB4水平变化;观察2组治疗期间及治疗后6个月内急性加重次数,并进行安全性评价。结果2组治疗后ACT评分均较本组治疗前升高(P<0.05),CAT评分降低(P<0.05);且治疗组治疗后ACT评分高于对照组(P<0.05),CAT评分低于对照组(P<0.05)。2组治疗后FEV1/FVC、FEV1%及PEFR均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后血清LTB4水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。治疗组治疗期间、治疗后6个月内急性加重次数均较对照组少(P<0.05)。治疗组不良反应发生率8.0%,对照组不良反应发生率12.0%,治疗组不良反应发生率低于对照组(P<0.05)。结论补肾化痰、祛瘀通络膏联合西医治疗ACOS缓解期,可显著改善患者临床症状及肺功能,降低血清LTB4水平,减少急性加重次数,降低不良反应发生率。

Objective To observe the clinical effect of Bushen Huatan-Quyu Tongluo ointment on pulmonary function and serum leukotriene B4(LTB4)level in patients with asthma-COPD overlap syndrome(ACOS) in remission stage. Methods 100 ACOS patients in remission stage were divided into two groups according to random number table method. 50 cases in the control group were treated by western medicine. 50 cases in treatment group were treated by Bushen Huatan-Quyu Tongluo ointment on the basis of the control group. Both groups were treated for 3 months. The changes of asthma control test(ACT) score, chronic obstructive pulmonary symptom test(CAT) score, the percentage of forced expiratory volume(FEV1%), FEV1/forced vital capacity(FVC), peak expiratory flow(PEFR) and LTB4 level before and after treatment in two groups were observed. The times of acute exacerbation was observed during treatment period and within 6 months after treatment, and the safety was evaluated. Results After treatment, the ACT score in two groups were higher than those in the group before treatment(P<0.05), and the CAT score were decreased(P<0.05). The ACT score of the treatment group was higher than that of the control group(P<0.05), the CAT score was lower than the control group(P<0.05). After treatment, FEV1/FVC, FEV1% and PEFR in two groups were higher than those in the group before treatment(P<0.05), and the increase in the treatment group was more obvious(P<0.05). After treatment, the serum LTB4 level in two groups were lower than that in the group before treatment(P<0.05), and the decrease in the treatment group was more obvious(P<0.05). The times of acute exacerbation in the treatment group was less than that in the control group during the treatment period and within 6 months after treatment(P<0.05). The incidence of adverse reactions was 8.0% in treatment group and 12.0% in the control group. The incidence of adverse reactions in the treatment group was lower than that in the control group(P<0.05). Conclusion Bushen Huatan-Quyu Tongluo ointment combined with western medicine can significantly improve the clinical symptoms and lung function of patients with ACOS in remission stage, reduce the level of serum LTB4, reduce the number of acute exacerbations, and reduce the incidence of adverse reactions.