六君子丸联合噻托溴铵治疗慢性阻塞性肺疾病稳定期的临床研究

Clinical study on Liujunzi Pills combined with tiotropium bromide in treatment of stable period of COPD

目的探讨六君子丸联合噻托溴铵治疗慢性阻塞性肺疾病稳定期的临床效果。方法选取2016年1月-2018年12月商丘市第一人民医院收治的慢性阻塞性肺疾病稳定期患者372例,随机分成对照组(186例)和治疗组(186例)。对照组吸入噻托溴铵吸入粉雾剂,1粒/次,1次/d。治疗组在对照组基础上口服六君子丸,1袋/次,2次/d。两组患者均治疗12周。观察两组患者临床疗效,同时比较治疗前后两组患者肺功能、慢性阻塞性肺疾病患者自我评估测试问卷(CAT)评分、6 min步行距离(6MWD)、St George’s呼吸问卷(SGRQ)评分及血清白三烯B4(LTB4)、半乳糖凝集素-3(Gal-3)和C反应蛋白(CRP)水平。结果治疗后,对照组临床有效率为87.6%,显著低于治疗组的96.2%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者各项肺功能参数第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰流速(PEF)、FEV1占预计值百分比(FEV1%预计值)、FEV1/FVC和一氧化碳弥散量(DLCO)占预计值百分比(DLCO%预计值)较治疗前均显著升高(P<0.05),且治疗组患者这些肺功能指标明显高于对照组(P<0.05)。治疗后,两组患者CAT评分均较治疗前显著下降(P<0.05),6MWD值显著升高(P<0.05),且治疗组患者CAT评分、6MWD明显好于对照组(P<0.05)。治疗后,两组SGRQ中各功能区评分及总分均显著降低(P<0.05),且治疗组患者SGRQ各评分及总分明显低于对照组(P<0.05)。治疗后,两组患者血清LTB4、Gal-3、CRP浓度均显著下降(P<0.05),且治疗组患者血清LTB4、Gal-3、CRP水平明显低于对照组(P<0.05)。结论六君子丸联合噻托溴铵治疗慢性阻塞性肺疾病稳定期的整体疗效确切,能明显减少患者症状,改善肺功能及运动耐量。

Objective To investigate the clinical effect of Liujunzi Pills combined with tiotropium bromide in treatment of stable period of COPD. Methods Patients(372 cases) with stable period of COPD in First People’s Hospital of Shangqiu from January 2016 to December 2018 were randomly divided into control(186 cases) and treatment(186 cases) groups. Patients in the control group were inhalation administered with Tiotropium Bromide Powder for Inhalation, 1 grain/time, once daily. Patients in the treatment group were po administered with Liujunzi Pills on the basis of the control group, 1 bag/time, twice daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the lung function, CAT scores, 6 MWD, SGRQ scores, and serum levels of LTB4, Gal-3, and CRP in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 87.6%, which was significantly lower than 96.2% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, the FEV1, FVC, PEF, estimated value of FEV1%, FEV1/FVC and estimated value of DLCO% in two groups were significantly increased(P < 0.05), and the lung function in the treatment group was significantly better than that in the control group(P < 0.05). After treatment, the CAT scores in two groups were significantly decreased(P < 0.05), but 6 MWD value was significantly increased(P < 0.05), and these indexes in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the SGRQ scores in two groups were significantly decreased(P < 0.05), and the scores in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the serum concentration of LTB4, Gal-3, CRP in two groups was significantly decreased(P < 0.05), and which in the treatment group was significantly lower than those in the control group(P < 0.05). Conclusion The overall effect of Liujunzi Pills combined with tiotropium bromide in treatment of stable period of COPD is accurate, the combined treatment can significantly improve the symptoms, lung function and exercise tolerance.