补肺逐瘀汤联合常规治疗对稳定期慢性阻塞性肺疾病患者的临床疗效

Clinical effects of Bufei Zhuyu Decoction combined with routine treatment on patients with chronic obstructive pulmonary disease in stable phase

目的探讨补肺逐瘀汤联合常规治疗对稳定期慢性阻塞性肺疾病患者的临床疗效。方法144例患者随机分为对照组和观察组,每组72例,对照组给予常规治疗(沙美特罗替卡松、常规康复训练),观察组在对照组基础上加用补肺逐瘀汤,疗程12周。检测临床疗效、肺功能指标[每分钟最大通气量占预计值百分比(MVV%pred)、第1秒用力呼气容积(FEV1)与用力肺活量(FVC)比值(FEV1/FVC)、一氧化碳弥散量(DLCO)与肺泡通气量(VA)比值(DLCO/VA)、FEV1占预计值百分比(FEV1%pred)]、活动耐力指标[6 min步行距离(6MWD)]、中医证候评分、气道黏液分泌相关指标[咳嗽、咳痰评分及诱导痰中基质金属蛋白酶⁃9(MMP⁃9)、中性粒细胞弹性蛋白酶(NE)]、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组肺功能指标升高(P<0.05),中医证候评分、气道黏液分泌相关指标降低(P<0.05),以观察组更明显(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论补肺逐瘀汤联合常规治疗能有效缓解稳定期慢性阻塞性肺疾病患者肺气虚兼血瘀证相关症状,改善肺功能,增强活动耐力,抑制气道黏液高分泌,安全性较高。

AIM To explore the clinical effects of Bufei Zhuyu Decoction combined with routine treatment on patients with chronic obstructive pulmonary disease in stable phase.METHODS One hundred and forty⁃four pa⁃tients were randomly assigned into control group(72 cases)for 12⁃week intervention of routine treatment(salmet⁃erol plus fluticasone propionate,routine rehabilitation training),and observation group(72 cases)for 12⁃week in⁃tervention of both Bufei Zhuyu Decoction and routine treatment.The changes in clinical efficacy,lung function indi⁃ces[maximal voluntary ventilation as percentage of predicted volume(MVV%pred),forced expiratory volume in one second(FEV1)⁃forced vital capacity(FVC)ratio(FEV1/FVC),carbon monoxide diffusing capacity(DLCO)⁃alveolar ventilation(VA)ratio(DLCO/VA),FEV1 as percentage of predicted volume(FEV1%pred)],exercise tolerance indices[6 min walking distance(6MWD)],TCM syndrome score,airway mucus secretion⁃related indices[cough and expectoration scores,matrix metalloproteinase⁃9(MMP⁃9)and neutrophil elastase(NE)in induced sputum]and occurrence of adverse reactions were detected.RESULTS The observa⁃tion group demonstrated higher total effective rate than the control group(P<0.05).After the treatment,the two groups displayed increased lung function indices(P<0.05),along with decreased TCM syndrome score and airway mucus secretion⁃related indices(P<0.05),especially for the observation group(P<0.05).No obvious difference in occurrence of adverse reactions was found between the two groups(P>0.05).CONCLUSION For the patients with chronic obstructive pulmonary disease in stable phase,Bufei Zhuyu Decoction combined with routine treatment can effectively relieve symptoms due to Lung Qi Deficiency and Blood Stasis Pattern,improve lung func⁃tions,enhance excise tolerance and inhibit airway mucus hypersecretion,exhibiting high safety.