复方鲜竹沥液联合福多司坦治疗慢性阻塞性肺疾病急性加重期的临床研究

Clinical study on Compound Xianzhuli Liquid combined with fidostatin in treatment of acute exacerbation of chronic obstructive pulmonary disease

目的探讨复方鲜竹沥液联合福多司坦治疗慢性阻塞性肺疾病急性加重期的临床效果。方法选取2018年4月—2019年6月天津市宝坻区人民医院收治的慢性阻塞性肺疾病急性加重期患者82例,随机分成对照组(41例)和治疗组(41例)。对照组餐后口服福多司坦片,0.4 g/次,3次/d。治疗组在对照组的基础上口服复方鲜竹沥液,20 mL/次,3次/d。两组患者均连续治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者临床表现缓解时间、自我评估测试(CAT)问卷评分、肺功能,以及痰上清液和血清中肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、基质金属蛋白酶-9(MMP-9)、转化生长因子-β(TGF-β)水平。结果治疗后,对照组和治疗组临床有效率分别为80.48%和95.12%,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组患者肺部哮鸣音及咳、痰、喘的缓解时间较对照组显著缩短(P<0.05)。治疗后,两组患者CAT问卷评分、残气容积与肺总量比值(RV/TLC)均显著降低(P<0.05),而第1秒用力呼气容积(FEV1)占预计值%、最大呼气中期流量(MMEF)及FEV1与用力肺活量比值(FEV1/FVC)显著升高(P<0.05),且治疗组上述指标改善效果明显优于对照组(P<0.05)。治疗后,两组痰上清液和血清中TNF-α、IL-8、MMP-9、TGF-β水平显著降低(P<0.05),且治疗组上述各项指标水平均较对照组显著降低(P<0.05)。结论复方鲜竹沥液联合福多司坦治疗慢性阻塞性肺疾病急性加重期有利于迅速稳定患者病情,改善肺通气功能,整体疗效确切。

Objective To investigate the clinical effect of Compound Xianzhuli Liquid combined with fidostatin in treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods Patients(82 cases) with acute exacerbation of chronic obstructive pulmonary disease in Tianjin Baodi Hospital from April 2018 to June 2019 were randomly divided into control(41 cases) and treatment(41 cases) groups. Patients in the control group were po administered with Fludostam Tablets, 0.4 g/time, three times daily. Patients in the treatment group were po administered with Compound Xianzhuli Liquid on the basis of the control group, 20 mL/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the remission time of clinical manifestation, CAT questionnaire scores, lung function, TNF-α, IL-8, MMP-9, and TGF-β in sputum supernatants and serum in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 80.48% and 95.12% respectively, and there were differences between two groups(P < 0.05). After treatment, the remission time of pulmonary wheezing, cough, phlegm and asthma in the treatment group was significantly shorter than that in the control group(P < 0.05). After treatment, the CAT questionnaire scores, RV/TLC in two groups were significantly decreased(P < 0.05), but the FEV 1% accounting for predicted value, MMEF and FEV1/FVC were significantly increased(P < 0.05), and the indicators in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the level of TNF-α, IL-8, MMP-9 and TGF-β in sputum supernatants and serum in two groups was significantly decreased(P < 0.05), and the level of these indicators in the treatment group was significantly lower than that in the control group(P < 0.05). Conclusion Compound Xianzhuli Liquid combined with fidostatin in treatment of acute exacerbation of chronic obstructive pulmonary disease is beneficial to rapidly stabilize the patient’s condition and improve lung ventilation function, which has exact overall effect.