虎芦合剂改善慢性阻塞性肺疾病急性加重期患者肺功能的临床观察

Clinical Observation on Improvement of Pulmonary Function in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease by Hulu Mixture

目的:探讨虎芦合剂改善慢性阻塞性肺疾病急性加重期(AECOPD)患者肺功能的效果。方法:选取2017年1月至2018年4月南通市中医院收治的AECOPD患者86例作为研究对象,按照随机数字表法分为对照组和观察组,每组43例。对照组患者给予西医常规治疗,观察组患者在此基础上加用虎芦合剂。通过评价中医证候积分比较2组治疗的临床效果,比较肺功能、生命质量、血清中相关因子水平变化。结果:观察组的有效率90.70%,显著高于对照组的有效率74.42%(P<0.05);观察组治疗后的中医证候评分明显低于对照组(P<0.05),肺功能指标FVC、FEV1、PEF、FEV1/FVC水平明显高于对照组(P<0.05),生命质量相关症状、疾病影响、日常生活能力评分明显低于对照组(P<0.05),血清因子IL-10水平明显高于对照组,TGF-β1、GRO-α水平则明显低于对照组(P<0.05)。结论:虎芦合剂利于减轻痰瘀互结证AECOPD患者的临床症状,改善肺功能,提高患者的生命质量,其机制可能是通过抑制肺组织中炎性反应递质的分泌而避免炎性反应细胞的聚集与活化以减少气道炎性反应实现的。

Objective:To investigate the effect of hulu mixture on improving lung function of chronic obstructive pulmonary disease(AECOPD)patients.Methods:A total of 86 AECOPD patients admitted to the respiratory outpatient department of Nantong Hospital of Traditional Chinese Medicine were divided into a control group(n=43)and a treatment group(n=43)by random number table method.The control group were given conventional Western medicine,the treatment group were given Hulu mixture on the basis of conventional treatment.The clinical effect of treatment was compared between the 2 groups by evaluating TCM syndrome score,and changes in lung function,quality of life and serum levels of related factors were compared.Results:The effective rate of the treatment group was 90.70%,which was significantly higher than that of the control group(74.42%)(P<0.05).TCM syndrome scores of the observation group after treatment were significantly lower than the control group(P<0.05),the pulmonary function index FVC,FEV1,PEF and FEV1/FVC levels were significantly higher than control group(P<0.05);the quality of life related symptoms,disease impact,daily life ability scores were significantly lower than the control group(P<0.05),the serum level of IL-10 was significantly higher than that of the control group,the levels of TGF-β1 and GRO-αwere significantly lower than those of the control group(P<0.05).Conclusion:Hulu mixture is beneficial to relieving the clinical symptoms of AECOPD patients with phlegm and blood stasis syndrome,improving lung function and the life quality of the patients.The mechanism may be achieved by inhibiting the secretion of inflammatory mediators in lung tissues and avoiding the aggregation and activation of inflammatory cells to reduce airway inflammation.