益气宣肺汤加减治疗慢性阻塞性肺疾病稳定期肺脾气虚型患者对肺功能及血清学指标的影响

The Effect of Modified Yiqi Xuanfei Decoction on Pulmonary Function and Serological Indexes of Patients with Chronic Obstructive Pulmonary Disease in Stable stage

目的探讨益气宣肺汤加减治疗慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期肺脾气虚型患者的临床疗效及对血清学指标的影响。方法前瞻性选取2018年4月—2019年10月期间于北京市平谷区中医医院肺病科诊治入院的COPD稳定期肺脾气虚型患者96例,将其随机分为治疗组和对照组两组,每组各48例。对照组接受西医常规治疗,治疗组在对照组治疗方案基础上加服益气宣肺汤,所有患者均接受4个疗程治疗。于治疗前后对两组患者肺功能1s用力呼气容积(Forced expiratory volume in 1s,FEV1)、用力肺活量(Forced vital capacity,FVC)及FEVl/FVC、呼吸困难分级评分(medicine research council scale,m MRC)、血清学指标[血清前白蛋白(Serum prealbumin,pro-ALB)、血清白蛋白(serum albumin,ALB)、总淋巴细胞计数(Total lymphocyte count,LYM))及炎症因子C-反应蛋白(C-reactive protein,CRP)、白细胞介素(Interleukin-8,IL-8)、肿瘤坏死因子(tumor necrosis factor-α,TNF-α)]进行观察分析。结果治疗后两组肺功能指标FEV1、FVC、FEV1/FVC指标均较治疗前明显提升(P <0.05),且治疗组优于对照组(P <0.05)。治疗后两组患者呼吸困难分级评分(m MRC)均较治疗前显著下降(P <0.05),且治疗组优于对照组,下降程度更为显著(P <0.05)。治疗后两组患者血清学指标pro-ALB、ALB、LYM与治疗前比较均得到明显改善(P <0.05),且治疗后治疗组优于对照组(P <0.05)。治疗后两组炎症因子CRP、IL-8、TNF-α水平与治疗前比较均明显降低(P <0.05),且治疗组CRP、IL-8、TNF-α降低水平优于对照组(P <0.05)。治疗后对照组总有效率为66.67%(32/48),治疗组总有效率为87.50%(42/48),两组比较差异有统计学意义(P <0.05)。结论益气宣肺汤加减治疗COPD稳定期肺脾气虚型患者临床疗效显著,可明显提升患者减退的肺功能,改善患者呼吸困难等临床症状,改善患者血清学指标,并降低患者气道炎症反应。

Objective To explore the clinical efficacy of Yiqi Xuanfei Decoction in the treatment of chronic obstructive pulmonary disease(COPD)patients with Lung-Spleen-Qi deficiency in stable stage.Methods A prospective selection of 96 patients with COPD stable lung and spleen deficiency type who were diagnosed and treated at the Pulmonary Disease Department of Beijing Pinggu District Traditional Chinese Medicine Hospital from April 2018 to October 2019 were randomly divided into treatment group and control group.There are 48 cases in each group.The control group received conventional Western medicine treatment for COPD in the stable phase of lung and spleen Qi deficiency.The treatment group was treated with Yiqi Xuanfei Decoction on the basis of the treatment plan of the control group.All patients received 4 courses of treatment.Before and after treatment,the lung function[Forced expiratory volume in 1 s(FEV1),Forced vital capacity(FVC),FEVl/FVC,and medicine research council scale,m MRC,serological indicators(serum prealbumin(pro-ALB),serum albumin(ALB),total lymphocyte count(LYM))and inflammatory factors(C-reactive protein)(C-reactive protein,CRP),interleukin(Interleukin-8,IL-8),tumor necrosis factor(tumor necrosis factor-α,TNF-α)]were observed and analyzed.Results After treatment,the two groups of lung function indexes FEV1,FVC,FEV1/FVC indicators were significantly higher than before treatment(P<0.05),and the treatment group was better than the control group,and the improvement effect was more obvious(P<0.05).After treatment,the dyspnea classification scores(m MRC)of the two groups were All were significantly lower than before treatment(P<0.05),and the treatment group was better than the control group,and the degree of decline was more significant(P<0.05).After treatment,the two groups of patients’serum indexes pro-ALB,ALB,LYM were compared with those before treatment All were significantly improved(P<0.05),and the treatment group was better than the control group after treatment,and the improvement effect was more obvious(P<0.05).After treatment,the levels of inflammatory factors CRP,IL-8,and TNF-αin the two groups were compared with those before treatment All were significantly reduced(P<0.05),and the reduction levels of CRP,IL-8 and TNF-αin the treatment group were better than those in the control group,and the decline was more significant(P<0.05).The total effective rate of the control group after treatment was 66.67%(32/48),the total effective rate of the treatment group was 87.50%(42/48),and the difference between the two groups was statistically significant(P<0.05).Conclusion Yiqi Xuanfei Decoction has a clear clinical effect in the treatment of COPD patients with lung and kidney Qi deficiency at stable stage.It can significantly improve the pulmonary function,improve the clinical symptoms of patients with dyspnea,improve the patients’serological indicators,and reduce the patients’airway inflammatory.