玉屏风散合补肺汤加减治疗慢性阻塞性肺疾病稳定期临床研究

Clinical Study on Modified Yupingfeng Powder and Bufei Tang for Chronic Obstructive Pulmonary Disease in Stable Stage

目的:观察玉屏风散合补肺汤加减对慢性阻塞性肺疾病(COPD)稳定期患者血清炎症因子及呼吸功能的影响。方法:选取COPD稳定期患者120例,按随机数字表法分为观察组和对照组各60例。对照组予以西医常规治疗,观察组在对照组基础上辅以玉屏风散合补肺汤加减治疗。比较2组临床疗效,检测治疗前后肺功能指标[用力肺活量占预用值的百分比(FVC%pred)、第一秒用力呼气占预用值的百分比(FEV1%pred)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)、深吸气量占预测值百分比(IC%pred)]、动脉血气指标[二氧化碳分压(PaCO_(2))、血氧张力(PaO_(2))、氧饱和度(SaO_(2))、酸碱度(pH)]以及血清炎症指标[降钙素原(PCT)、前白蛋白(PA)、超敏C-反应蛋白(hs-CRP)、α1抗胰蛋白酶(α1-AT)]水平变化。结果:观察组总有效率为96.67%,高于对照组83.33%,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分较治疗前降低,且观察组中医证候积分低于对照组,差异有统计学意义(P<0.05)。治疗后,2组IC%pred较治疗前升高(P<0.05),且观察组IC%pred高于对照组(P<0.05)。治疗后,2组PaCO_(2)较治疗前降低,PaO_(2)、SaO_(2)、pH较治疗前升高;且观察组PaCO_(2)低于对照组,PaO_(2)、SaO_(2)、pH高于对照组;差异均有统计学意义(P<0.05)。治疗后,2组血清PCT、hs-CRP水平较治疗前降低,PA、α1-AT水平较治疗前升高;且观察组血清PCT、hs-CRP水平低于对照组,PA、α1-AT水平高于对照组;差异均有统计学意义(P<0.05)。结论:玉屏风散合补肺汤加减可改善COPD稳定期患者的肺功能和血气指标,缓解炎性反应。

Objective:To observe the effect of modified Yupingfeng powder and Bufei tang on inflammatory factors in serum and respiratory function in patients with chronic obstructive pulmonary disease(COPD)in stable stage.Methods:A total of 120 cases of COPD patients in stable stage were divided into the observation group and the control group according to the random number table method,60 cases in each group.The control group was given routine western medicine,and the observation group was additionally given modified Yupingfeng powder and Bufei tang based on the treatment of the control group.The clinical effect was compared between the two groups.The changes in levels of indexes of the lung function[forced vital capacity as a percentage of predicted value(FVC%pred),forced expiratory volume in one second as a percentage of predicted value(FEV1%pred),the ratio of FEV1 to FVC(FEV1/FVC),and inspiratory capacity as a percentage of predicted value(IC%pred)],the indexes of arterial blood gas[partial pressure of carbon dioxide(PaCO_(2)),partial pressure of blood oxygen(PaO_(2)),oxygen saturation(SaO_(2)),and potential of hydrogen(pH)],and inflammatory indexes in serum[procalcitonin(PCT),prealbumin(PA),high-sensitivity C-reactive protein(hs-CRP),andα1-antitrypsin(α1-AT)]were detected before and after treatment.Results:The total effective rate was 96.67%in the observation group,higher than that of 83.33%in the control group,the difference being significant(P<0.05).After treatment,Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment,and the scores in the observation group were lower than those in the control group,differences being significant(P<0.05).After treatment,IC%pred in the two groups was increased when compared with that before treatment,and IC%pred in the observation group was higher than that in the control group(P<0.05).After treatment,PaCO_(2)in the two groups was decreased when compared with that before treatment,and PaO_(2),SaO_(2)and pH were increased;PaCO_(2)in the observation group was lower than that in the control group,and PaO_(2),SaO_(2)and pH were higher;differences were significant(P<0.05).After treatment,the levels of PCT and hs-CRP in serum in the two groups were decreased when compared with those before treatment,and the levels of PA andα1-AT were increased;the levels of PCT and hs-CRP in serum in the observation group were lower than those in the control group,and the levels of PA andα1-AT were higher;differences were significant(P<0.05).Conclusion:In the treatment of COPD patients in stable stage,modified Yupingfeng powder combined with Bufei tang can improve the lung function and indexes of blood gas,and relieve inflammatory response.