加味桑白皮汤辅助治疗对慢性阻塞性肺疾病急性加重期患者的影响

The effect of supplementary therapy of modified Sang-bai-pi decoction on patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨加味桑白皮汤辅助治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的疗效及活动能力和生活质量的影响。方法将我院2020年5月至2021年9月收治的AECOPD患者95例,按照随机数字表法分为常规组(47例)及联合组(48例),常规组接受常规西医治疗;联合组在此基础上予以加味桑白皮汤辅助治疗。治疗2周后比较两组临床疗效、肺功能、炎症因子水平;治疗1、2周后及随访1、3个月后评价活动能力、生活质量以及不良反应情况,比较两组治疗前后生活质量。结果随访3个月,无1例失访。治疗2周后,联合组总有效率(95.61%)高于常规组(82.61%)(P<0.05);联合组第一秒最大呼气容积(FEV1)、用力肺活量(FVC)、第一秒用力呼气容积占所有呼气量的比例(FEV1/FVC)水平以及FEV1占预计百分比高于常规组,血清细胞间黏附分子-1、血管细胞黏附分子-1及白介素-17水平低于常规组(P<0.05)。联合组不同时间点运动能力得分均低于常规组,喘息、疲劳、情感以及病情控制得分均高于常规组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论加味桑白皮汤辅助治疗AECOPD患者,可下调炎症因子水平,加快肺功能恢复,改善运动耐力和生活质量,且不增加不良反应发生率。

Objective To explore the effect of modified Sang-bai-pi decoction in the supplementary treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and its influence on activity ability and quality of life of the patients.Methods Ninety-five patients with AECOPD treated in our hospital from May 2020 to September 2021 were randomly divided into a routine group(n=47)and a combined group(n=48).The routine group received routine western medicine treatment.On the basis of this,the combined group was treated with modified Sang-bai-pi decoction.The clinical efficacy,pulmonary function,inflammatory factor level,activity ability,quality of life and adverse reactions after two weeks of treatment were compared between the two groups.The activity ability,quality of life and adverse reaction were evaluated after 1 week and 2 weeks of treatment as well as 3 and 6 months of follow-up.The quality of life before and afar treatment were compared between the two groups.Results All patients were followed up for 3 months,and no case was lost.After 2 weeks of treatment,the total effective rate of the combined group was 95.61%that was higher than 82.61%of the conventional group(P<0.05).The maximum expiratory volume in the first second(FEV1),forced vital capacity(FVC),the ratio of forced expiratory volume in the first second(FEV1/FVC)and the estimated percentage of FEV1in the combined group were higher than those in the conventional group,while the levels of intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),and interleukin-17(IIL-17)were lower than those in the conventional group(P<0.05).The scores of exercise ability in the combined group at different time points were lower than those in the conventional group,and the scores of wheezing,fatigue,emotion and disease control were higher than those in the conventional group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Modified Sang-bai-pi decoction can reduce the level of inflammatory factors,speed up the recovery of lung function,improve the exercise endurance and quality of life without increasing the incidence of adverse reactions.