柴葶宁肺方治疗气结痰瘀型慢性阻塞性肺疾病急性加重期合并焦虑抑郁临床研究

Clinical efficacy of Chaiting Ningfei Formula for acute exacerbation of chronic obstructive pulmonary disease with anxiety and depression of Qi stagnation and phlegm stasis

目的观察柴葶宁肺方治疗气结痰瘀型慢性阻塞性肺疾病急性加重期(AEC0PD)合并焦虑抑郁的临床疗效。方法将110例气结痰瘀型AECOPD合并焦虑抑郁患者按照随机数字表法分为2组,对照组55例予西医常规治疗,治疗组55例在对照组治疗基础上加服柴葶宁肺方。2组均治疗2周。比较2组疗效;比较2组治疗前后中文版医院焦虑抑郁量表(HADS)评分变化;比较2组治疗前后神经递质指标5-羟色胺(5-HT)、多巴胺(DA)、血管活性肠肽(VIP)水平变化;比较2组治疗前后血清白细胞计数(WBC)、中性粒细胞淋巴细胞比率(NLR)、C反应蛋白(CRP)、白细胞介素1β(IL-1β)、IL-17A水平变化;比较2组治疗前后COPD评估测试(CAT)评分、6 min步行距离(6MWD)、圣乔治呼吸问卷(SGRQ)评分变化。结果治疗组总有效率94.55%(52/55),对照组总有效率83.64%(46/55),治疗组疗效优于对照组(P<0.05)。2组治疗后HADS-A评分、HADS-D评分均较本组治疗前降低(P<0.05),治疗后治疗组HADS-A评分、HADS-D评分均低于对照组(P<0.05)。2组治疗后5-HT、DA水平均较本组治疗前升高(P<0.05),VIP水平较本组治疗前降低(P<0.05);治疗后治疗组5-HT、DA水平均高于对照组(P<0.05),VIP水平低于对照组(P<0.05)。2组治疗后WBC、NLR、CRP、IL-1β及IL-17A水平均较本组治疗前降低(P<0.05),治疗后治疗组WBC、NLR、CRP、IL-1β及IL-17A水平均低于对照组(P<0.05)。2组治疗后CAT评分、SGRQ评分均较本组治疗前降低(P<0.05),6MWD较本组治疗前升高(P<0.05),治疗后治疗组CAT评分、SGRQ评分均低于对照组(P<0.05),6MWD高于对照组(P<0.05)。结论柴葶宁肺方联合西医常规治疗气结痰瘀型AECOPD合并焦虑抑郁,能提高患者临床疗效及生活质量,改善焦虑抑郁状况及炎症指标。

Objective To observe the clinical efficacy of Chaiting Ningfei Formula for acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with anxiety and depression of Qi stagnation and phlegm stasis.Methods Totally 110 AECOPD patients with anxiety and depression(Qi stagnation and phlegm stasis)were randomly assigned into the treatment group(n=55)and the control group(n=55).All patients were managed by conventional Western medicine,and those in the treatment group were additionally treated with Chaiting Ningfei Formula.Treated for 2 weeks,the aim was to compare the Chinese version of the Hospital Anxiety and Depression Scale(HADS),neurotransmitter indicators(5-hydroxy tryptamine[5-HT],dopamine[DA],vasoactive intestinal peptide[VIP]),white blood cell(WBC)count,neutrophil-to-lymphocyte ratio(NLR),C-reactive protein(CRP),interleukin-1β(IL-1β),IL-17A,COPD Assessment Test(CAT),6 min walking distance(6MWD),St George’s respiratory questionnaire(SGRQ)scores.The curative effect was assessed.Results The overall effective rate in the treatment group was better than that in the control group(94.55%[52/55]vs 83.64%[46/55],[P<0.05],respectively).After treatment,HADS-Anxiety(HADS-A)scores and HADS-Depression(HADS-D)scores in the both groups were decreased(P<0.05),which in the treatment group were decreased compared with the control group(P<0.05).5-HT and DA in the both groups were increased(P<0.05),which were higher in the treatment group than in the control group(P<0.05).VIP in the both groups was decreased(P<0.05),the reduction in the treatment group was more prevalent relative to the control group(P<0.05).WBC,NLR,CRP,IL-1β,IL-17A in the both groups were decreased(P<0.05),the treatment group was more common with respect to the control group(P<0.05).Decreased CAT and SGRQ and increased 6MWD groups were found in the both groups(both P<0.05),the treatment group were superior to the control group for the above indexes(all P<0.05).Conclusion For AECOPD patients with anxiety and depression(Qi stagnation and phlegm stasis),Chaiting Ningfei Formula combined with conventional Western medicine can improve clinical efficacy and quality-of-life,improve anxiety,depression and inflammation indicators.