三桑活血汤联合氨溴索治疗肺肾两虚证老年慢阻肺的效果及对患者肺功能的影响

Effect of Sansang Invigorating Circulation Decoction Combined with Ambroxol on Chronic Obstructive Pulmonary Disease of Elderly Patients with Lung and Kidney Deficiency and its Influence on Pulmonary Function

目的分析在老年慢阻肺(肺肾两虚证)患者中联合应用三桑活血汤和氨溴索治疗的价值。方法纳入2020年1~12月本院收治的60例老年慢阻肺(肺肾两虚证)患者,根据患者自愿原则分组。对照组30例采用常规西医治疗,观察组30例联合三桑活血汤治疗,比较两组治疗前后中医证候积分、治疗有效率,治疗前后肺功能指标(FVC、FEV_(1)、FEV_(1)/FVC、PEF50)及炎症因子(IL-6、PCT、CPR及TNF-α)及睡眠质量PSQI评分,两组患者免疫功能改善情况。结果治疗后观察组中医证候积分(15.34±1.26)分低于对照组中医证候积分(20.17±1.49)分,差异有统计学意义(P<0.05);观察组治疗有效率93.33%高于对照组治疗有效率66.67%(P<0.05);两组治疗前后肺功能指标FEV_(1)/FVC比较无显著差异(P>0.05)。观察组治疗后肺功能指标FVC(3.33±0.97)L、FEV_(1)(39.92±2.14)L、PEF50(73.59±7.88)L/min水平均高于对照组FVC(2.64±0.88)L、FEV_(1)(37.07±2.32)L、PEF50(68.69±7.56)L/min,差异有统计学意义(P<0.05);观察组治疗后炎症因子指标IL-6(103.16±11.85)ng/L、PCT(0.44±0.01)ng/L、CPR(6.95±1.21)ng/L、TNF-α(86.31±9.45)mg/L水平均低于对照组炎症因子指标IL-6(141.03±12.65)ng/L、PCT(0.58±0.01)ng/L、CPR(15.16±3.19)ng/L、TNF-α(116.37±13.25)mg/L,差异有统计学意义(P<0.05);治疗前两组睡眠质量评分变化无差异(P>0.05),治疗后观察组睡眠质量评分(2.04±0.27)分低于对照组睡眠质量评分(3.22±0.30)分,差异有统计学意义(P<0.05);观察组免疫功能改善优良率96.67%高于对照组免疫功能改善优良率66.67%,差异有统计学意义(P<0.05)。结论三桑活血汤联合氨溴索治疗肺肾两虚证老年慢阻肺患者的疗效显著,能明显改善患者肺功能指标,抑制炎症,辅助改善老年患者的睡眠质量,强化免疫,值得推广应用。

Objective To analyze value of combined application of Sansang invigorating circulation decoction and ambroxol for elderly patients with chronic obstructive pulmonary disease(COPD)(deficiency of both lung and kidney).Methods The paper chose 60 elderly patients with chronic obstructive pulmonary disease(deficiency of both lung and kidney)admitted to our hospital from January to December 2020,and divided them into groups according to voluntariness principle.30 cases in control group were treated with routine western medicine,and 30 cases in observation group with Sansang invigorating circulation decoction.TCM syndrome scores,treatment efficiency,pulmonary function indexes(FVC,FEV_(1),FEV_(1)/FVC,PEF50)and inflammatory factors(IL-6,PCT,CPR and TNF-α),PSQI scores of sleep quality was compared between two groups before and after treatment.Results After treatment,scores of TCM syndromes in observation group(15.34±1.26)were lower than control group(20.17±1.49),with statistically significant difference(P<0.05).Effective rate of observation group was 93.33% higher than control group(66.67%,P<0.05);there was no significant difference in FEV_(1)/FVC before and after treatment between two groups(P>0.05).After treatment,levels of FVC(3.33±0.97)L,FEV_(1)(39.92±2.14)L,PEF50(73.59±7.88)L/min in observation group were significantly higher than control group(2.64±0.88)L,FEV_(1)(37.07±2.32)L,PEF50(68.69±7.56)L/min(P<0.05),In observation group,after treatment,inflammatory factor indicators IL-6(103.16±11.85)ng/L,PCT(0.44±0.01)ng/L,CPR(6.95±1.21)ng/L,TNF-α level(86.31±9.45)mg/L was lower than inflammatory factor indicators IL-6(141.03±12.65)ng/L,PCT(0.58±0.01)ng/L,CPR(15.16±3.19)ng/L and TNF-α(116.37±13.25)mg/L in control group,difference was statistically significant(P<0.05).There was no difference in sleep quality scores between two groups before treatment(P>0.05).After treatment,sleep quality scores of observation group(2.04±0.27)were lower than control group(3.22±0.30),with statistically significant difference(P<0.05);excellent and good rate of immune function improvement in observation group was 96.67%,which was significantly higher than control group(66.67%,P<0.05).Conclusion Sangsang invigorating circulation decoction combined with ambroxol can achieve significant effect on elderly patients with chronic obstructive pulmonary disease of lung and kidney deficiency syndrome.