润肺健脾益肾汤联合噻托溴铵、丙酸氟替卡松和沙美特罗吸入治疗肺肾气虚型稳定期慢性阻塞性肺疾病45例

Clinical efficacy of self-made Runfei Jianpi Yishen decoction combined with conventional western medicine treatment on stable COPD of insufficiency of Qi of the lung and kidney type:45 cases

目的探究自拟润肺健脾益肾汤联合噻托溴铵、丙酸氟替卡松和沙美特罗吸入治疗肺肾气虚型稳定期慢性阻塞性肺疾病(COPD)的临床疗效及对病人血清γ干扰素(IFN-γ)、骨桥蛋白(OPN)表达的影响。方法选取2019年10月至2021年10月南充市中医医院收治的90例肺肾气虚型稳定期COPD病人作为研究对象,采用随机数字表法分为常规组(45例)及联合组(45例)。常规组给予噻托溴铵、丙酸氟替卡松和沙美特罗吸入治疗,联合组在常规组基础上联合自拟润肺健脾益肾汤治疗。比较两组血清IFN-γ、OPN水平,肺功能[用力肺活量(FVC)、1 s用力呼气容积(FEV_(1))、1 s用力呼气容积占预计值的百分比(FEV_(1)%)],中医证候积分,呼吸困难严重程度、住院时间及次数,临床疗效。结果与治疗前比较,两组治疗后血清IFN-γ、OPN水平、中医证候积分、mMRC评分均降低(P<0.05),且与治疗后常规组比较,联合组降低,差异有统计学意义(P<0.05);两组治疗后FVC、FEV_(1)、FEV_(1)%水平均升高(P<0.05),且与常规组比较,联合组升高,差异有统计学意义(P<0.05);联合组住院时间[(4.58±1.21)d比(6.13±1.56)d]及住院次数[(1.44±0.35)次比(2.13±0.46)次]与常规组比较均减少,差异有统计学意义(P<0.05);联合组临床疗效(88.89%)高于常规组(71.11%),差异有统计学意义(P<0.05)。结论自拟润肺健脾益肾汤联合西药常规治疗肺肾气虚型稳定期COPD病人可有效降低IFN-γ、OPN水平,改善临床症状,提高肺功能,促进恢复,效果较好。

Objective To explore the clinical efficacy of self-made Runfei Jianpi Yishen decoction combined with conventional western medicine treatment on stable chronic obstructive pulmonary disease(COPD)of insufficiency of Qi of the lung and kidney type,and its effects on the expression of serum interferon-γ(IFN-γ)and osteopontin(OPN)in patients.Methods Ninety stable COPD patients of insufficiency of Qi of the lung and kidney type in Nanchong Hospital of Traditional Chinese Medicine from October 2019 to October 2021 were selected as the research objects,and they were randomly assigned into a conventional group(45 cases)and a combined group(45 cases).Patients in the conventional group were given tiotropium bromide,fluticasone propionate and salmeterol inhalation,while patients in the combined group were given self-made Runfei Jianpi Yishen decoction on the basis of conventional group.The levels of serum IFN-γand OPN,lung function[forced vital capacity(FVC),forced expiratory volume in the first second(FEV_(1)),the percentage forced expiratory volume in the first second to predicted value(FEV_(1)%)],TCM syndrome score,severity of dyspnea,length of hospital stay,the number of hospital stays,and clinical efficacy in the two groups were compared.Results Compared with before treatment,the serum IFN-γand OPN levels,TCM syndrome scores,and mMRC scores of the two groups were reduced after treatment(P<0.05),and compared with the conventional group after treatment,the combined group were reduced,the difference was statistically significant(P<0.05);compared with before treatment,the FVC,FEV_(1) and FEV_(1)%levels in the two groups were increased after treatment(P<0.05),and compared with the conventional group,the combined group were increased,the difference was statistically significant(P<0.05);the length of hospital stay[(4.58±1.21)d vs.(6.13±1.56)d]and the number of hospital stays[(1.44±0.35)vs.(2.13±0.46)]in the combined group were reduced compared with those in the conventional group,the difference was statistically significant(P<0.05);the clinical efficacy of the combined group(88.89%)was higher than that of the conventional group(71.11%),the difference was statistically significant(P<0.05).Conclusions The self-made Runfei Jianpi Yishen decoction combined with western medicine can effectively reduce IFN-γand OPN levels,improve clinical symptoms,improve lung function,and promote recovery in patients with stable COPD of insufficiency of Qi of the lung and kidney type.The effect is good.