薯蓣膏治疗稳定期慢性阻塞性肺疾病患者的临床研究

Clinical study of dioscorea glue in the treatment of stable chronic obstructive pulmonary disease

目的观察薯蓣膏治疗稳定期慢性阻塞性肺疾病(COPD)患者的临床疗效。方法本文为前瞻性随机对照试验。选取2020年11月至2022年3月佛山市中医院呼吸内科门诊就诊的稳定期COPD肺脾气虚患者120例为研究对象,采用随机数字表法分为两组,各60例。治疗组男42例,女18例,年龄(65.77±5.59)岁;对照组男40例,女20例,年龄(64.68±4.92)岁。对照组给予常规西医治疗,治疗组在常规西医治疗基础上加服薯蓣膏,疗程6个月。观察两组患者治疗前及治疗后3个月、6个月的肿瘤坏死因子-α(TNF-α)、CD3^(+)、CD4^(+)、白蛋白(ALB)、BODE指数、急性加重次数指标的变化。采用t检验、χ^(2)检验。结果治疗后3个月、6个月,治疗组TNF-α指标[(5.89±1.14)ng/L、(5.55±1.21)ng/L]均低于照组[(6.79±1.11)ng/L、(6.66±1.19)ng/L],CD3^(+)[(56.61±5.49)%、(59.89±5.01)%]、CD4^(+)指标[(34.56±4.49)%、(35.50±4.29)%]均高于对照组[(53.64±5.68)%、(53.28±5.05)%、(30.82±4.20)%、(30.79±4.20)%],差异均有统计学意义(均P<0.05)。治疗后6个月,治疗组ALB指标[(35.89±0.64)g/L]高于对照组[(29.14±0.64)g/L],BODE指数[(1.63±0.95)分]、急性加重次数[(1.30±0.17)次]均低于对照组[(2.18±1.12)分、(1.62±0.21)次],差异均有统计学意义(均P<0.05)。结论加服薯蓣膏治疗稳定期COPD肺脾气虚证患者,可减轻患者症状,抑制炎症因子表达,调节机体免疫功能,改善营养状态,从而提高患者生活质量,减少急性加重风险。

Objective To evaluate the clinical efficacy of dioscorea glue in the treatment of stable chronic obstructive pulmonary disease(COPD).Methods This was a prospective randomized controlled trial.From November 2020 to March 2022,a total of 120 patients with stable COPD and qi deficiency of lung and spleen in Department of Respiratory Medicine of Foshan Hospital of Traditional Chinese Medicine were divided into a treatment group(60 cases)and a control group(60 cases)by the random number table method.In the treatment group,there were 42 males and 18 females,aged(65.77±5.59)years.In the control group,there were 40 males and 20 females,aged(64.68±4.92)years.The control group was given conventional western medicine treatment,and the treatment group was given dioscorea glue on the basis of conventional western medicine treatment for 6 months.The changes of tumor necrosis faction-α(TNF-α),CD3^(+),CD4^(+),albumin(ALB),BODE index,and number of acute exacerbations before treatment and 3 and 6 months after treatment were observed in the two groups.t test and χ^(2) test were used.Results Three and six months after treatment,the TNF-α indexes[(5.89±1.14)ng/L and(5.55±1.21)ng/L]in the treatment group were lower than those in the control group[(6.79±1.11)ng/L and(6.66±1.19)ng/L],and the CD3^(+)[(56.61±5.49)% and(59.89±5.01)%]and CD4^(+)indexes[(34.56±4.49)%and(35.50±4.29)%]were higher than those in the control group[(53.64±5.68)%,(53.28±5.05)%,(30.82±4.20)%,and(30.79±4.20)%],with statistically significant differences(all P<0.05).Six months after treatment,the ALB index[(35.89±0.64)g/L]in the treatment group was higher than that in the control group[(29.14±0.64)g/L],and the BODE index[(1.63±0.95)points]and the number of acute exacerbations[(1.30±0.17)times]were lower than those of the control group[(2.18±1.12)points and(1.62±0.21)times],with statistically significant differences(all P<0.05).Conclusion Dioscorea glue combined with bronchodilator inhalant is effective in the treatment of stable COPD patients with qi deficiency of lung and spleen,which can eliminate the inflammation,regulate the immune function,improve the clinical symptoms and nutritional status,reduce the number of acute exacerbations,and improve the quality of life.