芪藿益肺方治疗肺肾气虚型慢性阻塞性肺疾病稳定期的临床研究

Clinical Study of Qihuo Yifei Decoction in the Treatment of Chronic Obstructive Pulmonary Disease with Qi Deficiency of Lung and Kidney in Stable Stage

目的评价芪藿益肺方治疗肺肾气虚型慢性阻塞性肺疾病(COPD)稳定期患者的临床疗效。方法选取64例患者采用随机数字表法分为对照组和观察组,每组32例。对照组予吸入性糖皮质激素联合吸入性支气管扩张剂治疗,观察组联合芪藿益肺方,2组疗程均为60天,观察比较2组患者治疗前后临床疗效、中医证候积分、肺功能指标[第1秒用力呼气容积占预计值百分比(FEV1%Pred)]、慢性阻塞性肺疾病症状评估测试(CAT)评分、6分钟步行试验(6MWT)、血清免疫指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))变化情况及不良反应状况。结果观察组总有效率为93.33%,显著高于对照组的70.00%,差异具有统计学意义(P<0.05)。治疗30 d后,观察组患者咳嗽、喘息、胸闷、气短、乏力症状、CAT评分、6MWT较前改善;治疗60天后,2组患者咳嗽、喘息、胸闷、气短、乏力症状、CAT评分、6MWT均较前改善,且观察组改善显著优于对照组,差异有统计学意义(P<0.05)。治疗后,2组CD8^(+)水平均低于治疗前,且观察组低于对照组;CD4^(+)、CD4^(+)/CD8^(+)水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,2组FEV1%Pred比较,差异暂无统计学意义(P>0.05)。结论芪藿益肺方在改善肺肾气虚型COPD稳定期患者中医证候、CAT评分、6MWT及提高机体免疫方面具有良好疗效,但在提升肺功能方面仍需长期观察。

Objective:To evaluate the clinical effect of Qihuo Yifei Decoction in the treatment of chronic obstructive pulmonary disease(COPD)with Qi deficiency of lung and kidney.Methods:64 patients were selected and divided into a control group and an observation group by random number table method,32 cases each group.The control group was treated with inhaled glucocorticoid combined with inhaled bronchodilator and the observation group was treated with inhaled glucocorticoid combined with Qihuo Yifei Decoction.The course of treatment in both groups was 60 days.The clinical effect,TCM syndrome score and lung function index[Percentage of 1-second forced expiration volume to predicted value(FEV1%Pred)],chronic obstructive pulmonary disease symptom assessment test(CAT)score,6-minute walking test(6MWT),changes in serum immune indicators(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and adverse reactions of the two groups were observed and compared before and after treatment.Results:The total effective rate of the observation group was 93.33%,which was significantly higher than that of the control group(70.00%),and the difference was statistically significant(P<0.05).After 30 days of treatment,cough,wheezing,chest tightness,shortness of breath,fatigue symptoms,CAT score and 6MWT were improved in the observation group.After 60 days of treatment,cough,wheezing,chest tightness,shortness of breath,fatigue symptoms,CAT score and 6MWT were all improved in the two groups,and the improvement in the observation group was significantly better than that in the control group,with statistical significance(P<0.05).After treatment,CD8^(+)levels in the two groups were lower than those before treatment,and the observation group was lower than the control group.The levels of CD4^(+)and CD4^(+)/CD8^(+)were higher than before treatment,and the observation group was higher than the control group,and the difference was statistically significant(P<0.05).After treatment,there was no statistical significance in FEV1%Pred between the two groups(P>0.05).Conclusion:Qihuo Yifei Decoction has a good effect on the improvement of TCM syndrome,CAT score,6MWT and immunity in stable COPD patients with lung-kidney qi deficiency,but it still needs long-term observation in improving lung function.