健脾补肺止咳方联合盐酸氨溴索治疗肺脾气虚型老年慢性支气管炎患者的效果

Effect of Jianpi Bufei Zhike Decoction Combined with Ambroxol Hydrochloridein Treating Elderly Patients with Chronic Bronchitis ofLung-Spleen Qi Deficiency Syndrome

目的探究健脾补肺止咳方联合盐酸氨溴索治疗肺脾气虚型老年慢性支气管炎(CB)患者的效果。方法选取2021年5月至2023年1月南阳市中心医院收治的96例老年CB患者,按照随机数字表法分为对照组和试验组,各48例。均给予两组基础治疗,对照组接受盐酸氨溴索进行治疗,试验组接受健脾补肺止咳方联合盐酸氨溴索治疗。对比两组治疗前后中医证候积分、肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、FEV_(1)/FVC及每分钟最大通气量(MVV)]、炎症指标[降钙素原(PCT)、白细胞介素(IL)-4水平、γ-干扰素(INF-γ)]、免疫指标(IgA、IgG、IgM)变化,分析不良反应差异。结果治疗后,两组FVC、FEV_(1)、FEV_(1)/FVC、MVV、血清INF-γ、IgA、IgG、IgM水平较治疗前均升高,且试验组升高幅度较对照组更大(P<0.05);两组主、次证积分、血清PCT、IL-4水平较治疗前均降低,且试验组降低幅度较对照组更大(P<0.05);试验组急性发作次数、症状持续时间均低于对照组(P<0.05),试验组治疗期间不良反应发生率为2/48(4.17%),与对照组[3/48(6.25%)]比较,差异无统计学意义(P>0.05)。结论健脾补肺止咳肺方联合盐酸氨溴索治疗肺脾气虚型老年CB能通过抑制炎症反应,提高患者免疫功能,进而有效改善其肺功能与临床症状,有效预防急性发作。

Objective To explore the efficacy of Jianpi Bufei Zhike decoction combined with ambroxol hydrochloride on elderly patients with chronic bronchitis of lung-spleen qi deficiency syndrome.Methods A total of 96 elderly patients with chronic bronchitis admitted Nanyang Central Hospital from May 2021 to January 2023 were selected and classified into control group and treatment group according to the random number table method,with 48 cases in each group.Both groups were given basic treatment,and the control group was treated with ambroxol hydrochloride,and the treatment group was given Jianpi Bufei Zhike decoction combined with ambroxol hydrochloride.The TCM syndromes scores,lung function[forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1)),FEV_(1)/FVC and maximum ventilation volume per minute(MVV)],inflammatory indicators[procalcitonin(PCT),interleukin(IL)-4,interferon-γ(INF-γ)]and immune indicators(IgA,IgG,IgM)were compared between the two groups before and after treatment,and the differences in adverse reactions were analyzed.Results After treatment,the FVC,FEV_(1),FEV_(1)/FVC,MVV,and serum INF-γ,IgA,IgG and IgM levels were increased in both groups than those before treatment,and the increases in treatment group were greater than those in control group(P<0.05).The scores of primary syndrome and secondary syndrome and levels of serum PCT and IL-4 in the two groups were reduced compared to before treatment,and the reductions were greater in treatment group(P<0.05).The number of acute attacks and duration of symptoms in treatment group were lower or shorter than those in control group(P<0.05).The incidence of adverse reactions during treatment in the experimental group was 2/48(4.17%),and the difference was not statistically significant compared with the control group[3/48(6.25%)](P>0.05).Conclusion Jianpi Bufei Zhike decoction combined with ambroxol hydrochloride can inhibit inflammatory response,enhance immune function,effectively improve lung function and clinical symptoms,and effectively prevent acute attack in the treatment of elderly patients with chronic bronchitis of lung-spleen qi deficiency syndrome.