益肺健骨方联合硫酸沙丁胺醇、阿仑膦酸钠治疗老年慢性阻塞性肺疾病合并骨质疏松的效果

Efficacy of Yifeijiangu formula combined with albuterol sulfate and alendronate sodium in the treatment of chronic obstructive pulmonary disease complicated with osteoporosis in elderly people

目的:观察益肺健骨方联合硫酸沙丁胺醇、阿仑膦酸钠治疗老年慢性阻塞性肺疾病(COPD)合并骨质疏松(OP)的临床效果。方法:将76例COPD合并OP老年患者随机分为对照组和观察组,各38例。对照组给予硫酸沙丁胺醇雾化吸入、阿仑膦酸钠口服治疗,观察组在对照组的基础上给予益肺健骨方口服。连续治疗3个月,比较两组肺功能、圣·乔治呼吸问卷(SGRQ)评分、6 min步行测试(6MWT)距离、骨密度、血清中骨代谢指标、炎症因子水平。结果:治疗后,观察组的6MWT距离、肺功能指标、腰椎L_(1~4)的骨密度、骨碱性磷酸酶水平等均高于对照组和治疗前;SGRQ评分、β-Ⅰ型胶原羧基端肽、白介素-6、肿瘤坏死因子-a等水平均低于对照组和治疗前(P<0.05)。结论:益肺健骨方联合硫酸沙丁胺醇、阿仑膦酸钠利于改善老年COPD合并OP的肺功能,提高生活质量、运动耐力,增加骨密度,可能与改善骨代谢、降低炎症反应有关。

Objective:To observe the clinical efficacy of Yifeijiangu formula combined with albuterol sulfate and alendronate sodium in the treatment of chronic obstructive pulmonary disease(COPD)complicated with osteoporosis(OP)in the elderly.Methods:Seventy-six cases of the patients were randomly divided into a control group and an observation group with 38 cases each.Both groups were first given salbutamol sulfate nebulized inhalation and albuterol sulfate oral treatment and then oral Yifeijiangu was additionally given in the observation group,and the treatment was lasted for 3 months.Lung function,St.George’s Respiratory Questionnaire(SGRQ)score,6-minute walking test(6MWT)distance,bone mineral density,bone metabolism indexes in serum,and levels of inflammatory factors were compared between the two groups.Results:After treatment,the 6MWT distance,the levels of lung function indexes,bone density of lumbar vertebrae L_(1~4),and bone alkaline phosphatase in the observation group were all longer or higher,and SGRQ score,the levels of b-C-terminal telopeptide of typeⅠcollagen,interleukin-6,and tumor necrosis factor-a were lower in the observation group than the control group as well as after than before treatment(P<0.05).Conclusion:The combination of Yifeijiangu formula with albuterol sulfate and alendronate sodium is of benefit to the improvement of lung function,quality of life,exercise endurance,and bone density in the elderly with COPD complicated with OP,which may be related to the improvement of bone metabolism and the reduction of inflammatory response.