罗氟司特联合灯盏花素对COPD患者认知功能及血清炎症介质、氧化应激指标的影响

Effects of roflumilast combined with erigeron breviscapus on cognitive function,serum inflammatory mediators,and oxidative stress indicators in patients with COPD

目的探讨罗氟司特联合灯盏花素冻干粉剂对慢性阻塞性肺病(COPD)患者认知功能及血清炎症介质、氧化应激指标的影响。方法选取2022年2月~2023年6月商丘市第四人民医院收治的COPD患者100例,按照随机数字法分为对照组和观察组。对照组给予常规治疗,观察组在对照组基础上静滴灯盏花素,并口服罗氟司特片。比较两组患者的临床疗效、肺功能、免疫功能、认知功能情况及血清炎症介质、氧化应激指标水平变化。结果治疗24周后,观察组总有效率显著高于对照组(96.0%vs 76.0%,χ^(2)=8.306,P=0.004);两组患者FVC%、FEV1%、FEV1/FVC及CD4^(+)、CD4^(+)/CD8^(+)明显上升,CD8^(+)下降,且观察组患者各项指标水平变化均较对照组显著(P<0.05);观察组患者急性加重次数和持续时间显著低于对照组(P<0.05);两组患者圣·乔治呼吸问卷评分(SGRQ)均降低、蒙特利尔认知评估量表评分(MoCA)均升高,且观察组各评分变化较对照组更显著(P<0.05);观察组各血清炎症介质指标及氧化应激指标改善情况均优于对照组(P<0.05);两组不良反应发生率比较无显著差异(22.00%vs 14.00%,χ^(2)=1.084,P=0.298)。结论罗氟司特联合灯盏花素冻干粉剂可显著改善COPD患者肺功能和免疫功能,减少急性加重的发生,改善患者认知功能,并可减轻机体炎症和氧化应激反应造成的损伤,安全性高。

Objective To investigate the effects of roflumilast combined with Erigeron breviscapus freeze-dried powder on cognitive function,serum inflammatory mediators,and oxidative stress indicators in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 100 COPD patients admitted to the Fourth People's Hospital of Shangqiu City from February 2022 to June 2023 were selected and divided into a control group and an observation group using a random number method.The control group received conventional treatment,while the observation group received intravenous Erigeron breviscapus and oral roflumilast tablets on the basis of the control group's treatment.The clinical efficacy,lung function,immune function,cognitive function,and changes in serum inflammatory mediators and oxidative stress indicators were compared between the two groups.Results After 24 weeks of treatment,the total effective rate in the observation group was significantly higher than that in the control group(96.0%vs 76.0%,χ^(2)=8.306,P=0.004).Both groups showed a significant increase in FVC%,FEV1%,FEV1/FVC,CD4^(+),and CD4^(+)/CD8^(+),with a decrease in CD8^(+).Additionally,the changes in all indicators in the observation group were more significant than those in the control group(P<0.05).The number and duration of acute exacerbations in the observation group were significantly lower than those in the control group(P<0.05).The St.George's Respiratory Questionnaire(SGRQ)scores decreased,while the Montreal Cognitive Assessment(MoCA)scores increased in both groups,and the changes in scores in the observation group were more significant than those in the control group(P<0.05).The improvement in serum inflammatory mediators and oxidative stress indicators in the observation group was better than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(22.00%vs 14.00%,χ^(2)=1.084,P=0.298).Conclusion Roflumilast combined with Erigeron breviscapus freeze-dried powder can significantly improve lung function and immune function,reduce the occurrence of acute exacerbations,improve cognitive function,and alleviate the damage caused by inflammatory and oxidative stress reactions in patients with COPD,with high safety.