健脾补肾益肺方雾化吸入对慢性阻塞性肺疾病稳定期患者气道黏液高分泌及肺功能的影响

Effects of aerosol inhalation with Jianpi Bushen Yifei Formula for airway mucus hypersecretion and pulmonary function in patients with chronic obstructive pulmonary disease at stable stage

目的观察健脾补肾益肺方雾化吸入治疗慢性阻塞性肺疾病(COPD)稳定期患者的疗效及对患者气道黏液高分泌和肺功能的影响。方法将74例COPD稳定期患者按照随机数字表法分为2组。对照组37例予常规治疗,治疗组37例在对照组治疗基础上加健脾补肾益肺方雾化吸入治疗,2组均治疗2周。比较2组临床疗效及治疗前后肺功能[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及FEV_(1)/FVC],血清白细胞介素6(IL-6)、超氧化物歧化酶(SOD)、C反应蛋白(CRP)水平,外周血中性粒细胞绝对值(NE绝对值)及气道黏液高分泌指标痰液黏蛋白5AC(MUC5AC)水平。结果治疗组总有效率97.30%(36/37),对照组总有效率78.38%(29/37),治疗组总有效率显著高于对照组(P<0.05)。治疗后,2组患者肺功能指标FEV_(1)、FVC及FEV_(1)/FVC均较本组治疗前提高(P<0.05),且治疗组均高于对照组(P<0.05)。治疗后,2组炎症指标IL-6、CRP及NE绝对值均较本组治疗前降低(P<0.05),SOD均较本组治疗前升高(P<0.05),且治疗组IL-6、CRP及NE绝对值均低于对照组(P<0.05),SOD高于对照组(P<0.05)。治疗后,2组痰液MUC5AC水平均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后对照组发生1例呕吐恶心,治疗组无明显不良反应发生,2组不良反应比较差异无统计学意义(P>0.05)。结论健脾补肾益肺方雾化吸入治疗COPD稳定期可改善患者气道黏液高分泌及肺功能,提高临床疗效。

Objective To observe the efficacy of aerosol inhalation with Jianpi Bushen Yifei Formula for patients with stable chronic obstructive pulmonary disease(SCOPD)and its influences on airway mucus hypersecretion(AMH)and pulmonary function.Methods A total of 74 patients with SCOPD were randomly assigned into treatment group(n=37)and control group(n=37).All patients were managed by conventional therapy,and those in treatment group were additionally given aerosol inhalation with Jianpi Bushen Yifei Formula.Treated for 2 weeks,the aim was to compare pulmonary function(forced expiratory volume in one second[FEV_(1)],forced vital capacity[FVC],FEV_(1)/FVC),serum interleukin-6(IL-6),superoxide dismutase(SOD),C-reactive protein(CRP),absolute neutrophil count(ANC),mucin 5AC(MUC5AC).The curative effect was assessed.Results The overall effective rate in the treatment group was significantly higher than that in the control group(97.30%[36/37]vs 78.38%[29/37],P<0.05).After treatment,FEV_(1),FVC and FEV_(1)/FVC in groups were significantly increased(P<0.05),which increased notably in the treatment group compared with the control group(P<0.05).Significantly decreased IL-6,CRP and ANC,and significantly increased SOD were found in both groups after treatment(all P<0.05),which were significantly pronounced in treatment group(all P<0.05).After treatment,MUC5AC level in groups was significantly decreased(P<0.05),which was significantly lower in the treatment group than in the control group(P<0.05).After treatment,there was no statistically significant difference adverse reaction between the treatment group(0 case)and the control group(1 case of vomiting and nausea,P>0.05).Conclusion The combination of aerosol inhalation and Jianpi Bushen Yifei Formula in patients with SCOPD can improve AMH and pulmonary function,and enhance clinical efficacy.