清肺颗粒对慢性阻塞性肺疾病伴呼吸衰竭患者血清炎症因子和黏蛋白5AC的影响

The effect of Qingfei granules on serum inffammatory markers and mucoprotein 5AC in sputum of patients with chronic obstructive pulmonary disease accompanied by respiratory failure

目的 观察清肺颗粒对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)伴呼吸衰竭患者血清炎症指标及血液黏蛋白(mucoprotein,MUC)5AC的影响。方法 应用SPSS26.0软件产生随机数字,结合依次就诊顺序,随机分为治疗组和对照组。所有患者在接受14 d常规治疗的同时,治疗组口服清肺颗粒,对照组口服清肺颗粒模拟剂。观察患者治疗的临床总有效率、单项症状积分、中医证候积分、动脉氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、血清D-二聚体、C-反应蛋白(C-reactive protein,CRP)、白介素(interleukin,IL)-6、MUC5AC水平及不良反应等。结果 选取2021年12月至2023年9月上海市中医医院呼吸科收治的COPD伴呼吸衰竭患者64例,治疗前两组患者单项症状积分、中医证候积分、PaO_(2)、PaCO_(2)及血清D-二聚体、CRP、IL-6、MUC5AC水平比较,无统计学差异(P>0.05)。治疗后,治疗组的临床总有效率高于对照组,具有统计学差异(P<0.05)。两组患者中医证候积分比较,有统计学差异(P<0.05);两组患者PaO_(2)较治疗前显著升高(P<0.05),但治疗后两组患者之间比较,无统计学差异(P>0.05);两组患者PaCO_(2)均较治疗前显著下降(P<0.05),但治疗后两组患者之间比较,无统计学差异(P>0.05);两组患者血清CRP、IL-6及MUC5AC水平均较治疗前显著下降 (P<0.05),且治疗组患者血清IL-6、MUC5AC水平较对照组下降更明显(P<0.05)。两组患者均未发生严重不良反应。结论 清肺颗粒治疗COPD伴呼吸衰竭患者,可有效改善患者咳痰困难,降低气道黏液高分泌状态,抑制炎症反应,改善患者呼吸功能。

Objective To observe the effect of Qingfei granules on serum inflammatory markers and mucprotein(MUC)5AC in patients with chronic obstructive pulmonary disease(COPD)accompanied by respiratory failure.Methods SPSS 26.0 software was used to generate random numbers, and the patients were randomly divided into a treatment group and a control group according to the order of their visits. All patients received routine treatment for 14 days, and at the same time, the treatment group took oral Qingfei granules and the control group took a placebo. Total clinical effective rate, patient symptoms, traditional Chinese medicine(TCM) syndrome scores, arterial oxygen pressure(PaO_(2)), arterial carbon dioxide pressure(PaCO_(2)), serum D-dimer, C-reactive protein(CRP), interleukin(IL)-6, MUC5AC levels, and adverse reactions were observed. Results Sixty-four cases with COPD accompanied by respiratory failure admitted to the Department of Respiratory, Shanghai Municipal Hospital from December 2021 to September 2023 were selected. Before treatment, there was no signiffcant difference in single symptom score, TCM syndrome scores, PaO_(2), PaCO_(2), the levels of serum D-dimer, CRP, IL-6, and MUC5AC between the two groups(P>0.05). After treatment, the total effective rate of the treatment group was higher than that of the control group, with statistical difference(P<0.05). There was a signiffcant difference in TCM syndrome scores between the two groups(P<0.05). The PaO_(2) in both groups increased signiffcantly after treatment(P<0.05), but there was no signiffcant difference between the two groups after treatment(P>0.05). The PaCO_(2) in both groups decreased signiffcantly after treatment(P<0.05), but there was no signiffcant difference between the two groups after treatment(P>0.05). The levels of CRP, IL-6, and MUC5AC in both groups decreased signiffcantly compared to before treatment(P<0.05), and the levels of IL-6, and MUC5AC in the treatment group were signiffcantly decreased compared to the control group(P<0.05). There was no serious adverse reactions in both groups. Conclusion Qingfei granules can effectively improve expectoration difficulties, reduce airway mucus hypersecretion, suppress inffammatory reactions, and improve respiratory function in patients with COPD accompanied by respiratory failure.