肺力咳合剂联合噻托溴铵粉雾剂在高龄慢性阻塞性肺疾病病人中的效果观察

Effect of Feilike Mixture combined with tiotropium bromide powder aerosol in elderly patients aged≥80 years old with chronic obstructive pulmonary disease

目的观察肺力咳合剂联合噻托溴铵粉雾剂治疗高龄COPD病人的疗效。方法选择2016年5月至2021年1月收治的86例高龄COPD病人,采用随机数表法分为研究组(n=43)与对照组(n=43)。对照组接受基础治疗及噻托溴铵粉雾剂治疗,研究组在对照组的基础上接受肺力咳合剂治疗。2组均治疗2周。对比2组肺功能、免疫功能、细胞因子水平、临床疗效、相关量表评分及不良反应。结果治疗后,2组最大呼气峰流速(PEF)、FEV1、FEV1/FVC均升高(P<0.05),且研究组更高(P<0.05)。治疗后,2组CD3+、CD4+水平均升高(P<0.05),且研究组更高(P<0.05);2组CD8+水平均降低(P<0.05),且研究组更低(P<0.05)。治疗后,2组辅助性T细胞17(Th17)/调节性T细胞(Treg)、IL-10水平均升高(P<0.05),且研究组更高(P<0.05);2组血清IL-17水平均降低(P<0.05),且研究组更低(P<0.05)。研究组总有效率高于对照组(95.35%比79.07%,P<0.05)。治疗后,2组慢性阻塞性肺疾病评估测试(CAT)评分均降低(P<0.05),且研究组更低(P<0.05);治疗后,2组健康调查简表(SF-36)评分均升高(P<0.05),且研究组更高(P<0.05)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论肺力咳合剂联合噻托溴铵粉雾剂治疗高龄COPD病人疗效确切,可改善病人免疫功能、肺功能及生活质量,减轻炎症反应,调节Th17/Treg平衡,且安全可靠。

Objective To observe the effect of Feilike Mixture combined with tiotropium bromide powder aerosol in elderly patients aged≥80 years old with chronic obstructive pulmonary disease(COPD).Methods From May 2016 to January 2021,86 elderly patients with COPD were selected and divided into the study group(n=43)and the control group(n=43)by random number table method.Both groups received basic treatment,and the control group received tiotropium bromide powder inhalation,and the study group received Feilike mixture treatment on the basis of the control group.Both groups were treated for 2 weeks.Lung function,immune function,cytokine level,clinical efficacy,relevant scale score and adverse reactions were compared between the two groups.Results After treatment,the levels of peak expiratory flow rate(PEF),forced expiratory volume in 1 second(FEV1),FEV1/forced vital capacity(FVC),CD3+and CD4+,helper T cell 17(Th17)/regulatory T cell(Treg),interleukin-10(IL-10)and the scores of Health Survey Summary Form(SF-36)were all significantly increased in both groups(P<0.05),especially in the study group(P<0.05).After treatment,the levels of CD8+and IL-17,the score of chronic obstructive pulmonary disease assessment test(CAT)were significantly decreased in both groups(P<0.05),especially in the study group(P<0.05).The total effective rate in the study group was significanthy higher than that in the control group(95.35%vs.79.07%,P<0.05).There was no difference in the total incidence rate of adverse reactions between the two groups(P>0.05).Conclusions Feilike Mixture combined with tiotropium bromide powder aerosol is effective in the treatment of COPD in the elderly patients aged≥80 years old,which can safely improve the immune function,lung function and quality of life of the patients,and reduce inflammation and regulate Th17/Treg balance.