加味小青龙汤联合噻托溴铵治疗COPD稳定期患者的效果

Effect of modified Xiaoqinglong decoction combined with tiotropium bromide in the treatment of patients with stable COPD

目的探讨加味小青龙汤联合噻托溴铵治疗COPD稳定期患者的临床效果。方法选择本科室收治的200例COPD稳定期为研究对象,按照随机数表法将患者分为常规组(n=100,噻托溴铵治疗)和联合组(n=100,加味小青龙汤联合噻托溴铵治疗),比较两组患者呼吸困难指数、运动耐力、临床症状积分、气道重构、肺功能、炎症因子及免疫功能水平及生活质量。结果治疗后,联合组呼吸困难指数、咳嗽、气喘及咳痰积分、气道壁厚度、白细胞介素-6、C反应蛋白水平明显低于常规组,6 min步行距离、气道内径、用力肺活量、1 s用力呼气容积、CD4^+及CD3^+水平明显优于常规组(P<0.05)。停药后3个月,两组患者EORTCQLQ-C30评分均显著升高,且联合组高于常规组(P<0.05)。结论加味小青龙汤联合噻托溴铵应用于COPD稳定期患者中,可抑制气道重构,改善患者肺功能及炎症反应,提高免疫功能,运动耐力及生活质量,值得临床推广。

Objective To investigate the therapeutic effect of modified Xiaoqinglong decoction combined with tiotropium bromide in patients with stable COPD. Methods A total of 200 patients with stable COPD admitted in our department were selected as the research objects. The patients were divided into conventional group(n=100, tiotropium bromide treatment)and combined group(n=100, modified Xiaoqinglong decoction combined with tiotropium bromide treatment) according to the random number table method. Dyspnea indexes, exercise endurance, clinical symptom scores, airway remodeling, lung function, inflammatory cytokines, immune function and quality of life were compared between the two groups. Results After treatment, the dyspnea index, scores of cough, wheezing and expectoration, airway wall thickness, levels of interleukin-6 and C-reactive protein in the combined group were significantly lower than those in the conventional group, distance of six-minute walk, airway diameter, forced vital capacity, 1 s forced expiratory volume, levels of CD4^+and CD3^+were significantly better than those in the conventional group(P<0.05). Three months after withdrawal, the EORTCQLQ-C30 scores of both groups significantly increased, and that in the combined group was higher than the conventional group( P <0.05).Conclusion Modified Xiaoqinglong decoction combined with tiotropium bromide in patients with stable COPD can inhibit airway remodeling, improve pulmonary function and inflammatory response, immune function, exercise endurance and quality of life, which is worthy of clinical promotion.