归肺理气方治疗急性加重期COPD痰热壅肺证临床研究  

Clinical Research on the Prescription of Lung-Converging and Qi-Regulating in the Treatment of Acute Exacerbation Phlegm-heat Blocking the Lung Type of COPD

作　　者：陈颖[1] 李梁[1] 吴诚[1] 胡豆豆[1] 堵玉萍 

机构地区：[1]上海市中西医结合医院,上海200082

出　　处：《中医学报》2016年第4期486-489,共4页Acta Chinese Medicine

基　　金：上海市虹口区卫生和计划生育委员会医学科研课题(虹卫1404-02)

摘　　要：目的:观察归肺理气方治疗急性加重期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)痰热壅肺证的临床疗效,及其对外周血基质金属蛋白酶9(matrix metalloproteinases-9,MMP-9)与金属蛋白酶组织抑制剂1(tissue inhibitor of metalloproteinases-1,TIMP-1)的影响。方法:38例COPD痰热壅肺证急性加重期患者随机分为对照组与观察组。对照组给予西医诊疗指南所述的常规方案,观察组在对照组基础上给予归肺理气方。比较两组临床疗效、肺功能、MMP-9和TIMP-1。经过治疗两组患者均出现不同程度的好转,且观察组的显效率为70.6%,对照组的显效率为23.8%,两者差异有统计学意义(P<0.05);治疗后对照组的用力肺活量(forced vital capacity,FVC)为(2.45±0.19)L,与治疗前比较,差异无统计学意义(P>0.05),第1秒用力呼气容积(forced expiratory volume in one second,FEV1)为(1.54±0.15)L、FEV1/FVC%为(62.85±6.16)%、FEV1%为(71.63±12.15)%,较治疗前显著增加(P<0.05),治疗后观察组的FEV1、FVC、FEV1/FVC%及FEV1%分别为(1.73±0.19)L、(2.51±0.24)L、(68.92±5.98)%、(80.47±10.92)%,较治疗前均显著增加(P<0.05);治疗后对照组与观察组的外周血MMP-9含量分别为(348.01±97.21)μg·L^(-1)、(285.94±86.24)μg·L^(-1),TIMP-1含量分别为(551.75±129.06)μg·L^(-1)、(491.89±106.74)μg·L^(-1),较治疗前均显著下降(P<0.05),对照组治疗后外周血MMP-9/TIMP-1值为0.63±0.14,与治疗前比较,差异无统计学意义(P>0.05),观察组治疗后外周血MMP-9/TIMP-1值为(0.58±0.09),较治疗前均显著下降(P<0.05)。结论:归肺理气方可显著改善COPD痰热壅肺证急性加重期患者的症状,其机制可能与降低MMP-9和TIMP-1含量及MMP-9/TIMP-1值有关。Objective：To survey the clinical therapeutic effect of acute exacerbation phlegm-heat blocking the lung type of chronic obstructive pulmonary disease（ COPD） by using the method of Lung-converging and Qi-regulation,and to survey the influence of the method on peripheral blood matrix metalloproteinases-9（ MMP-9） and tissue inhibitor of metalloproteinases-1（ TIMP-1）. Method：38 patients of phlegm-heat blocking the lung type of COPD were randomly divided into the control group and the observation group. The control group was treated with common diagnostic plan of western medicine. The observation group was given the method of lung-converging and Qi-regulating based on the method of control group. To compare the clinical therapeutic effect,lung function,MMP-9 and TIMP-1. After treatment,the patients’ situation of two group took a favorable turn on different degrees. The treatment effectiveness of the observation group was 70. 6%,while that of the control group was 23. 8%. The difference between them was statistically significant（ P 〈 0. 05）. After the treatment,the forced vital capacity（ FVC） of the control group was（ 2. 45 ±0. 19） L,which has no statistically significant compared with pre-treatment. The forced expiratory volume in one second（ FEV1）was（1. 54 ± 0. 15） L,while FEV1 / FVC% was（62. 85 ± 6. 16） %,and FEV1 % was（71. 63 ± 12. 15） %. There was a significant rise compered with pre-treatment. The FEV1,FVC,FEV1 / FVC% and FEV1% of the observation group were（1. 73 ± 0. 19）L,（2. 51 ± 0. 24） L,（68. 92 ± 5. 98） % and（80. 47 ± 10. 92） % respectively after treatment,which improved significantly compared with pre-treatment（ P 〈 0. 05）. The peripheral blood MMP-9 content of control group and observation group were respectively（348. 01 ± 97. 21） μg·L-1and（285. 94 ± 86. 24） μg·L-1. The TIMP-1 content of control group and observation group were respectively（551. 75 ± 129. 06） μg·L-1and（491. 89 ± 106. 74） μg·L-1,which ha

关 键 词：归肺理气方 慢性阻塞性肺疾病 痰热壅肺证 基质金属蛋白酶9 金属蛋白酶组织抑制剂 

分 类 号：R259.63[医药卫生—中西医结合]