百令胶囊联合补肺活血胶囊对肺肾气虚证慢性阻塞性肺疾病稳定期患者肺康复的影响  

Effect of Bailing Capsules Combined with Bufei Huoxue Capsules on Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease at Stable Stage of Lung-kidney-Qi Deficiency Syndrome

作　　者：白淑荣[1] 吴源[1] 王艳[1] 刘军 李萍[1] 沈乐[1] 杨静[1] 

机构地区：[1]宁夏回族自治区人民医院,西北民族大学第一附属医院,银川750001 [2]商都县中医院,内蒙古商都013450

出　　处：《中国实验方剂学杂志》2016年第24期182-186,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：宁夏自然科学基金资助项目(NZ15184)

摘　　要：目的:探讨百令胶囊合补肺活血胶囊对慢性阻塞性肺疾病(COPD)稳定期患者疾病康复的疗效及对免疫功能、白细胞介素-10(IL-10),IL-17的影响。方法:168例患者采用随机按数字表法分为对照组83和观察组85例。对照组采用沙美特罗替卡松粉吸入剂,25μg/次,2次/d;若症状控制不良,加用氨茶碱片口服,0.1 g,2次/d;并给予营养、氧疗和疾病健康教育指导。观察组在对照组治疗的基础上服用百令胶囊,3粒/次,3次/d,和补肺活血胶囊4粒/次,3次/d,口服。疗程为每2周随访1次,共随访12次,两组疗程均为24周。记录24周内COPD急性加重次数及持续时间,记录24周内感冒发作次数及持续时间。进行症状、体征、肺肾气虚证、改良版英国医学研究委员会呼吸问卷(m MRC),慢阻肺患者自我评估测试问卷和圣乔治呼吸问卷(SGRQ)评分;进行治疗前后肺功能检查,记录用力肺活量(FVC),第1秒用力呼气容积(FEV1)和FEV1%;检测治疗前后血清免疫球蛋白G(IgG),免疫球蛋白M(IgM),免疫球蛋白A(IgA),补体C3,C4,IL-17和IL-10水平。结果:经Ridit分析,观察组中医证候疗效优于对照组(P<0.05);治疗后观察组FVC,FEV1和FEV1%均高于对照组(P<0.05);治疗后观察组SGRQ量表3个维度评分及总分均低于对照组(P<0.01);治疗后观察组IL-17水平低于对照组,IL-10水平高于对照组(P<0.01);治疗后观察组IgG,IgM,IgA水平均高于对照组(P<0.01);两组补体C3和C4水平治疗前后变化无统计学意义;在24周的观察期间,观察组感冒发作次数,COPD急性加重次数均少于对照组,其持续时间短于对照组(P<0.01)。结论:百令胶囊合补肺活血胶囊治疗COPD稳定期肺肾气虚证患者,能控制症状、改善肺功能,提高患者的生活质量和机体免疫功能,减轻炎症反应,稳定病情,促进肺康复的作用。Objective： To discuss the efficacy of Bailing capsules combined with Bufei Huoxue capsules in treating chronic obstructive pulmonary diseases at stationary phase,and their effect on immunologic function,interleukin-10（ IL-10） and interleukin-17（ IL-17）. Method： One hundred and sixteen-eight patients were divided into control group（ 83 cases） and observation group（ 85 cases） by random number table. Patients in control group got salmeterol and fluticasone propionate inhalation 25 μg / time,bid,as well as nourishment,oxygen therapy and guidance of health education for disease. In addition to the therapy of control group,patients in observation group was also given Bailing capsules,3 gains / time,tid,and Bufei Huoxue capsules,4 gains / time,tid. A follow-up visit was made once every 2 weeks,and the courses of treatment were 24 weeks. Frequency of acute exacerbation COPD and duration were recorded within 24 weeks. And frequency and duration of cold attacks were recorded within 24 weeks. Symptoms,signs,syndrome of qi deficiency of lung and kidney,improved version of the British Medical Research Council respiratory questionnaire（ m MRC）,self-assessment test questionnaire for patients with chronic obstructive pulmonary disease and St George＇s respiratory questionnaire（ SGRQ） were scored. Before and after treatment,lung function was detected. Forced vital capacity（ FVC）,forced expiratory volume for 1 second（ FEV1） and FEV1% were recorded. Levels of IgG,IgM,IgA,alexin C3 and C4 and IL-17 and IL-10 were detected. Result： Through analysis on Ridit,the total rate of TCM symptoms in observation group was superior to that in control group（ P〈0. 05）. Scores of cough,sputum expectoration,puffing,chest distress,short breathe,weakness,cyanosis,syndrome of qi deficiency of lung and kidney,m MRC and CAT in observation group were lower than those in control group（ P〈0. 01）. After treatment,FVC,FEV1 and FEV1% in observation group were higher than those in control group（ P〈0. 05�

关 键 词：慢性阻塞性肺疾病 稳定期 肺肾气虚 百令胶囊 补肺活血胶囊 白细胞介素-10 白细胞介素-17 

分 类 号：R287[医药卫生—中药学]