宽胸理肺汤对COPD急性加重期患者FeNO值及血清炎症因子的影响  

Clinical Observation of Kuanxiong Lifei Decoction Effects on FeNO and Serum Inflammatory Factor at the Acute Stage of COPD

作　　者：陈婷 吴文珍 黄雪元 胡明露 赵稼萤 朱绮 陶蕾 Chen Ting;Wu Wenzhen;Huang Xueyuan(Jiading TCM Hospital of Shang-hai,Shanghai 201899,China)

机构地区：[1]上海嘉定区中医医院,上海201899 [2]上海市黄浦区豫园街道社区卫生服务中心,上海200011

出　　处：《中国中医急症》2018年第8期1423-1426,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：上海市嘉定区卫生和计划生育委员会项目(2015-QN-ZYY-07)

摘　　要：目的观察宽胸理肺汤加载治疗对慢性阻塞性肺疾病(COPD)急性加重期(痰浊壅肺证)患者呼出气一氧化氮测定(FeNO)值以及血清炎症因子白介素-1(IL-1)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的影响。方法 80例患者随机分为两组。对照组以西医常规方法治疗;宽胸理肺汤组在对照组基础上加服宽胸理肺汤(每日2次),1周为1疗程,观察两组临床疗效、治疗前后FeNO值变化、血气分析指标(PaCO_2、PaO_2)、血清炎症因子(IL-1、IL-6、TNF-α)、主要临床症状评分(喘息、咳嗽、咯痰、哮鸣、胸痛)及肺通气功能指标(FVC、FEV1)的变化情况。结果宽胸理肺汤组临床疗效优于对照组(P<0.05);宽胸理肺汤组治疗后FeNO值下降,与对照组相比有显著差异(P<0.05);宽胸理肺汤组治疗后PaCO_2、PaO_2均升高,与对照组差异有统计学意义(P<0.05);宽胸理肺汤组治疗后血清炎症因子(IL-1,IL-6,TNF-α)降低,与对照组差异有统计学意义(P<0.05);宽胸理肺汤组治疗后喘息、咯痰、咳嗽、哮鸣、胸痛评分均降低,与对照组差异有统计学意义(P<0.05);宽胸理肺汤组治疗后FVC、FEV1较治疗前均升高,与对照组差异有统计学意义(P<0.05)。结论在西药基础上合用宽胸理肺汤临床有效,并能有效降低AECOPD(痰浊壅肺证)患者FeNO值及血清炎症因子水平,并能有效升高血氧分压,改善患者肺功能。Objective： To observe the clinical effects of Kuanxiong Lifei Decoction on FeNO and serum inflammatory factors（IL-1,IL-6,TNF-α） at the acute stage of COPD patients with turbid phlegm obstructing lung syndrome. Methods： 80 cases were randomly divided into 2 groups. In the experimental group,41 cases were treated by Western medicine routine treatment,39 cases in Kuanxiong Lifei Decoction（KSLFD） group were added Kuanxiong Lifei Decoction on the basis of the experimental group,twice a day. A week was a treatment course.The clinical effects,the changes of FeNO,blood-Qi analysis indexes（PaCO2,PaO2）,serum inflammatory factor value（IL-1,IL-6,TNF-α）,major clinical symptom scores（pant,coughing,expectoration,wheezing,chest pain）and pulmonary ventilation function indexes（FVC,FEV1） before and after treatment were observed. Results： The curative effect of Kuanxiong Lifei Decoction（KSLFD） group was better than that of the experimental group（P〈0.05）. The FeNO value decreased after treatment in Kuanxiong Lifei Decoction（KSLFD） group;compared with the experimental group,there was a significant difference（P〈 0.05）. PaCO2 and PaO2 rosed in KSLFD group;compared with the experimental group,there was a significant difference（P〈 0.05）. The serum inflammatory factors（IL-1,IL-6,TNF-α） were decreased in KSLFD group;compared with the experimental group,there was a significant difference（P 〈0.05）. The major clinical symptom scores（pant,coughing,expectoration,wheezing,chest pain）were decreased in KSLFD group;compared with the experimental group,there was a significant difference（P 〈0.05）. FVC and FEV1 rose in KSLFD group;compared with the experimental group,there was a significant difference（P〈 0.05）. Conclusion： Kuanxiong Lifei Decoction（KSLFD） combined with Western medicine is of clinical effects,and can effectively reduce FeNO and serum inflammatory factor value of COPD patients with turbid phlegm obstructing lung syndrome,increase the partial pressu

关 键 词：慢性阻塞性肺疾病 宽胸理肺汤 呼出气一氧化氮测定 FENO 血清炎症因子 

分 类 号：R563.9[医药卫生—呼吸系统]