苓桂三子汤辅助治疗老年急性加重期慢性阻塞性肺疾病患者的疗效及其对CTRP5、SFRP5的影响  

Effect of Linggui Sanzi Decoction on Elderly Patients with Acute Exacerbation of COPD and Its Influence on CTRP5 and SFRP5

作　　者：王银菊 李文生 李琳琳 杨秀青 WANG Yin-ju;LI Wen-sheng;LI Lin-lin;YANG Xiu-qing(Department of Pulmonology,Puyang Hospital of Traditional Chinese Medicine,Puyang Henan 457000)

机构地区：[1]河南省濮阳市中医医院肺病科,河南濮阳457000

出　　处：《世界中西医结合杂志》2021年第8期1506-1510,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：2015年度河南省中医药科学研究专项课题(2015ZY02003)。

摘　　要：目的探讨苓桂三子汤辅助治疗老年急性加重期慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)的疗效及其对血清补体C1q肿瘤坏死因子相关蛋白5(CTRP5)和分泌型卷曲相关蛋白5(SFRP5)表达水平的影响。方法选取2017年1月—2018年12月期间河南省濮阳市中医医院肺病科收治的80例老年急性加重期COPD患者(辨证分型为痰瘀互结)为研究对象。按随机数字表法将患者分为西药组和中西结合组,各40例。西药组给予持续低流量吸氧、营养支持、维持水电解质平衡,定时进行吸痰治疗,根据药敏实验结果给予抗生素,支气管扩张剂硫酸特布他林、布地奈德混悬液雾化吸入、静脉滴注多索茶碱。中西结合组在西药组基础上口服苓桂三子汤。两组患者均治疗15 d后,比较两组患者中医症状评分、第1秒用力呼气容积占预计值百分比(FEV_(1) pred%)、1 s用力呼气量/用力肺活量(FEV1/FVC%)、血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))、白细胞、中性粒细胞、C反应蛋白、CTRP5和SFRP5指标。结果治疗后两组患者咳嗽、咯痰、喘息、肺部啰音、胸痛、发热、纳呆及口干评分均明显低于治疗前,差异有统计学意义(P<0.05),且中西结合组治疗后各评分均明显低于西药组,差异有统计学意义(P<0.05)。治疗后两组患者FEV1 pred%和FEV1/FVC%均明显高于治疗前,差异有统计学意义(P<0.05),且中西结合组患者治疗后FEV1/FVC%明显高于西药组,差异有统计学意义(P<0.05)。治疗后两组患者PaO_(2)、SaO_(2)均明显高于治疗前,PaCO_(2)明显低于治疗前,差异有统计学意义(P<0.05);且中西结合组治疗后PaO_(2)、SaO_(2)均高于西药组,PaCO_(2)低于西药组,差异有统计学意义(P<0.05)。治疗后两组患者白细胞计数、中心粒细胞百分比、C反应蛋白和CTRP5均明显低于治疗前,SFRP5明显高于治疗前,差异有统计学意义(P<0.05);且中西结合组Objective To explore the efficacy of Linggui Sanzi Decoction in adjuvant treatment of chronic obstructive pulmonary disease(COPD)in the elderly with acute exacerbation and its expression of serum complement-C1q/TNF-related protein 5(CTRP5)and secreted frizzled related protein 5(SFRP5).Methods From January 2017 to December 2018,80 elderly patients with acute exacerbation COPD admitted to the Department of Pulmonology,Puyang Hospital of Traditional Chinese Medicine,Henan Province,were selected as the research objects.According to the random number table,the patients were divided into a western medicine group and a combination of Chinese and Western medicine,40 cases in each group.The western medicine group was given continuous low-flow oxygen inhalation,nutritional support,maintenance of water and electrolyte balance,regular sputum suction treatment,antibiotics,bronchodilator terbutaline sulfate and budesonide suspension inhalation according to the results of drug sensitivity test,Doxofylline was given by intravenous drip;LingguiSanzi Decoction was taken orally on the basis of the western medicine group in the combined Chinese and Western medicine group.After 15 days of treatment,the two groups were compared with the TCM symptom scores,the forced expiratory volume in the first second as a percentage of the predicted value(FEV1 pred%),the forced expiratory volume in 1 s/forced vital capacity(FEV_(1)/FVC%),and the partial pressure of blood oxygen(PaO_(2)),carbon dioxide partial pressure(PaCO_(2)),blood oxygen saturation(SaO_(2)),white blood cells,neutrophils,C-reactive protein,CTRP5 and SFRP5 indicatorswere compared between the two groups.Results After treatment,the scores of cough,expectoration,wheezing,lung rales,chest pain,fever,appetite,and dry mouth were significantly lower in the two groups after treatment(P<0.05),and the scores of the combined Chinese and Western treatment group were all lower after treatment It was significantly lower than the western medicine group(P<0.05).After treatment,the FEV1 pred%and F

关 键 词：苓桂三子汤 慢性阻塞性肺疾病 炎症 CTRP5 SFRP5 

分 类 号：R563[医药卫生—呼吸系统]