自拟补肺健脾益肾方治疗慢性阻塞性肺疾病稳定期患者的临床疗效及对血清TGF-β1、bFGF、SOD水平的影响  

Clinical Efficacy of Self-prescribed Bufei Jianpi Yishen Recipe for the Treatment of Patients with Chronic Obstructive Pulmonary Diseases in Stable Period and Its Effect on Serum TGF-β1,bFGF and SOD Levels

作　　者：陈海萍 李永锋[2] 许坚[2] CHEN Hai-Ping;LI Yong-Feng;XU Jian(The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广州中医药大学第二附属医院/广东省中医院,广东广州510120

出　　处：《广州中医药大学学报》2023年第2期321-328,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20201127)。

摘　　要：【目的】探讨自拟补肺健脾益肾方治疗慢性阻塞性肺疾病(COPD)稳定期患者的临床疗效及对血清转化生长因子β1(TGF-β1)、碱性成纤维细胞生长因子(bFGF)、超氧化物歧化酶(SOD)水平的影响。【方法】将86例COPD稳定期肺脾肾虚证患者随机分为对照组和观察组,每组各43例。对照组给予布地奈德吸入剂吸入治疗,并予以常规戒烟、预防呼吸道感染和呼吸功能锻炼。观察组在对照组的基础上联合自拟补肺健脾益肾方治疗,疗程为3个月。观察2组患者治疗前后临床症状评分、慢性阻塞性肺疾病评估测量表(CAT)评分、肺功能指标以及血清TGF-β1、bFGF、SOD水平的变化情况,评价2组患者的临床疗效,并采用改良呼吸困难量表(m MRC)评估患者治疗后的呼吸困难改善情况。【结果】(1)治疗3个月后,观察组的总有效率为95.35%(41/43),对照组为81.40%(35/43),组间比较,观察组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的中医临床症状评分(包括主症评分和次症评分)、CAT评分和急性加重次数均较治疗前降低(P<0.05),且观察组的降低作用均明显优于对照组(P<0.05或P<0.01)。(3)治疗后,2组患者的1秒用力呼气容积(FEV1)、用力肺活量(FVC)及FEV1/FVC等肺功能指标均较治疗前改善(P<0.05),且观察组的改善作用均明显优于对照组(P<0.05或P<0.01)。(4)治疗3个月后,观察组患者的呼吸困难改善程度明显优于对照组(P<0.05)。(5)治疗后,2组患者血清SOD水平均较治疗前升高(P<0.05),血清TGF-β1、b FGF水平均较治疗前降低(P<0.05),且观察组对血清SOD水平的升高作用及对血清TGF-β1、bFGF水平的降低作用均明显优于对照组(P<0.01)。【结论】自拟补肺健脾益肾方对COPD稳定期患者疗效显著,可有效改善患者呼吸困难等临床症状与肺功能,降低急性加重发作次数,提高患者生活质量,其机制可能与清除自由基、降低气道炎症反应及纤维化Objective To investigate the clinical efficacy of self-prescribed Bufei Jianpi Yishen Recipe(a herbal compound mainly with the actions of replenishing lung,strengthening spleen and tonifying kidney) for the treatment of patients with chronic obstructive pulmonary diseases(COPD)in stable period and to observe its effect on serum transforming growth factor β1(TGF-β1),basic fibroblast growth factor(bFGF) and superoxide dismutase(SOD)levels.Methods Eighty-six stable COPD patients with the deficiency of lung,spleen and kidney syndrome were randomly divided into the control group and the observation group,with 43 cases in each group.The control group was given Budesonide Inhalant,and was required to give up smoking,prevent respiratory tract infection and take respiratory function exercise.The observation group was given oral use of self-prescribed Bufei Jianpi Yishen Recipe on the basis of treatment for the control group.The course of treatment for the two groups covered 3 months.Before and after treatment,the changes in traditional Chinese medicine(TCM)symptom scores,COPD assessment test(CAT)scores,lung function indexes and serum TGF-β1,bFGF and SOD levels in the two groups were monitored.After treatment,the clinical efficacy of the two groups was evaluated and the improvement of dyspnea was assessed using the modified British Medical Research Council(mMRC)dyspnea scale.Results (1)After 3 months of treatment,the overall effective rate of the observation group was 95.35%(41/43)and that of the control group was 81.40%(35/43),and the intergroup comparison showed that the efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)After treatment,the TCM symptom scores (including primary symptom scores and secondary symptom scores),CAT scores and the frequency of acute exacerbations in the two groups were all decreased compared with those before treatment(P<0.05),and the effect of the observation group was significantly superior to that of the control group(P<0.05 or P<0.01).(3)

关 键 词：慢性阻塞性肺疾病 稳定期 自拟补肺健脾益肾方 临床症状 肺功能 生活质量 转化生长因子Β1 碱性成纤维细胞生长因子 超氧化物歧化酶 

分 类 号：R259.63[医药卫生—中西医结合]