补肺活血颗粒治疗慢性阻塞性肺疾病稳定期患者的疗效及对肺功能、基质金属蛋白酶-9、基质金属蛋白酶抑制剂-1表达的影响  

Bufei Huoxue Granules Affect Lung Function and Expression of MMP-9 and TIMP-1 to Treat the Patients with Stable Chronic Obstructive Pulmonary Disease

作　　者：杭宇 危蕾[1] 王众福 黄婧怡 申燕华[1] 刘芳英[1] HANG Yu;WEI Lei;WANG Zhong-fu;HUANG Jing-yi;SHEN Yan-hua;LIU Fang-ying(Baoshan Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201900)

机构地区：[1]上海中医药大学附属宝山医院,上海201900

出　　处：《世界中西医结合杂志》2023年第6期1206-1210,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：上海市卫生健康委员会科研课题项目(20194Y0468);上海市卫生健康委员会科研课题项目(201940097);国家自然科学基金项目(81903977)。

摘　　要：目的 观察补肺活血颗粒治疗慢性阻塞性肺疾病(Chronic obstructive pulmonary disease, COPD)稳定期的临床疗效并探讨其作用机制。方法 选取2019年1月—2021年10月期间在上海市宝山区中西医结合医院门诊及住院部的76例COPD稳定期患者为研究对象,按随机、对照、双盲的研究方法分为对照组和治疗组,每组各38例。对照组予以沙美特罗替卡松+安慰剂治疗,治疗组予以沙美特罗替卡松+补肺活血颗粒治疗。治疗8周后,观察比较两组患者临床疗效、不良反应,治疗前后第1秒用力呼气容积(Forced Expiratory Volume in the first second, FEV1)、用力肺活量(Forced Vital Capacity, FVC)、FEV1/FVC比值、中医证候积分、慢性阻塞性肺疾病评估测试(COPD assessment test, CAT)评分、基质金属蛋白酶-9(Matrix Metalloproteinase-9,MMP-9)、基质金属蛋白酶抑制剂-1(Tissue Inhibitor of Metalloproteinase-1,TIMP-1)、MMP-9/TIMP-1比值水平。结果 治疗后治疗组总有效率84.2%(32/38)高于对照组总有效率60.5%(23/38),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分及CAT评分均较治疗前降低,差异有统计学意义(P<0.05)。且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组FVC、FEV1、FEV1/FVC均较治疗前升高,差异有统计学意义(P<0.05);且治疗组FVC、FEV1、FEV1/FVC均较对照组同期升高,差异有统计学意义(P<0.05)。治疗后两组患者MMP-9、TIMP-1、MMP-9/TIMP-1水平较治疗前降低,差异有统计学意义(P<0.05);且治疗组低于对照组,差异有统计学意义(P<0.05)。两组患者治疗期间均未发生严重不良反应。结论 补肺活血颗粒可减轻COPD稳定期患者临床症状,改善肺功能,调节基质金属蛋白酶平衡,抑制气道重塑,临床疗效显著,且安全可靠。Objective To observe the clinical efficacy and explore the mechanism of Bufei Huoxue Granules in treating stable chronic obstructive pulmonary disease(COPD).Methods A total of 76 patients with stable COPD treated in Baoshan Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2019 to October 2021 were selected and assigned into control and observation groups(n=38)according to a randomized,double-blind,controlled clinical research method.The control group was treated with salmeterol and placebo,and the observation group with salmeterol and Bufei Huoxue Granules.Both groups were treated for 8 weeks.The clinical efficacy and adverse reactions were compared between the two groups.The forced expiratory volume in the first second(FEV1),the forced vital capacity(FVC),the FEV1/FVC ratio,TCM syndrome scores,COPD assessment test(CAT)score,levels of matrix metalloproteinase-9(MMP-9)and tissue inhibitor of metalloproteinase-1(TIMP-1),and MMP-9/TIMP-1 ratio were measured and recorded.Results The total response rate in the observation group was 84.2%(32/38),which was higher than that 60.5%(23/38)in the control group(P<0.05).The TCM syndrome scores and CAT score decreased after treatment and were lower in the observation group than in the control group(P<0.05).The treatment in both groups increased the FEV1,FVC,and FEV1/FVC ratio and the values in the observation group were higher than those in the control group(P<0.05).The MMP-9,TIMP-1,and MMP-9/TIMP-1 ratio decreased after treatment and were lower in the observation group than in the control group(P<0.05).No serious adverse reactions occurred during treatment in the two groups.Conclusion Bufei Huoxue Granules can alleviate the clinical symptoms of the patients with stable COPD,improve lung function,regulate metalloproteinase balance,and inhibit airway remodeling,demonstrating significant clinical effects and good safety.

关 键 词：补肺活血颗粒 慢性阻塞性肺疾病 肺功能 气道重塑 

分 类 号：R563[医药卫生—呼吸系统]