加味补肺纳气汤对COPD急性加重期患者肺功能及血清炎症因子水平的影响  

Effect of jiawei bufei na qi decoction on lung function and serum inflammatory factor level in patients with acute exacerbation of COPD

作　　者：杨春青 王恩静 李亮 姜剑松[2] YANG Chunqing;WANG Enjing;LI Liang(Internal medicine,The Traditional Chinese medicine Hospital of Wuwei City,WuWei AnHui 238300,China)

机构地区：[1]无为市中医医院内科,安徽无为238300 [2]南通市第一人民医院呼吸科,江苏南通226014

出　　处：《四川中医》2024年第5期92-96,共5页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:探讨加味补肺纳气汤用于慢性阻塞性肺病(COPD)急性加重期对患者肺功能及血清炎症因子水平的影响。方法:选择我院2017年2月~2019年2月收治的58例COPD急性加重期患者为研究对象,利用随机数字法将其分成联合组和常规组,均29例。常规组入院后行常规治疗,包括酸碱平衡以及水电解质纠正、口服抗胆碱、抗感染药物等。联合组在常规组基础上给予加味补肺纳气汤治疗。比较两组患者临床疗效和治疗前后肺功能指标[用力肺活量(FVC)、第1s用力呼气容积(FEV_(1))、最高呼气流速(PEF)]及CAT评分,对比两组患者治疗前后血清炎症因子[肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)、前降钙素(PCT)]和呼吸力学相关指标[气道峰压(PIP)、呼吸做功(WOB)、气道阻力(Raw)、动态顺应性(Cdyn)]差异,最后统计两组患者不良发应发生情况。结果:联合组治疗后总有效率93.10%显著高于常规组68.97%(P<0.05)。联合组治疗后FVC显著高于治疗前及常规组治疗后(P<0.05);联合组治疗后CAT评分显著低于治疗前及常规组治疗后(P<0.05);两组治疗前后组内比较FEV_(1)和PEF显著增高(P<0.05);两组FEV1和PEF治疗前后组间比较(P>0.05)。联合组治疗后TNF-α、CRP和IL-6显著低于治疗前及常规组治疗后(P<0.05);两组治疗前后组内比较PCT显著降低(P<0.05);两组PCT治疗前后组间比较(P>0.05)。联合组治疗后PIP、WOB和Raw显著低于治疗前及常规组治疗后(P<0.05);联合组治疗后Cdyn显著高于治疗前及常规组治疗后(P<0.05)。联合组不良反应总发生率17.24%与常规组10.34%比较(P>0.05)。结论:加味补肺纳气汤治疗COPD急性加重期患者,可提高治疗效果,增强肺功能,降低炎症水平,改善呼吸力学指标,不会增加不良反应总发生率,具有一定的临床应用价值。Objective To investigate the effect of jiawei bufei na qi decoction on lung function and serum inflammatory factors in patients with chronic obstructive pulmonary disease(COPD)during acute exacerbation.Methods A total of 58patients with acute exacerbation of COPD admitted to our hospital from February 2017to February 2019were selected as the study objects,and they were divided into the combined group and the conventional group by random number method,with 29patients.The routine group received routine treatment after admission,including acid-base balance and water electrolyte correction,oral anticholine,anti-infection drugs,etc.The combined group was treated with jiawei bufei nanqi decoction on the basis of the conventional group.Compare the clinical efficacy and lung function indexes[forced vital capacity(English abbreviation,FVC),forced expiratory volume(English abbreviation,FEV_(1)),maximum expiratory flow rate(English abbreviation,PEF)]and CAT scores of the two groups before and after treatment.Comparison of serum inflammatory factors[tumor necrosis factor-α(English abbreviation,TNF-α),C-reactive protein(English abbreviation,CRP),interleukin-6(English abbreviation,IL-6),pre-and post-treatment Calcitonin(English abbreviation,PCT)]and respiratory mechanics indicators[peak air pressure(English abbreviation,PIP),respiratory work(English abbreviation,WOB),airway resistance(English abbreviation,Raw),dynamic compliance(Cdyn)]difference,and finally calculated the incidence of adverse reactions in the two groups of patients.ResultsThe total effective rate of the combined group after treatment was 93.10%,which was significantly higher than that of the conventional group,68.97%(P<0.05).After treatment,the FVC in the combination group was significantly higher than that before the treatment and after the conventional group(P<0.05);the CAT score after the combination group was significantly lower than that before the treatment and after the conventional group(P<0.05);FEV_(1)and PEF were significantly increased in the two

关 键 词：加味补肺纳气汤 慢性阻塞性肺病 呼吸 肺功能 

分 类 号：R563[医药卫生—呼吸系统]