苏子降气汤联合布地奈德对稳定期慢阻肺患者的疗效研究

摘要/Abstract

摘要： 目的研究苏子降气汤联合布地奈德对稳定期慢阻肺患者的疗效。方法选择2019年1月—2021年12月平凉市崆峒区中医院收治的80例稳定期慢阻肺患者,随机分为两组。对照组单用布地奈德,观察组联用苏子降气汤。检测两组的肺功能[呼气峰流量（PEF）、第一秒用力呼气量（FEV₁）、最大呼吸中期流速（MMEF）和第一秒用力呼气量占用力肺活量比例（FEV₁/FVC）],评估两组生活质量的变化,且检测两组血清白细胞介素-17（IL-17）、细胞间黏附分子-1（ICAM-1）、C 反应蛋白（CRP）、趋化因子13（CXCL13）和肿瘤坏死因子-α（TNF-α）水平。结果观察组的有效率明显高于对照组（P<0.05）。治疗前,两组PEF、FEV₁/FVC、MMEF和FEV₁比较差异无统计学意义（P>0.05）;治疗后,两组PEF、FEV₁/FVC、MMEF和FEV₁均明显升高（P<0.05）,且观察组PEF、FEV₁/FVC、MMEF和FEV₁更高（P<0.05）。治疗前,两组慢阻肺评估测试问卷（CTA）评分比较差异无统计学意义（P>0.05）;治疗后,两组CAT评分均明显降低（P<0.05）,且观察组更低（P<0.05）。治疗前,两组血清IL-17、ICAM-1、CRP、CXCL13和TNF-α水平比较差异无统计学意义（P>0.05）;治疗后,两组血清IL-17、ICAM-1、CRP、CXCL13和TNF-α水平均明显降低（P<0.05）,且观察组的血清IL-17、ICAM-1、CRP、CXCL13和TNF-α水平更低（P<0.05）。结论苏子降气汤联合布地奈德对稳定期慢阻肺患者有显著的疗效,能明显改善肺功能,提高生活质量,减轻炎症反应,值得临床应用。

关键词: 苏子降气汤, 布地奈德, 稳定期, 慢阻肺

Abstract: Objective To investigate the effect of Suzi Jiangqi Decoction combined with budesonide on patients with chronic obstructive pulmonary disease in stable stage. Methods Selected 80 cases of patients with chronic obstructive pulmonary disease from January 2019 to December 2021, divided into two groups randomly. The control group was treated with budesonide alone, and the observation group was treated with Suzi Jiangqi Decoction. The pulmonary function [peak expiratory flow (PEF), forced expiratory volume in the first second (FEV₁), maximum mid respiratory flow (MMEF), and forced expiratory volume in the first second (FEV₁/FVC)] of the two groups were measured to assess the changes in quality of life, and serum interleukin-17 (IL-17), intercellular adhesion molecule-1 (ICAM-1), C-reactive protein (CRP), chemokine 13 (CXCL13), and tumor necrosis factor (TNF-α) were detected. Results The effective rate of the observation group was significantly higher than control group (P<0.05). Before treatment, there was no significant difference in PEF, FEV₁/FVC, MMEF and FEV₁ between the two groups (P>0.05). After treatment, PEF, FEV₁/FVC, MMEF and FEV₁ in the two groups were significantly increased (P<0.05), and PEF, FEV₁/FVC, MMEF and FEV₁ in the observation group were significantly higher (P<0.05). Before treatment, there was no significant difference between the two groups in chest distress, cough, housework, expectoration, going out, sleep, energy, climbing score and CAT total score (P>0.05). After treatment, the chest distress, cough, housework, expectoration, going out, sleep, energy, climbing score and CAT total score of the two groups were significantly reduced (P<0.05), and the observation group were lower (P<0.05). Serum IL-17, ICAM-1, CRP, CXCL13 and TNF- α in both groups before treatment has no significant difference(P>0.05), after treatment, serum IL-17, ICAM-1, CRP, CXCL13 and TNF-α decreased significantly (P<0.05), and the levels of IL-17, ICAM-1, CRP, CXCL13 and TNF-α in the observation group were lower (P<0.05). Conclusion Suzi Jiangqi Decoction combined with budesonide has a significant effect on patients with chronic obstructive pulmonary disease in stable stage, which can significantly improve lung function, improve quality of life, and reduce inflammatory reaction, and is worthy of promotion.

Key words: Su Zi Jiang Qi tang, budesonide, stable period, chronic obstructive pulmonary disease

中图分类号:

R259

赵亚飞. 苏子降气汤联合布地奈德对稳定期慢阻肺患者的疗效研究[J]. 中华养生保健, 2023, 41(12): 34-37.

ZHAO Ya-fei. Study on the Therapeutic Effect of Suzi Jiangqi Decoction Combined with Budesonide on Patients with Chronic Obstructive Pulmonary Disease in Stable Stage[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(12): 34-37.

参考文献

[1] 李静,刘红梅,肖文香.糖皮质激素联合沙丁胺醇雾化吸入对慢阻肺急性加重期患者的疗效及肺功能,炎症因子的影响[J].海南医学,2021,32(16):2062-2065.
[2] 张绍塘,陈伦,叶健.多索茶碱联合盐酸氨溴索对老年稳定期慢阻肺患者血清IL-33/sST2轴表达的影响[J].中国临床药理学杂志,2022,38(4):291-295.
[3] 王蓓蓓,崔娜娟.苏子降气汤联合噻托溴铵对稳定期慢阻肺患者SGRQ评分,SAA水平及氧合指数的影响[J].四川中医,2022,40(8):81-84.
[4] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组,中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会.慢性阻塞性肺疾病诊治指南(2021年修订版)[J].中华结核和呼吸杂志,2021,44(3):170-205.
[5] 李建生,李素云,余学庆.慢性阻塞性肺疾病中医诊疗指南:2011版[J].中医杂志,2012,53(1):80-84.
[6] 阎丽,张春霞,孙希蓉,等.β-内酰胺类抗菌药物联合胸腺肽治疗慢阻肺并发肺部感染的临床疗效[J].中华医院感染学杂志,2021,31(10):1517-1521.
[7] 潘海洋,卢立国,严明月,等.慢阻肺急性加重期肺功能与呼出气一氧化氮,血清维生素D,IL-13水平的相关性分析[J].临床肺科杂志,2021,26(9):1343-1347.
[8] 许柳柳,朱洁晨,卞宏,等.布地奈德福莫特罗联合噻托溴铵吸入剂治疗慢阻肺疗效及对CRP,SaO2,PH水平影响[J].现代生物医学进展,2020,22(20):4369-4372.
[9] 孙宁,朱根源.补中益气汤合二陈汤联合针刺对慢阻肺合并睡眠呼吸暂停低通气综合征患者凝血功能,免疫及心肺功能影响[J].血栓与止血学,2022,28(4):574-576.
[10] 马文静,张维利,刘素梅,等.加味温胆汤对痰湿蕴肺型慢性阻塞性肺疾病急性加重期患者炎症细胞因子表达及BODE指数的影响[J].中医药信息,2022,39(9):53-57,62.
[11] 山萌,黄刚,李猛,等.益肺化痰活血颗粒治疗慢阻肺稳定期气虚痰瘀互结型的临床研究[J].现代中西医结合杂志,2020,29(23):2527-2530,2544.
[12] 丁睿,韩涛.苏子降气汤联合氨茶碱对慢性肺心病伴呼吸衰竭患者肺功能及血清炎症因子影响的研究[J].中医药学报,2022,50(3):67-71.
[13] 袁琛,朱振刚.苏子降气汤对慢性阻塞性肺疾病急性期痰浊阻肺证的临床疗效及对内分泌功能的影响[J].中药材,2021,44(5):1239-1243.
[14] 康艳,李耀辉,刘伊莎,等.基于网络药理学探究苏子降气汤治疗慢性阻塞性肺疾病作用机制[J].国际中医中药杂志,2021,43(12):1240-1246.
[15] 田琳,袁成波,姜威,等.补肺活血中药对间质性肺病患者血清KL-6,CXCL13及预后的影响[J].吉林中医药,2021,41(1):78-81.
[16] 王静,苗姝,佟金平,等.CXCL13在支气管哮喘患者的表达情况及其与IgE,EOS和肺功能的相关性[J].重庆医学,2022,51(18):3161-3165.
[17] 张新红,陈兴无,孙海燕.老年急性加重期慢阻肺患者血清TNF-α,HDAC2及PTX3的动态变化[J].临床肺科杂志,2022,27(9):1367-1370.
[18] 孙印,何士杰,景卫革,等.慢性阻塞性肺疾病患者血清IL-21,IL-17,TLR4的表达及临床意义[J].临床肺科杂志,2020,25(9):1363-1366.
[19] 王晓林,李静,黄艳丽.ICAM-1对脓毒症所致急性肺损伤与呼吸窘迫综合征的临床诊断和预后评估作用[J].中国实验诊断学,2020,24(5):759-762.