参附汤加味联合布地奈德福莫特罗粉及茶碱缓释片治疗慢性阻塞性肺疾病稳定期肺肾两虚型患者的临床疗效

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英文篇名：Clinical Effect of Modified Shenfu Decoction Combined with Budesonide and Formoterol Fumarate Powder and Theophylline Sustained Release Tablets in Treating Stable COPD Patients Diagnosed as TCM Lung Kidney Concur Defic 作者：陈茜 ; 毛艳 英文作者：CHEN Qian;MAO Yan;Department of Gerontology,the Traditional Chinese Medicine Hospital of Xi'an; 关键词：肺疾病 ; 慢性阻塞性 ; 肺肾两虚型 ; 参附汤加味 ; 布地奈德福莫特罗粉 ; 茶碱缓释片 英文关键词：Pulmonary disease,chronic abstractive;;Lung kidney concur defic;;Shenfu decoction;;Budesonide and formoterol fumarate powder;;Theophylline sustained release tablets 中文刊名：SYXL 英文刊名：Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease 机构：陕西省西安市中医医院老年病科; 出版日期：2018-05-25 出版单位：实用心脑肺血管病杂志 年：2018 期：v.26 语种：中文; 页：SYXL201805038 页数：4 CN：05 ISSN：13-1258/R 分类号：128-131

摘要

目的观察参附汤加味联合布地奈德福莫特罗粉及茶碱缓释片治疗慢性阻塞性肺疾病(COPD)稳定期肺肾两虚型患者的临床疗效。方法选取2016年2月—2017年8月西安市中医医院收治的COPD稳定期肺肾两虚型患者96例,采用随机数字表法分为对照组和观察组,每组48例。在常规治疗基础上,对照组患者给予布地奈德福莫特罗粉及茶碱缓释片治疗,观察组在对照组基础上给予参附汤加味;两组患者均连续治疗3个月。比较两组患者临床疗效,前后中医证候积分、肺功能指标、实验室检查指标。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者咳痰、气喘、咳嗽评分比较,差异无统计学意义(P>0.05);治疗后观察组患者咳痰、气喘、咳嗽评分低于对照组(P<0.05)。治疗前两组患者第1秒用力呼吸容积占预计值的百分比(FEV_1%)、用力肺活量(FVC)、最大呼气流量(PEF)比较,差异无统计学意义(P>0.05);治疗后观察组患者FEV_1%、FVC、PEF高于对照组(P<0.05)。治疗前两组患者血清干扰素-G诱导蛋白10(IP-10)、肺表面活性物质蛋白D(SP-D)、核因子κB(NF-κB)水平,RDW,痰Kelch样环氧氯丙烷相关蛋白-1(Keap1)、核转录因子红细胞系-2p45(Nrf2)相对表达量比较,差异无统计学意义(P>0.05);治疗后观察组患者血清IP-10、SP-D、NF-κB水平及RDW低于对照组,痰Nrf2、Keap1相对表达量高于对照组(P<0.05)。结论参附汤加味联合布地奈德福莫特罗粉及茶碱缓释片治疗COPD稳定期肺肾两虚型患者的临床疗效确切,可有效缓解临床症状、改善肺功能、减轻炎性反应并增强抗氧化功能。
        Objective To observe the clinical effect of modified Shenfu decoction combined with budesonide and formoterol fumarate powder and theophylline sustained release tablets in treating stable COPD patients diagnosed as TCM lung kidney concur defic. Methods A total of 96 stable COPD patients diagnosed as TCM lung kidney concur defic were selected in the Traditional Chinese Medicine Hospital of Xi'an from February 2016 to August 2017,and they were divided into control group and observation group according to random number table,each of 48 cases. Based on conventional treatment,patients in control group received budesonide and formoterol fumarate powder combined with theophylline sustained release tablets,while patients in observation group received modified Shenfu decoction based on that of control group;both groups continuously treated for 3 months. Clinical effect,TCM symptoms score,index of pulmonary function and laboratory examination results before and after treatment were compared between the two groups. Results Clinical effect in observation group was statistically significantly better than that in control group(P<0.05). No statistically significant differences of expectoration score,asthma score or cough score was found between the two groups before treatment(P>0.05),while expectoration score,asthma score and cough score in observation group were statistically significantly lower than those in control group after treatment(P<0.05). No statistically significant differences of FEV_1%,FVC or PEF was found between the two groups before treatment(P>0.05),while FEV_1%,FVC and PEF in observation group were statistically significantly higher than those in control group after treatment(P<0.05).No statistically significant differences of serum level of IP-10,SP-D or NF-κB,RDW,sputum relative expression quantity ofNrf2 or Keap1 was found between the two groups before treatment(P>0.05);after treatment,serum levels of IP-10,SP-Dand NF-κB,and RDW in observation group were statistically significantly lower than those in control group,while sputumrelative expression quantity of Nrf2 and Keap1 in observation group was statistically significantly higher than that in controlgroup,respectively(P<0.05). Conclusion Modified Shenfu decoction combined with budesonide and formoterol fumaratepowder and theophylline sustained release tablets has certain clinical effect in treating stable COPD patients diagnosed as TCMlung kidney concur defic,can effectively relieve the clinical symptoms and inflammatory reaction,improve the pulmonaryfunction,enhance the antioxidant function.

引文

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