补肺活血汤治疗稳定期慢性阻塞性肺疾病的临床观察
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摘要
[目的]探讨补肺活血汤治疗稳定期慢性阻塞性肺疾病(COPD)的临床疗效。[方法]选择2016年1月—2017年12月收治的103例COPD稳定期患者,根据随机数字表法分为对照组和治疗组,其中对照组51例、治疗组52例。对照组患者给予常规治疗措施,治疗组患者在对照组治疗的基础上给予补肺活血汤治疗,两组均连续给予治疗12周。评价并比较两组临床疗效。评价两组治疗前后的中医证候评分、6 min步行距离和生活质量评分。测定两组治疗前后的第1秒用力呼气量(FEV1)、用力肺活量(FVC)及FEV1和FVC的比值(FEV1/FVC)。检测两组治疗前后血清白介素-8(IL-8)、α1-抗胰蛋白酶(α1-AT)水平。记录治疗过程中严重不良反应的发生情况。[结果]治疗组的总有效率(88.46%)高于对照组(70.59%,P<0.05)。治疗后,两组FEV1、FVC及FEV1/FVC均较同组治疗前增大(P<0.05),且治疗组FEV1、FVC及FEV1/FVC变化均优于对照组(P<0.05)。治疗后,两组血清IL-8水平均较同组治疗前降低(P<0.05)、血清α1-AT水平均较同组治疗前升高(P<0.05),且治疗组血清IL-8、α1-AT水平变化均优于对照组(P<0.05)。治疗后,两组6 min步行距离均较同组治疗前增大(P<0.05),中医证候积分和生活质量评分均较同组治疗前减小(P<0.05),且治疗组中医证候积分、6 min步行距离及生活质量评分变化均优于对照组(P<0.05)。两组治疗过程中均无严重的不良反应发生。[结论]补肺活血汤治疗稳定期COPD的临床疗效显著,能够明显改善患者的肺功能,提高运动能力和生活质量,推测其作用机制可能与抑制气道炎症反应有关,且安全性较好,值得在临床上推广应用。
[Objective] To explore the clinical efficacy of Bufei Huoxue Decoction in the treatment of stable chronic obstructive pulmonary disease(COPD). [Methods] A total of 103 patients with stable COPD from January 2016 to December 2017 were enrolled in this study. According to the random number table method,the subjects were divided into the control group(n=51) and the treatment group(n=52). The patients in the control group were given routine treatment. The patients in the treatment group were treated with Bufei Huoxue Decoction on the basis of the treatment in the control group,and the two groups were treated continuously for 12 weeks. The clinical efficacy of the two groups after treatment was evaluated and compared. The score of TCM syndromes,6-minute walking distance and quality of life was evaluated before and after treatment. The first second forced expiratory volume(FEV1),forced vital capacity(FVC) and the ratio of FEV1 to FVC(FEV1/FVC) was measured before and after treatment. Serum level of interleukin-8(IL-8) and α1-antitrypsin(α1-AT) was measured before and after treatment in both groups. The occurrence of serious adverse reactions during the treatment of the two groups was recorded. [Results] The total effective rate of the treatment group(88.46%) was higher than that of the control group(70.59%,P<0.05). After treatment,FEV1,FVC and FEV1/FVC in the two groups increased significantly compared with those in the same group before treatment(P<0.05),and the changes of FEV1,FVC and FEV1/FVC in the treatment group was better than those in the control group(P<0.05). After treatment,the level of serum IL-8 in both groups was lower than those before treatment in the same group(P<0.05),and serum α1-AT level was higher than those before treatment in the same group(P<0.05),and the change of serum IL-8 and α1-AT levels in the treatment group was better than those in the control group(P<0.05). There were no serious adverse reactions in both groups. [Conclusion] Bufei Huoxue Decoction is effective in treating stable COPD. It can improve lung function,exercise ability and quality of life. It is speculated that the mechanism of Bufei Huoxue Decoction may be related to inhibiting airway inflammation,and its safety is good. It is worth popularizing and applying in clinic.
[Objective] To explore the clinical efficacy of Bufei Huoxue Decoction in the treatment of stable chronic obstructive pulmonary disease(COPD). [Methods] A total of 103 patients with stable COPD from January 2016 to December 2017 were enrolled in this study. According to the random number table method,the subjects were divided into the control group(n=51) and the treatment group(n=52). The patients in the control group were given routine treatment. The patients in the treatment group were treated with Bufei Huoxue Decoction on the basis of the treatment in the control group,and the two groups were treated continuously for 12 weeks. The clinical efficacy of the two groups after treatment was evaluated and compared. The score of TCM syndromes,6-minute walking distance and quality of life was evaluated before and after treatment. The first second forced expiratory volume(FEV1),forced vital capacity(FVC) and the ratio of FEV1 to FVC(FEV1/FVC) was measured before and after treatment. Serum level of interleukin-8(IL-8) and α1-antitrypsin(α1-AT) was measured before and after treatment in both groups. The occurrence of serious adverse reactions during the treatment of the two groups was recorded. [Results] The total effective rate of the treatment group(88.46%) was higher than that of the control group(70.59%,P<0.05). After treatment,FEV1,FVC and FEV1/FVC in the two groups increased significantly compared with those in the same group before treatment(P<0.05),and the changes of FEV1,FVC and FEV1/FVC in the treatment group was better than those in the control group(P<0.05). After treatment,the level of serum IL-8 in both groups was lower than those before treatment in the same group(P<0.05),and serum α1-AT level was higher than those before treatment in the same group(P<0.05),and the change of serum IL-8 and α1-AT levels in the treatment group was better than those in the control group(P<0.05). There were no serious adverse reactions in both groups. [Conclusion] Bufei Huoxue Decoction is effective in treating stable COPD. It can improve lung function,exercise ability and quality of life. It is speculated that the mechanism of Bufei Huoxue Decoction may be related to inhibiting airway inflammation,and its safety is good. It is worth popularizing and applying in clinic.
引文
[1] Hurst JR. Precision medi cine in chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med,2016,193(6):593-594.
[2] Pomares X,Montón C. Current treatment of chronic obstructive pulmonary disease[J]. Med Clin(Barc),2016,147(1):28-34.
[3]兰丰铃,王胜锋,曹卫华,等.慢性阻塞性肺疾病危险因素流行病学研究新进展[J].中华疾病控制杂志,2014,18(10):998-1002.
[4]白澎,孙永昌,盛海燕,等.北京市社区高危人群慢性阻塞性肺疾病诊断与疾病分类状况调查[J].中国呼吸与危重监护杂志,2014,13(4):330-333.
[5]方琳霞,郑敏宇.慢性阻塞性肺疾病中医证型研究进展[J].世界中医药,2015,10(11):1808-1811.
[6]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版)[J].中华结核和呼吸杂志,2007,30(8):7.
[7]中华中医药学会内科分会肺系病专业委员会.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.
[8]郑筱萸.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:57.
[9]国家中医药管理局.中医病证诊断疗效评定标准[S].南京:南京大学出版社,1994:5
[10]周仲瑛.中医内科学[M].第7版.北京:中国中医药出版社,2003:408.
[11]张才圣,柏正平,胡学军,等.慢性阻塞性肺疾病稳定期中医证型分布规律研究[J].湖南中医杂志,2017,33(4):132-133.
[12]刘炜,葛正行,李波.慢性阻塞性肺疾病患者中医体质分布特点及其与证候的关系研究[J].中国中药杂志,2013,38(20):3587-3590.
[13]俞惠君,周萍萍,嵇朝辉.补肺活血汤联合沙美特罗替卡松治疗慢性阻塞性肺疾病观察[J].浙江中医杂志,2016,51(8):590.
[14]张珍丽.补肺活血汤联合常规西医治疗可降低气道炎症并改善肺功能从而提高COPD的疗效[J].中西医结合心血管病电子杂志,2018,6(1):155-158.
[15]徐守成,李晓红.补肺活血汤治疗稳定期慢性阻塞性肺疾病临床研究[J].中医学报,2016,31(3):340-343.
[16]谌向忠,柯佳,刘泉,等.补肺活血汤联合沙美特罗替卡松治疗慢性阻塞性肺疾病的疗效及机制[J].中国实验方剂学杂志,2014,20(9):220-223.
[17]许冬梅,杨敏.补肺活血汤联合沙美特罗替卡松治疗慢性阻塞性肺疾病的临床疗效观察[J].影像研究与医学应用,2018,2(13):234-236.
[18]顾福根,丁群力.稳定期慢性阻塞性肺疾病血清IL-8、TNF-α、CRP的表达及与肺功能的关系[J].现代实用医学,2015,27(8):1021-1023.
[19]庞国菊,刘怀平.血清α1-抗胰蛋白酶和C反应蛋白水平与慢性阻塞性肺疾病的相关性研究[J].检验医学,2013,28(10):882-884.
[20]林琳,田景炜,颛孙永勋,等.稳定期慢性阻塞性肺疾病患者运动能力的影响因素分析[J].中山大学学报,2016,37(6):950-955.
[21]罗在容.补肺活血汤治疗慢性阻塞性肺疾病稳定期患者的临床疗效及其对气道炎症和肺功能的影响[J].实用心脑肺血管病杂志,2016,24(1):66-67.
[2] Pomares X,Montón C. Current treatment of chronic obstructive pulmonary disease[J]. Med Clin(Barc),2016,147(1):28-34.
[3]兰丰铃,王胜锋,曹卫华,等.慢性阻塞性肺疾病危险因素流行病学研究新进展[J].中华疾病控制杂志,2014,18(10):998-1002.
[4]白澎,孙永昌,盛海燕,等.北京市社区高危人群慢性阻塞性肺疾病诊断与疾病分类状况调查[J].中国呼吸与危重监护杂志,2014,13(4):330-333.
[5]方琳霞,郑敏宇.慢性阻塞性肺疾病中医证型研究进展[J].世界中医药,2015,10(11):1808-1811.
[6]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版)[J].中华结核和呼吸杂志,2007,30(8):7.
[7]中华中医药学会内科分会肺系病专业委员会.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.
[8]郑筱萸.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:57.
[9]国家中医药管理局.中医病证诊断疗效评定标准[S].南京:南京大学出版社,1994:5
[10]周仲瑛.中医内科学[M].第7版.北京:中国中医药出版社,2003:408.
[11]张才圣,柏正平,胡学军,等.慢性阻塞性肺疾病稳定期中医证型分布规律研究[J].湖南中医杂志,2017,33(4):132-133.
[12]刘炜,葛正行,李波.慢性阻塞性肺疾病患者中医体质分布特点及其与证候的关系研究[J].中国中药杂志,2013,38(20):3587-3590.
[13]俞惠君,周萍萍,嵇朝辉.补肺活血汤联合沙美特罗替卡松治疗慢性阻塞性肺疾病观察[J].浙江中医杂志,2016,51(8):590.
[14]张珍丽.补肺活血汤联合常规西医治疗可降低气道炎症并改善肺功能从而提高COPD的疗效[J].中西医结合心血管病电子杂志,2018,6(1):155-158.
[15]徐守成,李晓红.补肺活血汤治疗稳定期慢性阻塞性肺疾病临床研究[J].中医学报,2016,31(3):340-343.
[16]谌向忠,柯佳,刘泉,等.补肺活血汤联合沙美特罗替卡松治疗慢性阻塞性肺疾病的疗效及机制[J].中国实验方剂学杂志,2014,20(9):220-223.
[17]许冬梅,杨敏.补肺活血汤联合沙美特罗替卡松治疗慢性阻塞性肺疾病的临床疗效观察[J].影像研究与医学应用,2018,2(13):234-236.
[18]顾福根,丁群力.稳定期慢性阻塞性肺疾病血清IL-8、TNF-α、CRP的表达及与肺功能的关系[J].现代实用医学,2015,27(8):1021-1023.
[19]庞国菊,刘怀平.血清α1-抗胰蛋白酶和C反应蛋白水平与慢性阻塞性肺疾病的相关性研究[J].检验医学,2013,28(10):882-884.
[20]林琳,田景炜,颛孙永勋,等.稳定期慢性阻塞性肺疾病患者运动能力的影响因素分析[J].中山大学学报,2016,37(6):950-955.
[21]罗在容.补肺活血汤治疗慢性阻塞性肺疾病稳定期患者的临床疗效及其对气道炎症和肺功能的影响[J].实用心脑肺血管病杂志,2016,24(1):66-67.