六味补气颗粒剂联合舒利迭治疗COPD稳定期患者的临床研究
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摘要
目的观察六味补气颗粒剂联合舒利迭对慢性阻塞性肺疾病稳定期(肺肾气虚证)患者的临床疗效。方法按照纳入和排除标准筛选的60例慢性阻塞性肺疾病稳定期(肺肾气虚证)患者随机分成对照组(30例)和观察组(30例)。对照组在西医常规对症治疗基础上给予舒利迭吸入剂治疗,观察组在对照组治疗基础上给予六味补气颗粒剂治疗,疗程均为8周,比较2组患者治疗前后的临床疗效、急性加重次数、CAT评分以及血清淀粉样蛋白A(SAA)水平等变化。结果临床疗效方面,观察组与对照组总有效率分别为93.33%和70.00%(P<0.01)。治疗后,观察组急性加重次数显著低于对照组(P<0.01)。2组患者治疗前后CAT评分、血清SAA水平比较均有显著下降(P<0.01);治疗后观察组咳痰、乏力、自汗等症状的改善明显优于对照组(P<0.05~0.01),CAT评分与对照组相比有一定差异(P<0.05),血清SAA水平显著低于对照组(P<0.01)。结论六味补气颗粒剂联合舒利迭可有效改善慢性阻塞性肺疾病稳定期(肺肾气虚证)患者的临床症状,减少急性加重次数,降低血清SAA水平,临床疗效满意。
OBJECTIVE To observe the clinical effect of Liuwe Buqi granule combined with Seretide on patients with chronic obstructive pulmonary disease(COPD)at stable stage(deficiency of lung and kidney qi).METHODS 60 patients with COPD at stable stage were randomly divided into control group(30 cases)and observation group(30 cases).The control group was treated with Seretide inhalation on the basis of routine western medicine treatment,and the observation group was treated with Liuwei Buqi granule on the basis of the control group for 8 weeks.The clinical efficacy and the change of acute exacerbation times,CAT score and serum amyloid A(SAA)level of the two groups were compared before and after treatment.RESULTS The total effective rates of observation group and control group were 93.33%and 70.00%(P<0.01),respectively.After treatment,the times of acute exacerbation in observation group was significantly lower than that in control group(P<0.01).The CAT score and the serum SAA level in the two groups were significantly decreased before and after treatment(P<0.01).After treatment,the improvement of expectoration,fatigue and self-sweating in observation group was better than that in control group(P<0.05,P<0.01).The CAT score in observation group was significantly different from that in control group(P<0.01).The serum SAA level in observation group was significantly lower than that in control group(P<0.01).CONCLUSION Liuwei Buqi granules combined with Seretide can effectively improve the clinical symptoms of patients with COPD at stable stage(deficiency of lung and kidney qi),reduce the times of acute exacerbation and reduce the level of serum SAA.The clinical curative effect is satisfactory.
OBJECTIVE To observe the clinical effect of Liuwe Buqi granule combined with Seretide on patients with chronic obstructive pulmonary disease(COPD)at stable stage(deficiency of lung and kidney qi).METHODS 60 patients with COPD at stable stage were randomly divided into control group(30 cases)and observation group(30 cases).The control group was treated with Seretide inhalation on the basis of routine western medicine treatment,and the observation group was treated with Liuwei Buqi granule on the basis of the control group for 8 weeks.The clinical efficacy and the change of acute exacerbation times,CAT score and serum amyloid A(SAA)level of the two groups were compared before and after treatment.RESULTS The total effective rates of observation group and control group were 93.33%and 70.00%(P<0.01),respectively.After treatment,the times of acute exacerbation in observation group was significantly lower than that in control group(P<0.01).The CAT score and the serum SAA level in the two groups were significantly decreased before and after treatment(P<0.01).After treatment,the improvement of expectoration,fatigue and self-sweating in observation group was better than that in control group(P<0.05,P<0.01).The CAT score in observation group was significantly different from that in control group(P<0.01).The serum SAA level in observation group was significantly lower than that in control group(P<0.01).CONCLUSION Liuwei Buqi granules combined with Seretide can effectively improve the clinical symptoms of patients with COPD at stable stage(deficiency of lung and kidney qi),reduce the times of acute exacerbation and reduce the level of serum SAA.The clinical curative effect is satisfactory.
引文
[1]WANG C,XU J,YANG L,et al.Prevalence and risk factors of chronic obstructive pulmonary disease in China(the China Pulmonary Health[CPH]study):A national cross-sectional study[J].Lancet,2018,391(10131):1706-1717.
[2]WANG X.Prevalence of chronic obstructive pulmonary disease in China:A large,population-based survey[J].Am J Respirat Critic Care Med,2007,176(8):753.
[3]YANG GH,WANG Y,ZENG Y,et al.Rapid health transition in China,1990-2010:findings from the Global Burden of Disease Study 2010.[J].Lancet,2013,381(9882):1987-2015.
[4]LI MH,FAN LC,MAO B,et al.Short-term exposure to ambient fine particulate matter increases hospitalizations and mortality in COPD:A systematic review and meta-analysis[J].Chest,2016,149(2):447-458.
[5]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[J].中华结核和呼吸杂志,2007,46(1):8-17.
[6]王成阳,李泽庚.六味补气胶囊对COPD肺气虚证大鼠JAK/STAT通路、MMPs/TIMP的影响[J].中华中医药杂志,2014,29(5):1384-1390.
[7]董卓,姚韧辉,李春钢.六味补气胶囊在肺气虚型慢性阻塞性肺病稳定期治疗中的临床疗效[J].辽宁中医杂志,2017,44(7):1424-1426.
[8]刘志刚,李泽庚,彭波,等.慢性阻塞性肺疾病稳定期肺气虚证及其中药干预的血浆代谢组学研究[J].中国中西医结合杂志,2011,31(12):1619-1626.
[9]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(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[10]周仲瑛.中医内科学[M].北京:中国中医药出版社,2007:115-117.
[11]中药新药临床研究指导原则:试行[J].北京:中国医药科技出版社,2002:151-155.
[12]BARNES PJ,CELLI BR.Systemic manifestations and comorbidities of COPD[J].Eur Respir J,2009,33(5):1165-1185.
[13]高倩,曲妮妮.慢性阻塞性肺疾病中西医药物治疗新进展[J].北方药学,2015,12(1):104-105.
[14]巢元方.诸病源候论[M].宋白杨,校注.北京:中国医药科技出版社,2011:87.
[15]冯兆张.冯氏锦囊秘录[M].田思胜,校注.北京:中国中医药出版社,1996:389.
[16]COTE CG,DORDELLY LJ,CELLI BR.Impact of COPD exacerbations on patient-centered outcomes[J].Chest,2007,131(3):696-704.
[17]李春凤.联合雾化吸入治疗慢性阻塞性肺疾病55例临床分析[J].北华大学学报(自然科学版),2012,13(6):676-679.
[18]高蔚,翁婷,王丽芳.慢性阻塞性肺疾病患者血清SAA水平及其意义[J].临床肺科杂志,2011,16(2):282-283.
[19]杨瑞青,刘斌,郑法德,等.COPD患者血清淀粉样蛋白A变化及意义[J].安徽医学,2010,31(4):316-318.
[20]URIELISHOVAL S,LINKE RP,MATZNER Y.Expression and function of serum amyloid A,a major acute-phase protein,in normal and disease states[J].Curr Opin Hematol,2000,7(1):64-69.
[2]WANG X.Prevalence of chronic obstructive pulmonary disease in China:A large,population-based survey[J].Am J Respirat Critic Care Med,2007,176(8):753.
[3]YANG GH,WANG Y,ZENG Y,et al.Rapid health transition in China,1990-2010:findings from the Global Burden of Disease Study 2010.[J].Lancet,2013,381(9882):1987-2015.
[4]LI MH,FAN LC,MAO B,et al.Short-term exposure to ambient fine particulate matter increases hospitalizations and mortality in COPD:A systematic review and meta-analysis[J].Chest,2016,149(2):447-458.
[5]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[J].中华结核和呼吸杂志,2007,46(1):8-17.
[6]王成阳,李泽庚.六味补气胶囊对COPD肺气虚证大鼠JAK/STAT通路、MMPs/TIMP的影响[J].中华中医药杂志,2014,29(5):1384-1390.
[7]董卓,姚韧辉,李春钢.六味补气胶囊在肺气虚型慢性阻塞性肺病稳定期治疗中的临床疗效[J].辽宁中医杂志,2017,44(7):1424-1426.
[8]刘志刚,李泽庚,彭波,等.慢性阻塞性肺疾病稳定期肺气虚证及其中药干预的血浆代谢组学研究[J].中国中西医结合杂志,2011,31(12):1619-1626.
[9]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(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[10]周仲瑛.中医内科学[M].北京:中国中医药出版社,2007:115-117.
[11]中药新药临床研究指导原则:试行[J].北京:中国医药科技出版社,2002:151-155.
[12]BARNES PJ,CELLI BR.Systemic manifestations and comorbidities of COPD[J].Eur Respir J,2009,33(5):1165-1185.
[13]高倩,曲妮妮.慢性阻塞性肺疾病中西医药物治疗新进展[J].北方药学,2015,12(1):104-105.
[14]巢元方.诸病源候论[M].宋白杨,校注.北京:中国医药科技出版社,2011:87.
[15]冯兆张.冯氏锦囊秘录[M].田思胜,校注.北京:中国中医药出版社,1996:389.
[16]COTE CG,DORDELLY LJ,CELLI BR.Impact of COPD exacerbations on patient-centered outcomes[J].Chest,2007,131(3):696-704.
[17]李春凤.联合雾化吸入治疗慢性阻塞性肺疾病55例临床分析[J].北华大学学报(自然科学版),2012,13(6):676-679.
[18]高蔚,翁婷,王丽芳.慢性阻塞性肺疾病患者血清SAA水平及其意义[J].临床肺科杂志,2011,16(2):282-283.
[19]杨瑞青,刘斌,郑法德,等.COPD患者血清淀粉样蛋白A变化及意义[J].安徽医学,2010,31(4):316-318.
[20]URIELISHOVAL S,LINKE RP,MATZNER Y.Expression and function of serum amyloid A,a major acute-phase protein,in normal and disease states[J].Curr Opin Hematol,2000,7(1):64-69.