痰热清注射液联合噻托溴铵对尘肺病合并慢性阻塞性肺疾病患者呼吸功能的影响

目的 探讨痰热清注射液联合噻托溴铵对尘肺病合并稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者呼吸功能的影响。 方法 采用随机数字法将2016年12月-2018年3月间在广东同江医院接受治疗的128例尘肺病合并稳定期COPD患者分为2组,每组64例。对照组给予噻托溴铵粉雾剂吸入治疗,观察组在对照组基础上给予痰热清注射液治疗。比较2组临床疗效及治疗前后临床症状(咳痰、咳嗽、啰音/哮鸣音、喘息/呼吸困难、胸闷/脘闷、纳呆/腹胀、气短/自汗、易感冒)积分、肺功能(FEV%、FVC、FEV1/FVC)、血清IL-1、TNF-α、TGF-β1水平的变化。 结果 治疗后,观察组的总有效率为90.63%,明显高于对照组的73.44%(P<0.05)。治疗后,2组临床症状积分明显下降(均P<0.05),且观察组显著低于对照组(均P<0.05)。治疗后,2组FEV%、FVC、FEV1/FVC水平显著升高(均P<0.05),且观察组明显高于对照组(均P<0.05)。2组血清IL-1、TNF-α及TGF-β1水平显著降低(均P<0.05),且观察组明显低于对照组(均P<0.05)。 结论 痰热清注射液联合噻托溴铵可明显改善尘肺病合并稳定期慢性阻塞性肺疾病患者临床症状与呼吸功能,其干预途径可能与降低血清IL-1、TNF-α、TGF-β1水平,缓解气道炎症有关。 

Effect of Tanreqing injection combined tiotropium on respiratory function of pneumoconiosis patients with stable COPD and its mechanism

Objective To investigate the effect of Tanreqing injection combined with tiotropium on respiratory function in patients with pneumoconiosis and stable chronic obstructive pulmonary disease (COPD) and its mechanism. Methods A total of 128 pneumoconiosis patients with stable COPD in our hospital from December 2016 to March 2018 were randomized divided into 2 groups, 64 in each group. The control group was received inhalation therapy with Tiotropium bromide aerosol, and the observation group was treated with Tanreqing injection based on control group. The clinical efficacy, clinical symptoms before and after treatment (cough, sputum, arpeggio/wheezing, wheezing/dyspnea, chest tightness/puffiness, poor appetite, abdominal distension, shortness of breath/self-perspiration, flu) scores, lung function (FEV%, FVC, FEV1/FVC), serum IL-1, TNF-α, and TGF-β1 levels of two groups were compared. Results After treatment, the total effective rate of observation group was 90.63%, which was significantly higher than that of control group (73.44%), P<0.05. After treatment, the clinical symptoms scores of two groups were significantly decreased (all P<0.05), and the observation group was significantly lower than the control group (all P<0.05). After treatment, the FEV%, FVC, and FEV1/FVC levels of two groups increased significantly (all P<0.05), and the observation group was significantly higher than the control group (all P<0.05). Serum IL-1, TNF-α and TGF-β1 levels of two groups were significantly lower (all P<0.05), the observation group was significantly lower than control group (all P<0.05). Conclusion Tanreqing injection combined Tiotropium bromide can significantly improve the clinical symptoms and respiratory function of pneumoconiosis patients with stable chronic obstructive pulmonary disease, and its mechanism might be related to the reduce of serum IL-1, TNF-α, TGF-β1 levels and relieve airway inflammation.