补肺益肾化瘀汤对COPD稳定期患者气道功能的影响及其机制研究

目的 探讨补肺益肾化瘀汤对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者气道功能的影响及其作用机制研究。 方法 选取2015年1月-2016年12月温岭市第一人民医院收治的COPD稳定期患者166例,采用随机数字表法分为2组,每组83例。对照组给予沙丁胺醇与异丙托溴铵气雾吸入治疗,观察组在对照组基础上加用补肺益肾化瘀汤治疗。治疗后,统计2组临床症候积分、肺功能[1 s用力呼气容积占预计值百分比(FEV%)、FEV1/FVC]、血清肿瘤坏死因子(TNF-α)、转化生长因子-β1(TGF-β1)水平的变化及临床疗效,采用SPSS 16.0统计软件对2组数据进行统计学分析,进而分析补肺益肾化瘀汤对COPD稳定期患者气道功能的影响及其作用机制。 结果 治疗后,观察组的总有效率为92.77%,明显高于对照组的77.11%(P<0.05)。治疗后,2组临床症候积分均显著降低(P<0.05),且观察组明显低于对照组(P<0.05)。治疗后,2组FEV%、FEV1/FVC均明显升高(P<0.05),且观察组显著高于对照组(P<0.05)。治疗后,观察组血清TNF-α、TGF-β1水平明显降低(P<0.05),且低于对照组(P<0.05)。 结论 补肺益肾化瘀汤治疗COPD稳定期疗效显著,可明显改善患者的临床症状与肺通气功能,其干预气道重塑的内在机制可能与减轻气道炎症、降低TGF-β1水平有关。 

Effect of Bufei Yishen Huayu decoction on airway function of stable COPD patients and its mechanism

Objective To study the effect of Bufei Yishen Huayu Decoction on airway function of chronic obstructive pulmonary disease (COPD) patients and its mechanism. Methods One hundred and sixty-six patients with stable COPD were randomly divided into two groups, each group 83 cases. The control group was treated with salbutamol and ipratropium bromide inhalation. The observation group was treated with Bufei Yishen Huayu Decoction based on the control group. After treatment, clinical symptoms, pulmonary function[FEV%, FEV1/FVC], serum TNF-α and TGF-β1, and clinical efficacy of two groups were compared. Those data were analyzed by SPSS soft to analyze the effect of Bufei Yishen Huayu Decoction on airway function of COPD patients and its mechanism. Results After treatment, the total effective rate of observation group was 92.77%, which was significantly higher than that of control group (77.11%, P<0.05). After treatment, clinical symptoms scores of two groups were significantly decreased (P<0.05), and the observation group was significantly lower than the control group (P<0.05). After treatment, FEV% and FEV1/FVC of two groups were significantly increased (P<0.05), and the observation group was significantly higher than the control group (P<0.05). After treatment, the TNF-α and TGF-β1 levels of observation group were significantly reduced (P<0.05), and lower than those of control group (P<0.05). Conclusion Bufei Yishen Huayu Decoction could significantly improve the clinical symptoms and pulmonary ventilation function of patients with stable COPD. The internal mechanism of airway remodeling may be related to reduce airway inflammation and reduce TGF-β1.