鱼腥草注射液联合噻托溴铵和沙美特罗替卡松治疗缓解期慢性阻塞性肺疾病的临床研究

目的探讨鱼腥草注射液联合噻托溴铵和沙美特罗替卡松治疗缓解期慢性阻塞性肺疾病的临床疗效。方法选取2013年1月—2016年1月在延安大学附属医院就诊的缓解期慢性阻塞性肺疾病患者162例,随机分为对照组(81例)和治疗组(81例)。对照组患者吸入沙美特罗替卡松粉吸入剂,1泡/次,2次/d;同时雾化吸入噻托溴铵粉雾剂,1粒/次,1次/d。治疗组患者在对照组的基础上静脉滴注鱼腥草注射液,1 m L/kg加入5%~10%的葡萄糖注射液。两组患者均连续治疗12周。观察两组的临床疗效,同时比较两组治疗前后第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、FEV1%、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、外周白细胞(WBC)、血氧分压(p O2)、二氧化碳分压(p CO2)、6 min步行距离(6MWD)、呼吸困难症状评分的变化情况。结果治疗后,对照组和治疗组总有效率分别为87.65%、93.83%,两组比较差异有统计学意义(P0.05)。治疗后,两组FEV1、FEV1/FVC和FEV1%水平均较同组治疗前显著升高,同组治疗前后差异具有统计学意义(P0.05);且治疗后,治疗组这些观察指标显著高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组CRP、WBC和TNF-α水平均明显降低,同组治疗前后差异具有统计学意义(P0.05);且治疗后,治疗组患者上述指标水平改善情况优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,p O2和p CO2均好于同组治疗前(P0.05);且治疗后,治疗组这些观察指标显著优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者6MWD和呼吸困难症状评分较治疗前均得到明显改善(P0.05);且治疗组上述指标水平改善情况明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论鱼腥草注射液联合噻托溴铵和沙美特罗替卡松可有效改善缓解期慢性阻塞性肺疾病患者肺功能,缓解呼吸困难症状,具有一定的临床推广应用价值。

Clinical study on Yuxingcao Injection combined with tiotropium bromide and salmeterol xinafoate and fluticasone propionate in treatment of chronic obstructive pulmonary disease

Objective To explore the clinical curative effect of Yuxingcao Injection combined with tiotropium bromide and salmeterol xinafoate and fluticasone propionate in treatment of chronic obstructive pulmonary disease. Methods Patients (162 cases) with chronic obstructive pulmonary disease in Yan'an University Affiliated Hospital from January 2013 to January 2016 enrolled in this study were randomly divided into control group (81 cases) and treatment group (81 cases). The patients in the control group were inhalation administered with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation, 1 bubble/time, twice daily. And they were aerosol inhalation administered with Tiotropium Bromide Powder for inhalation, 1 grain/time, once daily. The patients in the treatment group were iv administered with Yuxingcao Injection on the basis of control group, 1 mL/kg added into 5%—10%glucose injection. The patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated, and the changes of FEV1, FEV1/FVC, FEV1%, CRP, TNF-α, WBC, PaO2, PaCO2, 6MWD, and dyspnea symptom scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 87.65% and 93.83%, respectively, and there were differences between two groups (P<0.05). After treatment, FEV1, FEV1/FVC, and FEV1%levels in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05). After treatment, CRP, WBC, and TNF-α in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). After treatment, the improvement of the indexes levels in the treatment group was better than those in the control group with significant difference between two groups (P<0.05). After treatment, pO2 and pCO2 in two groups were significantly improved (P<0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, 6MWD and dyspnea symptom scores in two groups were significantly improved (P<0.05). And the improvement of these indexes levels in treatment group was better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Yuxingcao Injection combined with tiotropium bromide and salmeterol xinafoate and fluticasone propionate can effectively improve the lung function of patients with chronic obstructive pulmonary disease, and relieve dyspnea symptoms, which has a certain clinical application value.