六君子汤治疗稳定期慢性阻塞性肺病肺脾两虚证的疗效及其对肺功能、运动耐力和血气分析的影响
本文选题：六君子汤 + COPD稳定期 ； 参考：《中国实验方剂学杂志》2017年22期
【摘要】：目的:探讨六君子汤治疗稳定期慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)肺脾两虚证疗效及其对肺功能、运动耐力和血气分析的影响。方法:106例COPD患者,用随机数字表法分为治疗组与对照组,每组53例。对照组患者仅给予沙美特罗替卡松气雾剂进行吸入治疗;治疗组患者在给予沙美特罗替卡松气雾剂的基础上口服六君子汤,治疗周期均为12周,分析两组患者治疗前后肺功能、运动耐力、呼吸肌疲劳、血清脑钠肽及炎症介质水平的变化。结果:临床疗效,治疗组患者总有效率为96.23%,对照组为83.02%,治疗组优于对照组(P0.05)。肺功能,治疗组与对照组治疗前第1秒用力呼吸容积(forced expiratory volume in 1 second,FEV_1),用力肺活量(forced vital capacity,FVC)及1 s率(FEV_1/FVC)差异无统计学意义,两组患者接受治疗12周后FEV_1,FVC,FEV_1/FVC均较治疗前明显提高(P0.05),且治疗组患者高于对照组(P0.05)。运动耐力(6 m WD),治疗前,两组患者6 m WD比较,差异无统计学意义,治疗后,与治疗前比较,两组患者6 m WD均显著改善,且治疗组优于对照组(P0.05)。血气分析(Pa O2,Sa O2,Pa CO2),与治疗前比较,治疗后两组患者血气分析指标均有明显改善,且治疗组改善程度优于对照组(P0.05)。血清脑钠肽(brain natriuretic peptide,BNP)水平,治疗组与对照组治疗前差异无统计学意义,治疗组患者接受治疗12周后血清BNP显示低于对照组(P0.05),且治疗组患者均低于对照组(P0.05)。炎症介质,治疗组与对照组治疗前白细胞介素-6(interleukin-6,IL-6),白细胞介素-8(interleukin-8,IL-8)和超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)差异无统计学意义,两组患者接受治疗12周后血清中IL-6,IL-8和hs-CRP水平均明显降低(P0.05),且治疗组患者均低于对照组(P0.05)。结论:六君子汤治疗COPD稳定期肺脾两虚证患者临床疗效明显,可提高患者肺功能及运动耐力,降低患者血清中BNP水平,减轻患者炎症反应。
[Abstract]:Objective: to investigate the effect of Liujunzi decoction (LJT) on lung and spleen deficiency syndrome and its effect on pulmonary function, exercise endurance and blood gas analysis in patients with stable chronic obstructive pulmonary disease (COPD). Methods 106 patients with COPD were randomly divided into treatment group (n = 53) and control group (n = 53). The patients in the control group were treated only with salmeterolticasone aerosol, and the patients in the treatment group were treated with Liujunzi decoction on the basis of salmeterolticasone aerosol for 12 weeks. The pulmonary function of the two groups was analyzed before and after treatment. Changes of exercise endurance, respiratory muscle fatigue, serum brain natriuretic peptide and inflammatory mediators. Results: the total effective rate of the treatment group was 96.23 and that of the control group was 83.02. The treatment group was superior to the control group (P 0.05). There was no significant difference in pulmonary function between the treatment group and the control group in forced respiratory volume forced expiratory volume in 1 second FEV 1, forced vital capacity FVCs and 1 s rate of FEVs 1 / FVCs before treatment between the treatment group and the control group. After 12 weeks of treatment, FEV _ (1) / FV _ (C) / FEV _ (1 / FVC) in both groups were significantly higher than that before treatment, and the patients in the treatment group were higher than those in the control group (P 0.05). Before treatment, there was no significant difference in 6-mWD between the two groups. After treatment, 6-mWD was significantly improved in both groups, and the treatment group was better than the control group (P 0.05). Compared with before treatment, the blood gas analysis indexes of the two groups were significantly improved, and the improvement degree of the treatment group was better than that of the control group (P 0.05). There was no significant difference in serum brain natriuretic peptide (BNP) levels between the treatment group and the control group before treatment. After 12 weeks of treatment, the serum BNP level in the treatment group was lower than that in the control group (P 0.05), and the level of serum BNP in the treatment group was lower than that in the control group (P 0.05). There was no significant difference in inflammatory mediators between the treatment group and the control group before treatment. There was no significant difference between the treatment group and the control group in interleukin-6, interleukin-8 (IL-8) and high-sensitivity C-reactive protein hs-CRP. After 12 weeks of treatment, the serum levels of IL-6, IL-8 and hs-CRP in both groups were significantly lower than those in the control group (P 0.05), and the levels of IL-8 and hs-CRP in the treatment group were significantly lower than those in the control group (P 0.05). Conclusion: Liujunzi decoction is effective in treating the patients with lung and spleen deficiency syndrome in stable period of COPD. It can improve the lung function and exercise endurance, decrease the level of BNP in serum and alleviate the inflammatory reaction of the patients.
【作者单位】： 上海中医药大学附属普陀医院;
【基金】：上海市重点学科建设项目(B116)
【分类号】：R259
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