补肺活血汤联合沙美特罗替卡松治疗慢性阻塞性肺疾病的疗效及机制

Discussion About Bufei Huoxue Decoction Combined Salmeterol Fluticasone Treatment on Chronic Obstructive Pulmonary Disease in o Curative Effect and Action Mechanism

摘要:

目的：探讨补肺活血汤联合沙美特罗替卡松治疗慢性阻塞性肺疾病（COPD）稳定期的疗效及对α₁-抗胰蛋白酶（α₁-AT）和白细胞介素-8（IL-8）的影响。方法：将诊断明确的COPD患者72例随机按接诊顺序分为观察组与对照组各36例。两组均给予西医常规吸氧、祛痰等治疗。对照组采用沙美特罗替卡松，1吸/次，2次/d。观察组在对照组治疗的基础上加用补肺活血汤，1剂/d。两组疗程均为12周。进行治疗前后肺功能检测，采用6 min步行距离（6 MWD）评定运动能力，采用COPD生存质量评分表（CAT问卷）评定生活质量，检测治疗前后α₁-抗胰蛋白酶（α₁-AT）和白细胞介素-8（IL-8）水平。结果：经参照单位（Ridit）分析观察组总体疗效优于对照组（P<0.05）；治疗后观察组用力肺活量（FVC）、1 s用力呼气容积（FEV₁）和FEV₁/FVC均高于对照组（P<0.01）；治疗后观察组6 MWD优于对照组（P<0.01）；治疗后观察组CAT评分低于对照组（P<0.01）；观察组α₁-AT较治疗前升高（P<0.01），并高于治疗后对照组（P<0.01）；治疗后两组血清IL-8水平均较治疗前下降（P<0.01），治疗后观察组IL-8水平低于对照组（P<0.01）。结论：补肺活血汤联合沙美特罗替卡松能改善COPD稳定期患者肺功能，提高患者运动能力和生活质量，临床疗效显著，其作用机制可能与抑制炎性反应有关。

Abstract:

Objective: The purpose is to discuss the efficacy of Bufei Huoxue decoction combined Salmeterol Fluticasone on cure of chronic obstructive pulmonary (COPD) curative effect and the influence of α₁-antitrypsin (α₁-AT) and interleukin-8 (IL-8). Method: The 72 patients diagnose clearly with COPD were randomly divided into control group and observation group. Each group were (36 cases). Both groups were given western medicine treatment as routine oxygen, eliminating phlegm et.Patients in control group took Salmeterol Fluticasone, 1 inhalation/time, 2 does/day.on the basis of the control treatment, patients in observation group plus therapy of Bufei Huoxue decoction, 1 does/day.Treatment courses for the two groups continued 12 weeks.Detect lung function, evaluate athletic ability by 6 min walking distance (6 MWD) and adopt COPD life quality scale (CAT questionnaire) to evaluate life quality before and after treatment.Besides test the level of α₁-AT and IL-8 around treatment. Result: Analyzing by Ridit, the total curative effect of the observation group was superior to the control group (P<0.05), after treatment, forced vital capacity (FVC) of the observation group, the FEV₁ volume of the observation group and FEV₁/FVC were all higher than that of the control group (P<0.01), after treatment 6 MWD of the observation group was superior to the control group (P<0.01), and the grade of CAT of the observation group was lower than that of the control group (P<0.01), and alpha 1-antitrypsin of the observation group was higher than that before therapy (P<0.01), which higher than that of the control group (P<0.01), Besides, the level of Serum IL-8 of the two groups were lower than that before therapy (P<0.01), and level of Serum IL-8 of the observation group was lower than that of control group (P<0.01). Conclusion: At the COPD stable phase, it can improve patients' lung function when Bufei Huoxue decoction combined with Salmeterol Fluticasone, and improve the exercise capacity and quality of life of patients, there was a significant curative effect, and the mechanism of action may be related to inhibiting inflammatory response.