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目的:探讨布地奈德雾化吸入联合暖肺祛瘀汤治疗慢性阻塞性肺疾病(COPD)急性发作期临床疗效。方法:研究对象选取医院2013年1月—2015年5月收治COPD急性发作期患者共170例,以随机抽签法分为对照组(85例)和联合组(85例),分别采用布地奈德雾化吸入单用和在此基础上加用暖肺祛瘀汤辅助治疗;比较两组患者临床疗效,治疗前后中医证候积分、FEV1/FVC、FEV1%预计值、TNF-α及IL-8水平等。结果:对照组和联合组患者临床治疗总有效率分别为82.35%(70/85),96.47%(82/85);联合组患者临床疗效显著优于对照组,差异具有显著性(P<0.05);对照组患者治疗前后中医证候积分分别为(14.80±2.82)分,(7.95±1.42)分;联合组患者治疗前后中医证候积分分别为(14.64±2.76)分,(4.24±0.70)分;联合组患者治疗后中医证候积分显著优于治疗前、对照组,差异具有显著性(P<0.05);对照组患者治疗前FEV1/FVC和FEV1%预计值分别为(49.85±3.50)%,(53.40±8.85)%;对照组患者治疗后FEV1/FVC和FEV1%预计值分别为(57.14±4.41)%,(64.44±10.51)%;联合组患者治疗前FEV1/FVC和FEV1%预计值分别为(50.03±3.57)%,(53.53±8.92)%;联合组患者治疗后FEV1/FVC和FEV1%预计值分别为(65.53±5.94)%,(70.83±12.94)%;联合组患者治疗后FEV1/FVC和FEV1%预计值均显著高于对照组、治疗前,差异具有显著性(P<0.05);对照组患者治疗前TNF-α和IL-8水平分别为(64.33±5.24)ng/L,(78.24±8.60)ng/L;对照组患者治疗后TNF-α和IL-8水平分别为(58.87±4.40)ng/L,(70.71±6.92)ng/L;联合组患者治疗前TNF-α和IL-8水平分别为(64.28±5.19)ng/L,(77.97±8.48)ng/L;联合组患者治疗后TNF-α和IL-8水平分别为(51.45±2.78)ng/L,(62.54±4.45)ng/L;联合组患者治疗后TNF-α和IL-8水平均显著低于对照组、治疗前,差异具有显著性(P<0.05)。结论:布地奈德雾化吸入联合暖肺祛瘀汤治疗COPD急性发作期可有效改善临床症状体征,增强肺部通气功能,并有助于降低气道炎症反应程度。
Objective: To investigate the clinical efficacy of budesonide inhalation combined with warming lung and removing stasis soup in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods: A total of 170 patients with acute exacerbation of COPD from January 2013 to May 2015 in our hospital were selected and randomly divided into control group (85 cases) and combination group (85 cases) Atomization inhalation alone and on this basis with the adjuvant therapy of Feifei Quyu Decoction. The clinical curative effect, TCM syndrome score before and after treatment, FEV1 / FVC, predictive value of FEV1%, TNF-α and IL-8 Level and so on. Results: The total effective rate of clinical treatment in control group and combined group was 82.35% (70/85) and 96.47% (82/85), respectively. The clinical effect in combination group was significantly better than that in control group (P <0.05 ) In the control group were (14.80 ± 2.82) and (7.95 ± 1.42) points respectively before and after treatment. The scores of TCM syndrome before and after treatment in the combination group were (14.64 ± 2.76) and (4.24 ± 0.70) (P <0.05). The predicted values of FEV1 / FVC and FEV1% before treatment in the control group were (49.85 ± 3.50), P <0.05 respectively. The scores of TCM syndromes in the combined group were significantly better than those in the control group (57.14 ± 4.41)% and (64.44 ± 10.51)% respectively in the control group; the FEV1 / FVC and FEV1% of the patients in the control group after treatment were estimated to be (57.14 ± 4.41)% and (64.44 ± 10.51)% respectively (50.03 ± 3.57)% and (53.53 ± 8.92)%, respectively. The predicted values of FEV1 / FVC and FEV1% in the combined group were (65.53 ± 5.94)% and (70.83 ± 12.94)%, respectively; The predicted values of FEV1 / FVC and FEV1% were significantly higher than those of the control group before treatment, and the difference was significant (P <0.05). The levels of TNF-α and IL-8 in the control group before treatment were (64.33 ± 5.24) ng /L,(78.24 ± 8.60) ng / L respectively. The levels of TNF-α and IL-8 in the control group were (58.87 ± 4.40) ng / L and (70.71 ± 6.92) ng / L, (64.28 ± 5.19) ng / L and (77.97 ± 8.48) ng / L, respectively. The levels of TNF-α and IL-8 in the combined group were (51.45 ± 2.78) ng / L and 4.45) ng / L. The levels of TNF-α and IL-8 in the combined group were significantly lower than those in the control group before treatment, with significant difference (P <0.05). Conclusion: Budesonide inhalation combined with Feifu Quyu Decoction in the treatment of acute exacerbation of COPD can effectively improve clinical symptoms and signs, enhance pulmonary ventilation, and help reduce the degree of airway inflammation.