金水宝胶囊联合布地奈德福莫特罗粉吸入剂治疗高风险慢性阻塞性肺疾病的临床疗效

摘要

目的：观察金水宝胶囊联合布地奈德福莫特罗粉吸入剂治疗高风险慢性阻塞性肺疾病（COPD）的临床疗效。方法选取2013年10月—2014年6月南京医科大学第二附属医院收治的高风险 COPD 患者68例，随机分为对照组与治疗组，每组34例。对照组患者予以常规治疗及布地奈德福莫特罗粉吸入剂，治疗组患者在对照组基础上加用金水宝胶囊；两组患者均连续治疗24周。比较两组患者治疗前后诱导痰液炎性细胞（巨噬细胞、中性粒细胞、淋巴细胞、嗜酸粒细胞）分数和白介素8（IL-8）水平、肺功能指标〔第1秒用力呼气容积（FEV1）、第1秒用力呼气容积占预计值百分比（FEV1%）、第1秒用力呼气容积与用力肺活量比值（ FEV1/ FVC）〕、氧化应激指标〔总抗氧化能力（TAOC）、超氧化物歧化酶（SOD）、丙二醛（MDA）〕。结果治疗前两组患者诱导痰液巨噬细胞、中性粒细胞、淋巴细胞、嗜酸粒细胞分数和 IL-8水平比较，差异无统计学意义（P ﹥0.05）；治疗后治疗组患者诱导痰液巨噬细胞分数高于对照组，诱导痰液中性粒细胞分数、IL-8水平低于对照组（P ﹤0.05），两组患者诱导痰液淋巴细胞、嗜酸粒细胞分数比较，差异无统计学意义（P ﹥0.05）。治疗前两组患者 FEV1、FEV1%、FEV1/ FVC 比较，差异无统计学意义（P ﹥0.05）；治疗后治疗组患者 FEV1、FEV1%、FEV1/ FVC 高于对照组（P ﹤0.05）。治疗前两组患者 TAOC、SOD、MDA比较，差异无统计学意义（P ﹥0.05）；治疗后治疗组患者 TAOC、SOD 高于对照组，MDA 低于对照组（P ﹤0.05）。结论金水宝胶囊联合布地奈德福莫特罗粉吸入剂治疗高风险 COPD 的临床疗效确切，能有效激活巨噬细胞、减轻炎性反应，改善患者肺功能。%Objective To observe the clinical effect of jinshuibao capsule combined with budesonide/ formoterol aerosol on high - risk chronic obstructive pulmonary disease(COPD). Methods A total of 68 high - risk COPD patients were selected in the Second Affiliated Hospital of Nanjing Medical University,and they were randomly divided into control group and treatment group,each of 34 cases. Patients of control group were given conventional treatment and budesonide/ formoterol aerosol, while patients of treatment group were given extra jinshuibao capsule based on that of control group;both groups continuously treated for 24 weeks. Induced sputum inflammatory cells( including macrophage,neutrophil,lymphocyte and eosinophil) percentage and IL-8,index of pulmonary function(including FEV1 ,FEV1% and FEV1 / FVC)and oxidative stress parameters〔including total antioxidant capacity( TAOC),SOD and MDA〕before and after treatment were compared between the two groups. Results No statistically significant differences of induced sputum macrophage percentage,neutrophil percentage, lymphocyte percentage or eosinophil percentage,or IL-8 was found between the two groups before treatment(P ﹥ 0. 05);after treatment,induced sputum macrophage percentage of treatment group was statistically significantly higher than that of control group,induced sputum neutrophil percentage and IL-8 of treatment group were statistically significantly lower than those of control group( P ﹤ 0. 05 ), while no statistically significant differences of induced sputum lymphocyte percentage or eosinophil percentage was found between the two groups(P ﹥ 0. 05). No statistically significant differences of FEV1 ,FEV1% or FEV1 /FVC was found between the two groups before treatment(P ﹥ 0. 05),while FEV1 ,FEV1% and FEV1 / FVC of treatment group were statistically significantly higher than those of control group after treatment ( P ﹤ 0. 05 ). No statistically significant differences of TAOC,SOD or MDA was found between the two groups before treatment(P ﹥ 0. 05);after treatment,TAOC and SOD of treatment group were statistically significantly higher than those of control group,while MDA of treatment group was statistically significantly lower than that of control group ( P ﹤ 0. 05 ). Conclusion Jinshuibao capsule combined with budesonide/ formoterol aerosol has certain clinical effect in treating high - risk COPD,can effectively activate the macrophage, relive the inflammatory reaction,improve the pulmonary function.