补肺汤联合西医常规治疗肺肾气虚型慢性阻塞性肺疾病的疗效及对患者气道纤维化指标的影响

摘要

目的 观察补肺汤联合西医常规治疗肺肾气虚型慢性阻塞性肺疾病 (COPD) 的疗效及对患者气道纤维化指标的影响.方法 将76例肺肾气虚型COPD患者按照随机数字表法分为2组.对照组38例予常规西医治疗;观察组38例在对照组治疗基础上加用补肺汤治疗.2组均治疗3个月统计临床疗效和不良反应情况, 比较2组治疗前后症状积分、气道纤维化指标[血清Ⅳ型胶原 (CⅣ) 、透明质酸 (HA) 、层黏连蛋白 (LN) ]的改善情况.结果 观察组总有效率97.37％, 对照组总有效率84.21％, 观察组疗效优于对照组 (P＜0.05) .治疗后2组各症状积分均降低 (P＜0.05), 且观察组咳嗽、咯痰, 气短喘息, 自汗乏力症状积分低于对照组 (P＜0.05) .治疗后2组HA、LN及CⅣ均降低 (P＜0.05), 且观察组低于对照组 (P＜0.05) .2组治疗期间均未出现与药物相关的不良反应情况.结论 补肺汤联合西医常规治疗肺肾气虚型COPD疗效确切, 并可改善患者的临床症状, 对气道重塑有明显的抑制作用.%Objective To observe the curative effect of Bufei decoction combined with routine western medicine on chronic obstructive pulmonary disease (COPD) of qi-deficiency type of lung and kidney and its influence on airway fibrosis index. Methods 76 COPD patients with qi-deficiency type of lung and kidney were divided into two groups according to random number table method. 38 cases in control group were treated by routine western medicine. 38 cases in the observation group were treated by Bufei decoction on the basis of control group. After 3 months of treatment, the clinical efficacy and adverse reactions were counted. The improvement of symptom scores, airway fibrosis index[serum collagen Ⅳ (CⅣ), hyaluronic acid (HA), laminin (LN) ] before and after treatment were compared between the two groups. Results The total effective rate was 97.37％ in observation group and 84.21％ in control group. The curative effect of the observation group was better than that of the control group (P＜0.05). After treatment, the scores of symptoms in both groups were decreased (P＜0.05), and the scores of cough, expectoration, shortness of breath and spontaneous sweating fatigue in the observation group were lower than those in the control group (P＜0.05). After treatment, HA, LN and CⅣ in both groups were decreased (P＜0.05), and the decrease in observation group was better than that in control group (P＜0.05). There were no adverse drug reactions during treatment in both groups. Conclusion Bufei decoction combined with routine western medicine has definite curative effect on COPD with qi-deficiency type of lung and kidney, and can improve clinical symptoms, and has obvious inhibitory effect on airway remodeling.