百令胶囊对慢性阻塞性肺疾病稳定期患者的干预效果

摘要

目的 探讨百令胶囊对慢性阻塞性肺疾病(COPD)稳定期患者的干预作用及其治疗机制.方法 选择新乡医学院第一附属医院呼吸内科2013年1月至2016年6月收治的急性加重被控制后病情平稳≥2周的COPD稳定期患者100例,随机分为对照组和观察组,每组50例.对照组患者给予常规治疗药物噻托溴铵粉雾剂吸入,观察组患者在对照组治疗基础上给予百令胶囊口服,2组患者均治疗12个月,比较2组患者的临床疗效和1 a内平均急性加重次数,并比较2组患者治疗前及治疗3、6、12个月时血清淀粉样蛋白A(SAA)水平.结果 治疗12个月后,观察组患者的治疗总有效率(84.0％)显著高于对照组(72.0％)(x2=4.097,P＜0.05).观察组患者1 a内平均急性加重次数显著少于对照组(P＜0.01).治疗前、治疗3个月时,2组患者的血清SAA水平比较差异均无统计学意义(P＞0.05);治疗6、12个月时,观察组患者的血清SAA水平均显著低于对照组(P＜0.05).2组患者治疗3个月时的血清SAA水平与治疗前比较差异均无统计学意义(P＞0.05);治疗6、12个月时,2组患者的血清SAA水平均显著低于治疗前及治疗3个月时(P＜0.05);治疗12个月时,2组患者的血清SAA水平均显著低于治疗6个月时(P＜0.05).结论 百令胶囊可能通过干预血清SAA的分泌而抑制COPD患者的机体炎症反应,从而改善COPD患者的临床表现,减少COPD的急性发作.%Objective To investigate the effect and mechanism of Bailing capsule on the patients with stable chronic obstructive pulmonary disease (COPD).Methods A total of 100 patients with more than two weeks of stable COPD were selected from January 2013 to June 2016 in the Department of Respiratory Medicine,the First Affiliated Hospital of Xinxiang Medical University.The patients were randomly divided into the control group and the observation group,with 50 cases in each group.The patients in the control group were treated with tiotropium bromide powder for inhalation,and the patients in the observation group were treated with Bailing capsule orally on the basis of tiotropium bromide powder for inhalation,the patients in the two groups were treated for 12 months.The clinical effect and the average number of acute exacerbations within one year were compared between the two groups;and the level of serum amyloid A (SAA) were compared between the two groups before treatment and 3,6 and 12 months after treatment.Results The total effective rate in the observation group (84.0％) was significantly higher than that in the control group (72.0％)after 12 months of treatment (x2 =4.097,P ＜ 0.05).The average number of acute exacerbations in the observation group within one year was significantly less than that in the control group (P ＜ 0.01).There was no significant difference in serum SAA level between the two groups before treatment and 3 months after treatment (P ＞ 0.05).The serum SAA level in the observation group was significantly lower than that in the control group at the time points of 6 and 12 months after treatment (P ＜ 0.05).There was no significant difference in serum SAA level between before treatment and 3 months after treatment in the two groups (P ＞ 0.05).The serum SAA level at 6 and 12 months after treatment was significantly lower than that before treatment and 3 months after treatment in the two groups (P ＜ 0.05).The serum SAA level at 12 months of treatment was significantly lower than that at 6 months of treatment in the two groups (P ＜ 0.05).Conclusion Bailing capsule can inhibit the inflammatory reaction of COPD patients by interfering with the secretion of serum SAA,so as to improving the clinical manifestations of COPD patients and reducing the acute attack of COPD.