特布他林联合清肺化痰汤治疗老年COPD疗效观察

摘要

目的:探讨特布他林联合清肺化痰汤治疗老年慢性阻塞性肺疾病(COPD)的临床疗效情况.方法:选取老年COPD患者86例,随机分为观察组和对照组各43例,对照组给予特布他林治疗,观察组在此基础上给予清肺化痰汤治疗.比较两组患者疗效情况,及治疗后两组患者肺功能及免疫功能情况,检测治疗后两组患者血清 PCT、Endotoxin及GLU表达水平情况.观察治疗后两组患者循环炎性因子表达水平(IL-13、C-反应蛋、TNF-α)和呼吸衰竭指数水平情况.结果:观察组患者治疗有效率(97.67%)明显高于对照组(72.09%),差异具有统计学意义(P<0.05).观察组的肺功能各项指标明显优于对照组,差异具有统计学意义(P<0.05).观察组CD3+、CD4+、CD4+ /CD8+水平高于对照组,CD8+水平低于对照组,差异具有统计学意义(P<0.05).治疗后,观察组PCT、Endotoxin及GLU水平明显低于对照组,差异具有统计学意义(P<0.05).治疗后,观察组患者C-反应蛋白、TNF-α和IL-13水平明显低于对照组,RFI明显高于对照组,差异具有统计学意义(P<0.05).结论:对COPD急性加重期痰热郁肺证型患者,采用清金化痰汤合麻杏石甘汤治疗治疗,可明显缓解临床症状,改善炎症反应症状,改善其肺功能并对调节免疫功能有一定作用.%Objective:To investigate the clinical efficacy of terbutaline combined with Qingfei Huatan decoc-tion in the treatment of chronic obstructive pulmonary disease(COPD)in the elderly.Methods:86 elderly COPD patients in our hospital were randomly divided into the observation group(43 cases)and the control group(43 ca-ses).The control group was given terbutaline treatment,and the observation group was given Qingfei Huatan de-coction on the basis of this treatment.The curative effect of two groups was compared.The lung function and im-mune function of two groups after treatment were compared.The levels of serum PCT,Endotoxin and GLU were detected after treatment in two groups.The levels of circulating inflammatory factors(IL-13,C-reaction,TNF-al-pha)and respiratory failure index in the two groups were observed after treatment.Results:The effective rate of treatment in the observation group(97.67%)was significantly higher than that of the control group(72.09%),and the difference was statistically significant(P<0.05).The indexes of lung function of the observation group were ob-viously superior to those of the control group,and the difference was statistically significant(P<0.05).The level of CD3+,CD4+ and CD4+ /CD8+ in the observation group was higher than that of the control group,and the level of CD8+ was lower than that of the control group.The difference was statistically significant(P<0.05).After treat-ment,the levels of PCT,Endotoxin and GLU in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of C- reactive protein,TNF-alpha and IL-13 in the observation group were significantly lower than those in the control group,RFI was significantly higher than that in the control group,the difference was statistically significant(P<0.05).Con-clusion:The acute exacerbation of COPD of phlegm heat obstructing lung syndrome patients,using Qingfei Huatan decoction and Maxing Shigan decoction treatment,can significantly relieve the clinical symptoms,improve inflam-mation symptoms,improve the pulmonary function and has certain effect on regulating the immune function.