噻托溴铵联合降气纳肾法对COPD缓解期患者的治疗作用

摘要

Objective This study investigated the effects of Tiotropium combine with Traditional Chinese Medicine in treating COPD patients who are in remittent stage.Method Using a prospective randomized controlled design,we equally divided 120 cases of COPD patients whose lung function were classified as levelⅡorⅢ into two groups: the treatment group and the control group. The treatment group were given Tiotropium 18μg qd and placebo,while the control group were treated by the herbs of Jiangqinashen. After three months treatment,we collected observations of serum IL-8 level,SGRQ score,activity tolerance,and adverse events.ResultsStudy showed that after treatment,both groups IL-8 level had reduced significantly(P<0.05),but that of the treatment group had not improved(P>0.05). both groups 6 minute walk test had improved significantly (P<0.05),while that of the treatment group had improved more significantly(P<0.05).However,In SGRQ score,The total score and affect score difference between the two groups before and after treatment had no significant difference(P>0.05),while part of the symptoms and activity differences(P<0.05).In adverse events of dry mouth,treatment group had significantly reduced than the control group.ConclusionTreating COPD patients with Tiotropium and Jiangqinashen Herbs improves patients activity tolerance and reduced the adverse events.%目的：探讨噻托溴铵联合降气纳肾法对慢性阻塞性肺疾病（COPD）缓解期患者的治疗作用。方法采用前瞻性随机对照设计，将120例COPD缓解期肺功能分级为Ⅱ或Ⅲ级的患者，随机分为对照组及观察组，每组各60例，对照组予噻托溴铵粉吸入剂18μg吸入联合安慰剂治疗为主，观察组则加用降气纳肾法中药，疗程为3个月。观察血清白介素-8（IL-8）水平、圣乔治评分、活动耐量及不良事件的变化。结果两组COPD患者经治疗后血清IL-8水平有明显下降（P<0.05），而治疗后观察组相对于对照组的血清IL-8无明显差异（P>0.05）。在圣乔治呼吸问卷评分中，治疗前后两组总分差值及影响部分未见明显差异（P>0.05），而症状及活动部分有明显差异（P<0.05）。经治疗后，两组的6分钟步行试验均得到改善，观察组改善程度大于对照组（P>0.05）。在不良事件中，观察组的口干事件较对照组有明显的减少（P<0.05）。结论噻托溴铵联合降气纳肾法治疗COPD稳定期患者可以改善活动耐量及减少不良事件。