摘要：
目的 评价复方蛤青胶囊联合富马酸福莫特罗片治疗老年慢性喘息型支气管炎合并肺气肿的疗效.方法 将符合入选标准的 156 例老年慢性喘息型支气管炎合并肺气肿患者采用随机数字表法分为2组,每组88例.2组均给予西医常规疗法治疗,在此基础上,对照组口服富马酸福莫特罗片,观察组口服复方蛤青胶囊.2组均治疗3个月.分别于治疗前后采用肺功能检测仪检测FEV1、用力呼气量占用力肺活量比值(the ratio of forced expiratory volume to forced pulmonary volume, FEV1/FVC)、峰值呼气流速(peak expiratory flow rate, PEF)、呼气高峰流量(peak expiratory flow, PEFR),采用ELISA法检测基质金属蛋白酶抑制剂-1(tissue inhibitors of metalloproteinase-1, TIMP-1)、IL-17、MMP-9、IL-8,采用流式细胞仪检测T淋巴细胞亚群(CD3+和CD4+),采用酶联免疫双抗体法检测免疫球蛋白(IgA、IgG和IgM)含量,评价临床疗效.结果 观察组总有效率为 93.2%(82/88)、对照组为 80.7%(71/88),2 组比较差异有统计学意义(Z＝3.781,P＝0.039).治疗后,观察组FEV1[(2.89±0.37)L比(2.22±0.33)L,t＝3.781]、FEV1/FVC[(65.10±6.67)%比(57.56±5.98)%,t＝3.894]、PEF[(6.76±0.69)L/S比(5.57±0.59)L/S,t＝3.351]、PEFR[(3.67±0.39)L/S 比(2.87±0.32)L/S,t＝3.561]水平均高于对照组(P＜0.05).治疗后,观察组血清 TIMP-1、IL-17、IL-8、MMP-9 水平均低于对照组(t 值分别为 3.567、3.692、3.491、3.394,P值均＜0.05),外周血CD3+、CD4+及IgA、IgG、IgM水平均高于对照组(t值分别为3.791、3.593、3.258、3.682、3.526,P值均＜0.05).结论 复方蛤青胶囊联合富马酸福莫特罗片可有效改善老年慢性喘息型支气管炎合并肺气肿患者的肺功能,降低炎症反应,提高机体免疫力.%Objective To explore the effects of Fufang-Haqing capsule with formoterol in the treatment of elderly pulmonary emphysema combined with chronic wheezing bronchitis. Methods A total of 156 patients with elderly pulmonary emphysema combined with chronic wheezing bronchitis in our hospital were divided into control group (88 cases) and observation group (88 cases). The control group was treated with formoterol, the observation group was treated with Fufang-Haqing capsule combined with formoterol. Both group treatment last three months. In the 2 groups, the levels of lung function indicators (FEV1, FEV1/FVC, PEF and PEFR), inflammatory markers [Matrix metalloproteinase inhibitors-1 (TIMP-1), interleukin-17 (IL-17), matrix metalloproteinase-9 (MMP-9) and interleukin-8 (IL-8)], immune function indicators [T lymphocyte subgroup (CD3+ and CD4+), immunoglobulin (IgA, IgG and IgM)] were detected before and after the treatment. During the treatment, the adverse actions were observed. Results The effect rate in treatment group was 93.2% (82/88), significantly higher than 80.7% (71/88) in control group (Z=3.781, P<0.05). After the treatment, the levels of FEV1 (2.89 ± 0.37 L vs. 2.22 ± 0.33 L, t=3.781), FEV1/FVC (65.10% ± 6.67% vs. 57.56% ± 5.98%, t=3.894), PEF (6.76 ± 0.69 L/S vs. 5.57 ± 0.59 L/S, t=3.351) and PEFR (3.67 ± 0.39 L/S vs. 2.87 ± 0.32 L/S, t=3.561) in the treatment group were significantly higher than those in the control group (P<0.05). The TIMP-1, IL-17, IL-8 and MMP-9 in the treatment group were significantly lower than those in the control group (t were 3.567, 3.692, 3.491, 3.394, all Ps<0.05), while the levels of CD3+, CD4+, IgA, IgG and IgM were in the treatment group were significantly higher than those in the control group (t were 3.791, 3.593, 3.258, 3.682, 3.526, all Ps<0.05). There was no significantly difference between the 2 groups in the adverse actions. Conclusions The Fufang-Haqing capsule with formoterol in the treatment of elderly pulmonary emphysema combined with chronic wheezing bronchitis showd good effect, could promote the levels of lung function, inflammatory and immune function.
