摘要
目的探讨咳喘顺丸联合噻托溴铵治疗哮喘-慢阻肺重叠综合征(ACOS)临床疗效及对血清炎症因子的影响。方法2019年12月—2020年12月在该院确诊的120例痰湿阻证ACOS患者,采用简单随机分组将所有纳入的患者分为观察组和对照组各60例。对照组采用噻托溴铵粉雾剂治疗,观察组在对照组的基础上联合咳喘顺丸治疗。连续治疗28 d,观察比较两组患者临床治疗效果、肺功能指标[用力肺活量(FVC)、呼气峰值流速(PEF)、第一秒用力呼气容积(FEV_(1))、残总比[残气容积(RV)/肺总量(TLC)]]、临床症状[中医证候、哮喘控制测试(ACT)、慢性阻塞性肺病评估测试(CAT)评分及急性加重次数]及血清炎症因子[肿瘤坏死因子-α(TNF-α)、白介素细胞-6(IL-6)与白介素细胞-4(IL-4)]水平差异,观察并记录两组患者治疗期间不良反应发生情况。结果观察组患者的临床治疗总有效率为95.00%(57/60),明显高于对照组患者的临床治疗总有效率为83.33%(40/60)(P<0.05);治疗后,观察组患者的中医证候评分均明显减少(P<0.05),且观察组患者评分明显低于对照组(P<0.05);治疗后,两组患者的ACT评分均明显增加(P<0.05),CAT评分和急性发作次数均明显减少(P<0.05),且观察组患者的ACT评分高于对照组(P<0.05),CAT评分和急性发作次数均低于对照组(P<0.05);治疗后,两组患者的FVC、PEF、FEV_(1)均明显增加(P<0.05),RV/TLC明显减少(P<0.05),且观察组FVC、PEF、FEV_(1)指标高于对照组,RV/TLC指标低于对照组(P<0.05);治疗后,观察组患者的TNF-α、IL-4、IL-6指标均明显减少(P<0.05),且观察组患者指标明显低于对照组(P<0.05);两组间不良反应发生情况差异无统计学意义(P>0.05)。结论咳喘顺丸联合噻托溴铵治疗AOSC患者,能够显著减轻患者体内炎性因子水平,调控机体免疫水平,改善患者肺功能,还能有效控制哮喘与慢阻肺的病情发展,减少急性加重发作次数,提高临床治疗总有效率,且治疗期间安全性良好,未见严重不良反应。
Objective To explore the clinical curative effect of Kechuanshun Pills(咳喘顺丸)combined with tiotropium on asthma-chronic obstructive pulmonary disease overlap syndrome(ACOS)and their influences on serum inflammatory factors.Methods A total of 120 patients confirmed with ACOS of phlegm-dampness obstruction syndrome in the hospital were enrolled between December 2019 and December 2020.According to the simple random grouping method,they were divided into the observation group and the control group,60 cases in each group.The control group was treated with tiotropium powder spray while the observation group was additionally treated with Kechuanshun Pills for 28 d.The clinical curative effect and changes in pulmonary function indexes[forced vital capacity(FVC),peak expiratory flow(PEF),forced expiratory volume in one second(FEV_(1)),residual volume/total lung capacity(RV/TLC)],scores of clinical symptoms[TCM syndromes,asthma control test(ACT),COPD assessment test(CAT),times of acute exacerbation]and levels of serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-4(IL-4)]were observed and compared between the two groups.The occurrence of adverse reactions during the treatment in both groups was observed and recorded.Results The total response rate in the observation group was significantly higher than that in the control group[95.00%(57/60)vs 83.33%(40/60)](P<0.05).After treatment,the scores of TCM syndromes in the observation group were significantly decreased(P<0.05),significantly lower than those in the control group(P<0.05).After treatment,the ACT scores were significantly increased(P<0.05),while the CAT scores and times of acute attacks were significantly decreased in both groups(P<0.05).After treatment,the ACT scores in the observation group were higher than those in the control group(P<0.05),while the CAT scores and times of acute attacks were lower than those in the control group(P<0.05).After treatment,the levels of FVC,PEF and FEV_(1) were significantly increased(P<0.05),while the ration of RV/TLC was significantly decreased in both groups(P<0.05).After treatment,the levels of FVC,PEF and FEV_(1) in the observation group were higher than those in the control group,while the ration of RV/TLC was lower than that in the control group(P<0.05).After treatment,the levels of TNF-α,IL-4 and IL-6 in the observation group were significantly decreased(P<0.05)and significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Kechuanshun Pills combined with tiotropium can significantly reduce the levels of inflammatory factors in AOSC patients,regulate the immune function,improve the pulmonary function,effectively control the development of asthma and chronic obstructive pulmonary disease,reduce the attack times of acute exacerbation and improve the total response rate of clinical treatment,with good safety during treatment and no serious adverse reaction.
作者
韩宝勇
HAN Baoyong(The First Department of Respiratory and Critical Care,Zhangjiakou First Hospital,Zhangjiakou 075000,Hebei,China)
出处
《辽宁中医杂志》
CAS
2022年第5期106-110,共5页
Liaoning Journal of Traditional Chinese Medicine
基金
张家口是科学技术研究计划项目(1221043D)
关键词
哮喘-慢阻肺重叠综合征
噻托溴铵
咳喘顺丸
炎症因子
asthma-chronic obstructive pulmonary disease overlap syndrome
tiotropium
Kechuanshun Pills(咳喘顺丸)
inflammatory factor
作者简介
韩宝勇(1976-),男,副主任医师,硕士研究生,研究方向:呼吸系统疾病的常见病、多发病及疑难病的临床研究。
