补肾益肺消癥方治疗老年COPD合并PIF的疗效及对患者血清VEGF、PAI-1、VCAM-1和肺功能的影响被引量：5

Efficacy of Bushen Yifei Xiaozheng decoction in the treatment of elderly chronic obstructive pulmonary disease with pulmonary interstitial fibrosis and its effects on serum vascular endothelial growth factor,plasminogen activator inhibitor-1,vascular cell adhesion molecule 1 and pulmonary function

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摘要目的观察补肾益肺消癥方治疗老年慢性阻塞性肺疾病(COPD)合并肺间质纤维化(PIF)的疗效,并探讨其对患者血清中血管内皮生长因子(VEGF)、纤溶酶原激活物抑制物1 (PAI-1)、血管细胞黏附因子(VCAM-1)和肺功能的影响。方法收集2019年4月至2022年4月就诊于宝鸡市人民医院的102例老年COPD合并PIF患者为研究对象,采用随机数表法将患者分为观察组和对照组各51例,对照组患者以西药方式进行对症治疗,观察组患者在对照组基础上加用补肾益肺消癥方,疗程为2个月。比较两组患者的临床治疗效果,治疗前后的中医症状积分、血清VEGF、PAI-1、VCAM-1水平及肺功能指标[用力肺活量(FVC)、一秒用力呼气容积(FEV1)、FEV1/FVC]变化。结果观察组患者的治疗总有效率为90.20%,明显高于对照组的72.55%,差异具有统计学意义(P<0.05);治疗前,两组患者的中医症状积分比较差异无统计学意义(P>0.05),治疗后,观察组患者的喘促、咳嗽、胸闷积分分别为(1.77±0.51)分、(1.88±0.59)分、(1.57±0.45)分,明显低于对照组的(2.67±0.83)分、(2.55±0.76)分、(2.17±0.63)分,差异均具有统计学意义(P<0.05);治疗后,两组患者的血清VEGF、PAI-1、VCAM-1水平均较治疗前明显降低,且观察组分别为(160.97±20.17) ng/L、(49.98±12.58) pg/mL、(359.17±103.05)μg/L,明显低于对照组的(171.17±21.53) ng/L、(57.65±13.36) pg/mL、(413.17±124.13)μg/L,差异均有统计学意义(P<0.05);治疗前,两组患者的肺通气功能比较差异无统计学意义(P>0.05),治疗后,观察组患者的FEV1、FVC、FEV1/FVC%分别为(3.07±0.87) L、(3.58±1.09) L、(80.19±8.05)%,明显高于对照组的(1.97±0.43) L、(2.95±0.86) L、(66.26±7.19)%,差异均具有统计学意义(P<0.05)。结论补肾益肺消癥方对老年COPD合并PIF的治疗效果较好,且能够降低患者的血清VEGF、PAI-1、VCAM-1水平,改善肺脏通气功能。 Objective To observe the efficacy of Bushen Yifei Xiaozheng decoction in treating elderly chronic obstructive pulmonary disease with pulmonary interstitial fibrosis,and explore its effects on serum vascular endothelial growth factor(VEGF),plasminogen activator inhibitor-1(PAI-1),vascular cell adhesion molecule 1(VCAM-1)and pulmonary function in the patients.Methods A total of 102 elderly patients with chronic obstructive pulmonary disease complicated with pulmonary interstitial fibrosis treated in Baoji People's Hospital between April 2019 and April 2022 were collected as the study objects.They were divided into an observation group(n=51)and a control group(n=51)by the random number table method.The patients in the control group were given western medicine for symptomatic treat-ment,and the patients in the observation group were additionally given Bushen Yifei Xiaozheng decoction on the basis of the control group,for 2 months.The clinical efficacy,and the changes of TCM symptom scores,serum VEGF,PAI-1,VCAM-1 levels and lung function indexes[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC]before and after treatment were compared between the two groups.Results The total effective rate of treat-ment in the observation group was 90.20%,which was significantly higher than 72.55%in the control group(P<0.05).Before treatment,there were no statistically significant differences in TCM symptoms scores between the two groups(P>0.05);after treatment,and the scores of dyspnea and tachypnea,cough,and chest tightness in the observation group were(1.77±0.51)points,(1.88±0.59)points,and(1.57±0.45)points,which were significantly lower than(2.67±0.83)points,(2.55±0.76)points,and(2.17±0.63)points in the control group(P<0.05).Compared with before treatment,the VEGF,PAI-1,and VCAM-1 in serum of both groups were significantly decreased after treatment,and the levels in the observa-tion group were(160.97±20.17)ng/L,(49.98±12.58)pg/mL,and(359.17±103.05)μg/L,respectively,which were signifi-cantly lower than(171.17±21.53)ng/L,(57.65±13.36)pg/mL,and(413.17±124.13)μg/L in the control group(P<0.05).Before treatment,there was no significant difference in pulmonary ventilation function between the two groups(P>0.05);but after treatment,the FEV1,FVC,and FEV1/FVC%in the observation group were(3.07±0.87)L,(3.58±1.09)L,and(80.19±8.05)%,which were significantly higher than(1.97±0.43)L,(2.95±0.86)L,and(66.26±7.19)%in the control group(P<0.05).Conclusion Bushen Yifei Xiaozheng decoction has good therapeutic effects on elderly chronic ob-structive pulmonary disease with pulmonary interstitial fibrosis,which can reduce the levels of serum VEGF,PAI-1 and VCAM-1,and improve the pulmonary ventilation function.

作者苏垠旭吴丹李婧曲萌 SU Yin-xu;WU Dan;LI Jing;QU Meng(Department of Traditional Chinese Medicine,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA)

机构地区宝鸡市人民医院中医科

出处《海南医学》 CAS 2023年第10期1388-1392,共5页 Hainan Medical Journal

基金陕西省科技发展计划项目(编号:2010K 1-201) 宝鸡文理学院重点项目(编号:ZK12013)。

关键词慢性阻塞性肺疾病肺间质纤维化补肾益肺消癥方肺功能疗效 Chronic obstructive pulmonary disease Pulmonary interstitial fibrosis Bushen Yifei Xiaozheng de-coction Pulmonary function Efficacy

分类号 R563 [医药卫生—呼吸系统]

作者简介第一作者:苏垠旭(1990-),女,硕士,主治医师,研究方向:呼吸与消化病中医内科临床研究。;通讯作者:曲萌(1990-),女,硕士,主治医师,研究方向:中西医结合呼吸、消化内科以及中西医结合肿瘤防治的临床研究,E-mail:qumeng90816@163.com。