蔡绪明;王志梅;杨栓柱;孙昉昉;张军城;王文;

• 1:陕西省中医医院肺病科

摘要(Abstract)：

目的评价清肺固本汤治疗慢性阻塞性肺疾病(COPD)稳定期的临床疗效。方法回顾分析80例COPD稳定期患者,采用随机数字表法分为治疗组、对照组,各纳入40例病例,对照组应用沙美特罗替卡松粉吸入剂(50μg/500μg)治疗,治疗组患者在对照组基础上加用清肺固本汤(枳壳10 g,桔梗10 g,陈皮10 g,法半夏9 g,茯苓15 g,桑白皮15 g,杏仁10 g,黄芩10 g,浙贝母15 g,乌贼骨15 g,苏子10 g,莱菔子15 g,炒冬瓜仁15 g,太子参15 g,炒白术10 g,炒麦芽30 g等),每月为1疗程,连续用药3个疗程。结果评价结果显示,治疗组总有效率(92.50%)显著高于对照组(75.00%)(P <0.05)。与治疗前比较,2组治疗后患者单项症状咳嗽、咳痰、气喘、呼吸困难指数、肺功能均有显著差异(P <0.05);2组治疗后组间对比,治疗组患者单项症状咳嗽、咳痰、呼吸困难指数分别为(1.55±1.47)分、(1.45±0.91)分、(1.20±0.76)分、均明显低于对照组(P <0.05),急性加重风险低于对照组(P <0.05),肺功能变化差异无统计学意义(P> 0.05)。结论在COPD稳定期,清肺固本汤可能通过改善血管内皮功能障碍,减轻气道炎症反应,从而改善患者咳嗽、咳痰等症状,提高总有效率,并降低急性加重风险。

关键词(KeyWords)： 慢性阻塞性肺疾病;清肺固本汤;沙美特罗替卡松粉吸入剂

Abstract:

Keywords:

基金项目(Foundation): 陕西省中医管理局中医药科研课题（2017ZYPT016）

作者(Author): 蔡绪明;王志梅;杨栓柱;孙昉昉;张军城;王文;

Email:

DOI: 10.13463/j.cnki.jlzyy.2019.12.021

参考文献(References)：

• [1]SING D, AGUSTI A, ANZUETO A, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease:the GOLD science committee report 2019[J]. Eur Respir J, 2019, 53(5):102.
• [2]WANG C, XU J, YANG L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China(the China Pulmonary Health[CPH] study):a national cross-sectional study[J]. Lancet, 2018, 391(10131):1706-1717.
• [3]ADELOYE D, CHUA S, LEE C, et al. Global and regional estimates of COPD prevalence:Systematic review and metaanalysis[J]. J Glob Health, 2015, 5(2):20415.
• [4]CHEN W, THOMAS J, SADATSAFAVI M, et al. Risk of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease:a systematic review and metaanalysis[J]. Lancet Respir Med, 2015, 3(8):631-639.
• [5]QURESHI H, SHARAFKHANEH A, HANANIA N A.Chronic obstructive pulmonary disease exacerbations:latest evidence and clinical implications[J]. Ther Adv Chronic Dis,2014, 5(5):212-227.
• [6]RILEY C M, SCIURBA F C. Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease:a Review[J]. JAMA, 2019, 321(8):786-797.
• [7]GERSHON A, CROXFORD R, CALZAVARA, et al.Cardiovascular safety of inhaled long-acting bronchodilators in individuals with chronic obstructive pulmonary disease[J].JAMA Intern Med, 2013, 173(13):1175-1185.
• [8]LI M, WANG F, CHEN R, et al. Factors contributing to hospitalization costs for patients with COPD in China:a retrospective analysis of medical record data[J]. Int J Chron Obstruct Pulmon Dis, 2018, 13:3349-3357.
• [9]LIAO Y N, HU W L, CHEN H J, et al. The Use of Chinese Herbal Medicine in the Treatment of Chronic Obstructive Pulmonary Disease(COPD)[J]. Am J Chin Med, 2017, 45(2):225-238.
• [10] HONG M, HONG C, CHEN H, et al. Ef fects of the Chinese herb formula Yufeining on stable chronic obstructive pulmonary disease:a randomized, double-blind, placebocontrolled trial[J]. Medicine(Baltimore), 2018, 97(39):e12461.
• [11] SHERGIS J L, LIU S, CHEN X, et al. Dang shen[Codonopsis pilosula(Franch.)Nannf] herbal formulae for chronic obstructive pulmonary disease:a systematic review and meta-analysis[J]. Phytother Res, 2015, 29(2):167-186.
• [12]蔡绪明,张军城,曹利平.曹氏加味清金化痰汤联合沙美特罗替卡松粉吸入剂治疗慢性阻塞性肺疾病稳定期临床疗效[J].陕西中医, 2016, 6(37):655-657.
• [13] VOGELMEIER C F, CRINER G J, MARTINEZ F J, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017Report:GOLD Executive Summary[J]. Eur Respir J, 2017,49(3):128-149.
• [14]李建生,李素云,余学庆.慢性阻塞性肺疾病中医诊疗指南(2011版)[J].中医杂志, 2012, 53(1):80-84.
• [15]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社, 2002:54-58.
• [16]葛均波,徐永健,王辰.内科学[M]. 9版.北京:人民卫生出版社, 2018:21-27.
• [17]韦柳萍,宋林,杨彬.联合吸入噻托溴铵与糖皮质激素/长效β2受体激动剂治疗稳定期慢性阻塞性肺疾病有效性和安全性的系统评价[J].中国临床药理学与治疗学,2016, 21(7):777-783.
• [18] AGUSTI A, FABBRI L M, SINGH D, et al. Inhaled corticosteroids in COPD:friend or foe[J]. European Respiratory Journal, 2018, 52(6):27.
• [19] SINGHD,ROCHEN,HALPIND,etal.Current Controversies in the Pharmacological Treatment of Chronic Obstructive Pulmonary Disease[J]. Am J Respir Crit Care Med, 2016, 194(5):541-549.
• [20]陈善夫,封继宏,魏葆琳.清热化痰法治疗慢性阻塞性肺疾病急性加重痰热郁(蕴)肺证研究进展[J].吉林中医药,2015, 35(12):1295-1298.
• [21]梁永妍.补中益气汤对慢性阻塞性肺疾病疗效及预后指标的影响[J].长春中医药大学学报, 2017, 33(4):581-583.