目的 探究桑白皮汤加减联合沙丁胺醇雾化治疗慢性阻塞性肺疾病急性加重期(Acute exacerbation of chronic obstructive pulmonary,AECOPD)患者的疗效及对其免疫功能的影响.方法 选取2020年10月-2022年10月期间亳州市中医院收治的AECOPD患者100例,按随机数字表法分为对照组和治疗组,每组各50例.对照组给予沙丁胺醇雾化及常规西药治疗,治疗组在对照组基础上给予桑白皮汤加减.两组患者均治疗14 d.观察比较两组患者临床疗效、不良反应情况,治疗前后中医证候积分,气道炎症指标[白细胞计数、血清降钙素原(Pro-calcitonin,PCT)、C 反应蛋白(C-reactive protein,CRP)]、血气指标[动脉血氧分压(Arterial blood oxygen pressure,PaO2)、二氧化碳分压(Partial pressure of carbon dioxide,PaCO2)]、免疫功能(CD3+、CD4+、CD4+/CD8+).结果 治疗后治疗组总有效率98.00%(49/50)明显高于对照组84.00%(42/50),差异有统计学意义(P<0.05).治疗后两组患者中医证候积分较治疗前降低,差异有统计学意义(P<0.05),且治疗组中医证候积分明显低于对照组,差异有统计学意义(P<0.05).治疗后两组患者血清PCT、CRP、白细胞计数水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血清PCT、CRP、白细胞计数水平均明显低于对照组,差异有统计学意义(P<0.05).治疗后两组患者血气指标PaO2水平均较治疗前升高,PaCO2水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组PaO2水平明显高于对照组,PaCO2水平明显低于对照组,差异有统计学意义(P<0.05).治疗后两组患者免疫功能CD3+、CD4+、CD4+/CD8+水平均较治疗前升高,差异有统计学意义(P<0.05);且治疗组免疫功能CD3+、CD4+、CD4+/CD8+水平均明显高于对照组,差异有统计学意义(P<0.05).治疗期间,两组患者不良反应总发生率比较,差异无统计学意义(P>0.05).结论 AECOPD使用桑白皮汤加减联合沙丁胺醇雾化治疗可有效提高免疫功能,改善患者临床症状,调节血气指标,减轻炎症反应,安全有效.
Efficacy of Modified Sangbaipi Decoction Combined with Salbutamol Atomization in the Treatment of Acute Exacerbation of COPD and Its Effect on Immune Function
Objective To explore the efficacy of modified Sangbaipi Decoction combined with salbutamol atomi-zation in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its effect on immune function.Methods A total of 100 patients with AECOPD who were admitted to Bozhou Hospital of Traditional Chinese Medicine were randomly divided into a control group(50 cases)and a treatment group(50 cases)with the random number table method.The control group was treated with salbutamol atomization and other conventional western medicines,while the treatment group was treated with modified Sangbaipi Decoction on the basis of the therapeutic method of the control group.The patients in the two groups were treated for 14 days.The clinical efficacy and adverse reactions in the two groups were observed and compared.The levels of following indicators before and after treatment were compared:traditional Chi-nese medicine(TCM)syndrome scores,airway inflammation indicators[white blood cell count,serum procalcitonin(PCT),and C-reactive protein(CRP)],blood gas indicators[arterial partial pressure of oxygen(PaO2)and partial pressure of carbon dioxide(PaCO2)],and immune function(CD3+,CD4+,and CD4+/CD8+).Results After treatment,the total effective rate of 98.00%(49/50)in the treatment group was significantly higher than that of 84.00%(42/50)in the con-trol group,and the difference was statistically significant(P<0.05).The TCM syndrome scores of the two groups de-creased after treatment compared with before treatment,with statistically significant differences shown(P<0.05).Further-more,the TCM syndrome scores of the treatment group were lower between the two groups with statistically significant differences(P<0.05).After treatment,the levels of serum PCT,CRP,and white blood cell count of patients in the two groups were lower than those before treatment,and the differences were statistically significant(P<0.05).In addition,these levels were much lower in the treatment group than in the control group with statistically significant differences(P<0.05).Both the groups saw increased PaO2 levels and lowered PaCO2 levels,and statistically significant differences were exhibited(P<0.05).In addition,the treatment method of the treatment group outperformed that of the control group re-garding these two indicators,and the differences were statistically significant(P<0.05).After treatment,the levels of CD3+,CD4+,and CD4+/CD8+reflecting immune function in the two groups were higher than those before treatment,and the differences were statistically significant(P<0.05).Noteworthily,the levels of CD3+,CD4+,and CD4+/CD8+in the treatment group were higher than those in the control group with statistical significances(P<0.05).During the treatment,the difference in the total incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion The treatment of AECOPD with modified Sangbaipi Decoction combined with salbutamol atomization can effectively improve immune function,relieve patients'clinical symptoms,regulate blood gas indicators,and reduce in-flammatory reaction,which is safe and effective.
Acute Exacerbation of COPDSalbutamolSangbaipi DecoctionImmune Function