摘要
目的观察喘可治注射液雾化吸入治疗慢性阻塞性肺疾病（COPD）急性发作的临床疗效。方法采用前瞻性研究方法将74例COPD急性加重患者按随机数字表法分为对照组（34例）和治疗组（40例），对照组予西医常规治疗（吸氧、抗感染、解痉、平喘、化痰、营养支持等），治疗组在此基础上雾化吸入喘可治，每次4ml，每日2次，疗程均为7d。观察患者治疗前后主要临床症状、体征、血白细胞计数（wBC）、中性粒细胞比例（N）、C-反应蛋白（CRP）、血气分析、肺功能、淋巴细胞亚群变化情况，同时观察不良反应发生情况。结果治疗组总有效率明显高于对照组（82．5％比76．5％，P〈0．05）。两组治疗后血WBC、N、CRP、动脉血氧分压（PaO2）、动血脉血二氧化碳分压（PaCO2）及1秒用力呼气容积（FEV，）均较治疗前明显改善（均P〈0．05），其中治疗组CRP、PaO2、PaCO2及FEV1较对照组改善更明显[CRP（mg／L）：7．8±5．6比17．0±7．2，PaO2（mmHg，1mmHg-0．133kPa）：82．8±7．3比73．5±8．1，PaCO2（ramHg）：35．3±4．3比45．4±4．8，FEV．：0．706±0．091比0．621±0．089，均P〈0．053。治疗组治疗后CD3＋、CD4＋、CD19＋明显升高，CD8＋明显下降，CD4＋／CD8＋比值升高（均P〈0．05），且治疗组与对照组治疗后相比差异有统计学意义（CD3＋：0．621±0．098比0．551±0．094，CD4＋：0．393±0．091比0．331±0．079，CD19＋：0．089±0．037比0．069±0．031，CD8＋：0．207±0．055比0．277±0．067，CD4＋／CD8＋比值：0．020±0．006比0．011±0．007，均P〈0．05）。两组均未见明显不良反应。结论喘可治雾化吸入治疗COPD急性发作患者可改善患者临床表现和免疫功能，无明显不良反应发生。
Objective To observe the clinical efficacy of Chuankezhi （喘可治） by atomizing inhalation in treating patients with acute exacerbation of chronic obstructive pulmonary disease （COPD）. Methods Seventy-four patients with COPD were randomly divided into two groups., the control group （n = 34） and treatment group （n = 40）. The control group accepted the western routine therapies, including oxygen therapy, anti-infection, spasmolysis, relieving asthma, reducing phlegm and nutritional support, etc. The treatment group received similar western routine therapies plus Chuankezhi by atomizing inhalation once 4 ml, twice a day, a therapeutic course being 7 days. The changes of main clinical symptoms, physical signs, white blood cell （WBC） count and the percentage of neutrophil （N）, C-reactive protein（CRP）,blood gas analysis, lung function and lymphocyte subsets before and after therapy were observed, and the side effects were recorded. Results The total effective rate of treatment group was obviously higher than that of control group （82.5% vs. 76.5% P〈0.05）. Compared with those before treatment, the blood WBC, N, CRP, partial pressure of oxygen in artery （PaO2）, partial pressure of carbon dioxide in artery （PaCO2）, forced expiratory volume in one second （FEV1%） after treatment in the two groups were improved （all P〈0. 05） , and the improvement of CRP, PaO2, PaCO2, FEV1% in treatment group was better than those in control group （CRP （mg/L） ： 7.8± 5.6 vs. 17.0±7.2, PaO2 （mm Hg, 1 mm Hg= 0. 133 kPa） ： 82.8±7.3 vs. 73.5 ±8. 1, PaCO2 （ram Hg）.. 35.3±4.3 vs. 45.4=t=4. 8, FEV1. 0. 706±0. 091 vs. 0. 621±0. 089, all P〈0. 05）. The levels of CD3＋, CD4＋, CD19＋ and CD4＋/CD8＋ after treatment in treatment group were obviously increased, and CD8＋ was decreased compared with those before treatment （all P〈0.05）,while in the control group, there were no significant changes of CD3＋. CD4＋. CD19＋. CD8＋. CD4＋/CD8＋ before and after treatment （P 0.05）, therefore after treatment the differences in changes of lymphocyte subsets between the two groups were statistically significant （CD3＋： 0. 621 ± 0. 098 vs. 0. 551 ± 0. 094, CD4＋ , 0. 393 ：h 0. 091 vs. 0. 331± 0.079, CD19＋ 0.089±0.037 vs. 0.069=t=0.031, CD8＋： 0.207±0.055 vs. 0.277±0.067, CD4＋/CD8＋： 0. 020 ±0. 006 vs. 0. 011±0. 007, all P〈0.05）. There was no obvious adverse reaction in both groups. Conclusion Chuankezhi by atomizing inhalation can improve clinical manifestations and immune function in the treatment of patients with COPD,and cause no obvious adverse reaction.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2011年第5期270-272,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
浙江省医药卫生科研基金项目（2009A067）
关键词
中药
喘可治
雾化吸入
肺疾病
阻塞性
慢性
急性发作
中西医结合疗法
Herb
Chuankezhi
Atomizing inhalation
Chronic obstructive pulmonary disease
Acute exacerbation
Combination of traditional Chinese and western medicine
