四君子汤联合三子养亲汤治疗痰浊壅肺型慢性阻塞性肺疾病稳定期临床研究
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Clinical Study on Sijunzi Decoction Combined with Sanzi Yangqin Decoction for Stable Chronic Obstructive Pulmonary Disease of Turbid Phlegm Obstructing Lung Type
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    摘要:

    目的:观察四君子汤联合三子养亲汤治疗痰浊壅肺型慢性阻塞性肺疾病(COPD) 稳定期的疗效。 方法:选取2023年11月—2024年8月绍兴市柯桥区中医医院医共体总院收治的134例COPD稳定期痰浊壅肺证 患者,按治疗方案差异分为观察组68例与对照组66例。对照组予以西药治疗,观察组在对照组基础上给予四 君子汤联合三子养亲汤治疗,2组均连续治疗4周。比较2组临床疗效及不良反应发生率,比较2组治疗前后中 医证候评分、肺功能指标[最大自主通气量(MVV)、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预 计值百分比(FEV1%)]、气道重塑指标[基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制因子-1(TIMP-1)、 血管内皮生长因子(VEGF)] 及血清炎症因子[白细胞介素-1α(IL-1α)、白细胞介素-17(IL-17)、肿瘤坏 死因子-α(TNF-α)] 水平的变化。结果:观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗 后,2组主症、次症中医证候积分均较治疗前下降(P<0.05),观察组主症、次症中医证候积分均低于对照组 (P<0.05)。治疗后,2组MVV、FEV1%、FEV1指标值均较治疗前升高,观察组上述3项指标值均高于对照组 (P<0.05)。治疗后,2组MMP-9、VEGF水平均较治疗前下降(P<0.05),TIMP-1水平均较治疗前升高(P<0.05), 观察组MMP-9、VEGF水平均低于对照组(P<0.05),TIMP-1水平高于对照组(P<0.05)。治疗后,2组IL-1α、 IL-17、TNF-α水平均较治疗前下降,观察组上述3项水平均低于对照组(P<0.05)。观察组不良反应发生率 为10.29% (7/68),对照组不良反应发生率为9.09% (6/66),2组不良反应发生率比较,差异无统计学意义 (P>0.05)。结论:四君子汤联合三子养亲汤治疗COPD稳定期痰浊壅肺证的临床疗效较好,能改善患者气道 重构及机体炎症程度,促进肺功能提升。

    Abstract:

    Abstract: Objective: To observe the curative effect of the combination use of Sijunzi Decoction and Sanzi Yangqin Decoction on stable chronic obstructive pulmonary disease(COPD)of turbid phlegm obstructing lung type. Methods:A total of 134 patients with stable COPD of turbid phlegm obstructing lung type admitted to Shaoxing City Keqiao District Traditional Chinese Medicine Hospital Medical Alliance Central Hospital from November 2023 to August 2024 were divided into the observation group(68 cases)and the control group(66 cases)according to various treatment plan. The control group was treated with western medicine, and the observation group was additionally treated with Sijunzi Decoction combined with Sanzi Yangqin Decoction based on the treatment in the control group. Both groups were treated for four weeks continuously. The clinical effects and incidence of adverse reactions,and the changes before and after treatment in traditional Chinese medicine syndrome scores, lung function indexes [maximal voluntary ventilation (MVV), forced expiratory volume in one second(FEV1) and forced expiratory volume in one second percentage predicted (FEV1%)], airway remodeling indexes [matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1(TIMP-1)and vascular endothelial growth factor(VEGF)] and the levels of serum inflammatory factors [interleukin-1α(IL-1α), interleukin-17(IL-17)and tumor necrosis factor-α(TNF-α)] were respectively compared between the two groups. Results: The clinical effects in the observation group were better than that in the control group,the difference being significant(P<0.05). After treatment,the traditional Chinese medicine syndrome scores of main and secondary symptoms in the two groups were decreased when compared with those before treatment (P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05). After treatment, the levels of MVV, FEV1% and FEV1 in the two groups were increased when compared with those before treatment, and the levels of above three indexes in the observation group were higher than those in the control group (P<0.05). After treatment, the levels of MMP-9 and VEGF in the two groups were decreased when compared with those before treatment(P<0.05),and the TIMP-1 levels in the two groups were elevated when compared with those before treatment(P<0.05); the levels of MMP-9 and VEGF in the observation group were lower than those in the control group(P<0.05),and the TIMP-1 level was higher than that in the control group(P<0.05). After treatment, the levels of IL-1α,IL-17 and TNF-α in the two groups dwindled when compared with those before treatment,and the above three levels in the observation group were lower than those in the control group(P<0.05). The incidence of adverse reactions was 10.29%(7/68)in the observation group and 9.09%(6/66)in the control group,there being no significance in the difference(P>0.05). Conclusion: The combination use of Sijunzi Decoction and Sanzi Yangqin Decoction has a good clinical effect on stable COPD with syndrome of turbid phlegm obstructing lung, which can improve the airway remodeling and degree of body inflammation,and promote the lung function.

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傅菡萏,何佳,寿丽芳.四君子汤联合三子养亲汤治疗痰浊壅肺型慢性阻塞性肺疾病稳定期临床研究[J].新中医,2025,57(17):32-37

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  • 在线发布日期: 2025-09-05
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