陈林晖 王海鹏 于祥 陈慧 张旭东

摘要 目的：探究金水六君煎辅助治疗对稳定期慢性阻塞性肺疾病（COPD）患者肺功能和免疫功能的影响。方法：选取2015年1月至2018年6月江苏省苏北人民医院收治的稳定期COPD患者160例作为研究对象，随机分为观察组和对照组，每组80例。对照组采用常规西药治疗，观察组在对照组基础上加服金水六君煎。比较2组患者治疗前后肺功能、免疫功能、免疫球蛋白以及临床有效率。结果：治疗后观察组临床有效率为86.25%，显著高于对照组68.75%（P<0.05）。治疗后2组免疫球蛋白（IgA、IgG和IgM）、肺功能（FEV1、FEV1和FEV1/FVC）、免疫功能（CD4+、Th17和Th17/Treg）较治疗前明显提高（P<0.05），且观察组上述指标治疗后均高于对照组（P<0.05）。治疗后2组CD8+较治疗前降低（P<0.05），且觀察组CD8+低于对照组（P<0.05）。结论：相较于常规的西药，加服金水六君煎治疗稳定期COPD能够显著改善患者呼吸功能，具有更好的疗效，可能与该方剂对免疫细胞及其细胞因子的作用有关。

关键词 稳定期;慢性阻塞性肺疾病;金水六君煎;肺功能;免疫功能;免疫球蛋白;第1秒钟用力肺活量;疗效

Effects of Jinshui Liujun Decoction in the Treatment of Chronic Obstructive Pulmonary Disease in Stable Stage

CHEN Linhui1， WANG Haipeng2， YU Xiang1， CHEN Hui1， ZHANG Xudong1

（1 Department of Geriatrics， Subei People′s Hospital， Jiangsu Province， Yangzhou 225001， China; 2 Department of Gastroenterology， North District Hospital， Subei People′s Hospital of Jiangsu Provine，Yangzhou 225001， China）

Abstract Objective：To explore the effects on lung function and immune function in patients with stable chronic obstructive pulmonary disease （COPD） by using Jinshui Liujun Decoction combined with Western medicine. Methods：A total of 160 patients with stable COPD admitted to the Department of Geriatrics of our hospital from January 2015 to June 2018 were selected as the research objects， and were randomly divided into an observatin group and a control group， with 80 cases in each group. The control group was treated with conventional Western medicine， while the combined Jinshui Liujun Decoction group was treated with Jinshui Liujun Decoction on the basis of the routine group. The lung function， immune function， immunoglobulin and clinical effectiveness were compared between the 2 groups. Results：After treatment， the clinical effective rate of the observation group was 86.25%， which was significantly higher than the clinical effective rate of the control group （68.75%） （P<0.05）. After treatment， the 2 groups of immunoglobulin （IgA， IgG and IgM）， lung function （FEV1， FEV1 and FEV1/FVC）， immune function （CD4+， Th17 and Th17/Treg） were significantly improved compared to those before treatment （P<0.05）. The above indicators in the observation group were higher than those in the control group after treatment （P<0.05）. After treatment， the CD8+ of the 2 groups was lower than that before treatment （P<0.05）， and the CD8+ of the observation group was lower than that of the control group （P<0.05）. Conclusion：Compared with conventional Western medicine， the addition of Jinshui Liujun Decoction in the treatment of stable COPD can significantly improve the respiratory function of patients with better curative effect， which may be related to the effect of the prescription on immune cells and their cytokines.

Keywords Stable period; Chronic obstructive pulmonary disease; Jinshui Liujun fried; Lung function; Immune function; Immunoglobulin; Forced vital capacity in the first second; Therapeutic effect

中图分类号：R289.5;R563文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.09.018

慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease，COPD）是由于慢性支气管炎或肺气肿进展演变而来的特征性呼吸气流受限疾病，根据疾病危重程度分为稳定期COPD和急性加重期COPD[1]。稳定期COPD患者虽然临床症状相对稳定，呼吸困难程度轻微，但气流受限进程仍处在不可逆发展中，加大了COPD急性加重期的发病风险，可能导致肺心病和呼吸衰竭等不良后果，是棘手的健康问题[2]。西医对稳定期COPD的治疗以控制炎症、缓解症状和止咳祛痰为主[3]，但难以有效抑制气流受限的进行性发展，使得患者劳动力逐渐丧失，生命质量不断下降[4]。不同于西医单纯的对症治疗，中药强调针对病因的综合调理作用，在改善临床症状的同时增强机体抵抗力，防治并发症的同时提高呼吸功能，具有显著的优势[5]。为探究中药对稳定期COPD患者肺部功能及免疫状态的影响，本研究采用噻托溴铵粉吸入剂联合金水六君煎治疗稳定期COPD患者。……