陈喜艳 张小沛 袁虎林 王贝贝 李新建

【摘要】 目的 研究参苓白术散加减联合多索茶碱治疗慢性阻塞性肺疾病（COPD）稳定期的效果。

方法 选取COPD稳定期患者102例（2018年9月～2019年9月），按照随机数字表分为单一组、联合组，各51例。单一组采用多索茶碱治疗，联合组采用参苓白术散加減联合多索茶碱治疗。比较两组疗效、治疗前、治疗2个月后中医证候积分、肺功能[第1 秒用力呼气容积（FEV1）、FEV1/用力肺活量（FVC）]、氧化应激指标[血清丙二醛（MDA）、超氧化物歧化酶（SOD）]及生活质量[生活质量综合评定问卷-74（GQOL-74）评分]。

结果 联合组总有效率94.12%高于单一组80.39%（P<0.05）;联合组中医证候积分低于单一组（P<0.05）;治疗2个月后，联合组FEV1、FEV1/FVC高于单一组（P<0.05），血清MDA水平低于单一组，SOD高于单一组（P<0.05），GQOL-74评分高于单一组（P<0.05）。

结论 参苓白术散加减联合多索茶碱治疗COPD稳定期疗效显著，能降低中医证候积分，改善肺功能，调节氧化应激指标，提高生活质量。

【关键词】 参苓白术散;多索茶碱;COPD稳定期;肺功能;GQOL-74评分

中图分类号：R256.1;R563.3   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2021.07.010

【Abstract】 Objective To study the effect of the addition or reduction of Shenling Baizhu powder combined with doxophylline in the treatment of chronic obstructive pulmonary disease （COPD） at stable stage.

Methods 102 patients with COPD at stable stage （from September 2018 to September 2019） were selected and divided into single group and combined group according to random number table， with 51 patients in each group. The single group were treated with doxophylline， and the combined group were treated with addition or reduction of Shenling Baizhu powder combined with doxophylline. And then， curative effects as well as TCM syndrome scores， lung functions （forced expiratory volume in one second [FEV1]， FEV1 / forced vital capacity [FVC]）， oxidative stress indexes （serum malondialdehyde [MDA]， superoxide dismutase [SOD]） and the quality of life （Generic Quality of Life Inventory-74 [GQOL-74] score） before and after 2 months of treatment  were compared between the two groups.

Results The total effective rate of the combined group was 94.12%， higher than that of the single group （80.39%） （P < 0.05）. The TCM syndrome score of the combined group was lower than that of the single group （P < 0.05）. After 2 months of treatment， FEV1 and FEV1/FVC in the combined group were higher than those in the single group （P < 0.05）， the serum MDA level of the combined group was lower than that of the single group， the SOD level was higher than that of the single group （P < 0.05）， and the GQOL-74 score was higher than that of the single group （P < 0.05）.

Conclusion Addition or reduction of Shenling Baizhu powder combined with doxtheophylline has significant therapeutic effect on COPD at stable stage， which can reduce TCM syndrome score， improve lung function， regulate oxidative stress index， and improve the quality of life.

【Key words】 Shenling Baizhu powder; doxophylline; COPD at stable stage; lung function; GQOL-74 score

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是临床常见病，多伴有咳嗽、胸闷、喘息，且近年来发病率逐渐上升，会严重降低患者生活质量[1]。临床应积极采取措施减轻临床症状，改善肺功能，提高生活质量。多索茶碱属于新型甲基黄嘌呤衍生物，能松弛平滑肌，扩张支气管，改善临床喘息、咳嗽症状[2]。中医药理论认为，COPD属于“咳喘”“痰饮”范畴，多由于本虚实标、脾肺气虚、痰瘀阻肺，临床应采取补脾益肺、补气活血、宣肺利水为原则进行治疗[3]。本研究选取我院COPD稳定期患者102例，旨在探讨参苓白术散加减联合多索茶碱的治疗效果，现报告如下。

1 资料与方法

1.1 一般资料

经我院医学伦理委员会批准，选取我院COPD稳定期患者102例（2018年9月～2019年9月），按照随机数字表分为单一组、联合组，各51例。……