目的 探討蘇子降氣丸聯(lián)合多索茶堿片治療慢性阻塞性肺氣腫的臨床療效和作用機(jī)制。方法 選取沈陽(yáng)二四二醫(yī)院2012年7月-2014年1月收治的慢性阻塞性肺氣腫患者56例,隨機(jī)分成對(duì)照組和治療組,每組各28例。對(duì)照組在常規(guī)治療的基礎(chǔ)上口服多索茶堿片200 mg/次﹐2次/d;治療組在對(duì)照組治療的基礎(chǔ)上加服蘇子降氣丸,6 g/次,2次/d。兩組均連續(xù)治療14 d,進(jìn)行肺功能指標(biāo)第1秒用力呼氣容積(FEV₁)、用力肺活量(FVC)以及比值(FEV_l/FVC),血?dú)鈩?dòng)脈血氧分壓(PaO₂)、動(dòng)脈血二氧化碳分壓(PaCO₂)和血氧飽和度(SaO₂)分析,觀察兩組患者的臨床療效,比較兩組血清腫瘤壞死因子-α(TNF-α)、白細(xì)胞介素-4(IL-4)、白細(xì)胞介素-8(IL-8)的水平變化,并進(jìn)行不良反應(yīng)的監(jiān)測(cè)。結(jié)果 治療后治療組的FVC、FEV₁、FEV₁/FVC優(yōu)于對(duì)照組(P<0.05)。治療后治療組PaO₂和SaO₂明顯高于對(duì)照組,PaCO₂明顯低于對(duì)照組(P<0.05)。治療組和對(duì)照組的總有效率分別為85.71%、75.00%,兩組總有效率比較的差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組治療后較治療前血清中IL-4、IL-8、TNF-α水平均顯著下降(P<0.05、0.01),并且治療組血清中IL-4、IL-8、TNF-α水平明顯低于對(duì)照組(P<0.05)。治療過(guò)程中兩組患者均未見明顯的不良反應(yīng)。結(jié)論 蘇子降氣丸聯(lián)合多索茶堿片治療慢性阻塞性肺氣腫的療效顯著,安全可靠?？赡芘c提高患者的肺功能、減輕炎癥反應(yīng),改善缺氧及二氧化碳潴留的情況有關(guān)。

Objective To investigate the therapeutic efficacy and mechanism of Suzi Jiangqi Pills combined with Doxofylline Tablets in treatment of elderly patients with chronic obstructive emphysema. Methods The patients with chronic obstructive emphysema (56 cases) of Shenyang 242 Hospital from July 2012 to January 2014 were randomly divided into control and treatment groups, and each group had 28 cases. The patients in the control group were po administered with Doxofylline Tablets on the basis of conventional therapy, 200 mg/time, twice daily. The patients in the treatment group were given Suzi Jiangqi Pills on the basis of control group, 6 g/time, twice daily. The patients in two groups were treated for 14 d. Pulmonary function (FVC, FEV₁, and FEV₁/FVC), blood gas analysis (PaO₂, PaCO₂, and SaO₂) were analysed. The clinical efficacies of the two groups were observed. The changes in the serum level of tumor necrosis factor -α (TNF-α), interleukin -4 (IL-4), and interleukin -8 (IL-8) were compared, and adverse reactions of the two groups were monitored. Results After treatment, FVC, FEV1, and FEV₁/FVC values of treatment group were higher than those of control group (P <0.05). PaCO₂ and SaO₂ of treatment group were higher than those of control group, but PaCO₂ was on the contrary after treatment (P <0.05). The efficacies in the control and treatment groups were 85.71% and 75.00%, respectively, and there were differences between the two groups (P< 0.05). The levels of TNF-α, IL-4, and IL-8 in both groups were significantly reduced than before treatment, and the treatment group was significantly lower than those in the control group with statistically significant difference before treatment (P< 0.01). There were no adverse reactions in two groups. Conclusion Suzi Jiangqi Pills combined with Doxofylline Tablets has good clinical effect in treatment of chronic obstructive emphysema, and no adverse reaction occurred. The mechanism is likely to relate to enhance lung function in patients, reduce inflammation, and improve oxygen and carbon dioxide retention.