目的 探討清氣化痰丸聯(lián)合茶堿緩釋片治療慢性阻塞性肺疾病穩(wěn)定期的臨床效果。方法 選取2016年5月—2019年5月駐馬店市中心醫(yī)院收治的134例穩(wěn)定期慢性阻塞性肺疾病患者，隨機分成對照組（n=67）和治療組（n=67）。對照組口服茶堿緩釋片，1片/次，2次/d，于早晚整片用溫開水送服。治療組在對照組基礎上口服清氣化痰丸，6 g/次，2次/d。兩組均連續(xù)治療8周。觀察兩組臨床療效，比較兩組改良版英國醫(yī)學研究委員會呼吸問卷（mMRC）、咳嗽和咳痰的評估問卷（CASA-Q）、慢性阻塞性肺疾病患者自我評估測試（CAT）問卷]評分、6 min步行距離（6MWD）、肺功能參數(shù)[第1秒用力呼氣容積（FEV₁）與用力肺活量比值（FEV₁/FVC）、一氧化碳彌散量（D_LCO）占預計值百分比（DLCO占預計值%）、FEV₁占預計值百分比（FEV₁占預計值%）、呼氣峰值流量（PEF）]、呼出氣一氧化氮（FeNO）水平及血清炎癥指標[白三烯（LT）B4、基質金屬蛋白酶（MMP）-9、C反應蛋白（CRP）]水平變化。結果 治療后，治療組總有效率是95.5%較對照組的85.1%顯著提高（P<0.05）。治療后，兩組mMRC、CAT問卷評分均顯著低于治療前，而CASA-Q評分則均顯著升高，6MWD均顯著延長（P<0.05）；且治療后，治療組患者以上各項指標（mMRC、CASA-Q、CAT問卷評分及6MWD）的改善效果均顯著優(yōu)于對照組（P<0.05）。治療后，兩組患者FEV₁/FVC、D_LCO占預計值%、FEV₁占預計值%、PEF值均顯著高于治療前（P<0.05）；但治療組肺功能指標改善更顯著（P<0.05）。與治療前相比，兩組治療后FeNO、LTB₄、MMP-9、CRP水平均顯著下降（P<0.05）；但治療組炎癥相關指標降低更顯著（P<0.05）。結論 清氣化痰丸聯(lián)合茶堿緩釋片治療慢性阻塞性肺疾病穩(wěn)定期有助于緩解患者呼吸道癥狀，提高健康狀況及運動耐力，改善肺功能，降低氣道及全身炎癥反應程度，值得臨床推廣應用。

Objective To investigate the clinical effect of Qingqi Huatan Pills combined with Theophylline Sustained-release Tablets in treatment of stable chronic obstructive pulmonary disease. Methods A total of 134 patients with stable COPD admitted to Zhumadian Central Hospital from May 2016 to May 2019 were randomly divided into control group (n=67) and treatment group (n=67). Patients in the control group were po administered with Theophylline Sustained-release Tablets with warm water in morning and evening, 1 tablet/time, twice daily. Patients in the treatment group were po administered with Qingqi Huatan Pills on the basis of the control group, 6 g/time, twice daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated. The changes of modified British Medical Research Council Respiration Questionnaire (mMRC), Cough and Sputum Assessment Questionnaire (CASA-Q), Chronic Obstructive Pulmonary Disease Patients Self-Assessment Test (CAT) Questionnaire] score, 6 min walking distance (6MWD), pulmonary function parameters [forced expiratory volume in the first second (FEV₁) to forced vital capacity ratio (FEV₁/FVC), Carbon monoxide dispersion (D_LCO) as a percentage of the predicted value (D_LCO as a percentage of the predicted value), FEV₁ as a percentage of the predicted value (FEV₁ as a percentage of the predicted value), peak expiratory flow (PEF)] value, exhaled nitric oxide (FeNO) concentration and changes in serum inflammatory indexes [leukotriene (LT) B4, matrix metalloproteinase (MMP)-9, C-reactive protein (CRP)] levels in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.5%, which was significantly higher than that of the control group (85.1%, P<0.05). After treatment, mMRC and CAT scores in both groups were significantly lower than before treatment, while CASA-Q scores were significantly increased, and 6MWD scores were significantly prolonged (P<0.05). After treatment, the improvement effect of the above indexes (mMRC, CASA-Q, CAT score and 6MWD) in the treatment group was significantly better than that in the control group (P<0.05). After treatment, FEV₁/FVC, D_LCO%, FEV₁%, and PEF value in two groups were significantly higher than those before treatment (P<0.05). However, the improvement of pulmonary function indexes in the treatment group was more significant (P<0.05). Compared with before treatment, the levels of FeNO, LTB4, MMP-9, and CRP in both groups were significantly decreased after treatment (P<0.05). However, inflammation related indexes in the treatment group decreased more significantly (P<0.05). Conclusion Qingqi Huatan Pills combined with Theophylline Sustained-release Tablets can help to relieve the patient's respiratory symptoms in treatment of stable chronic obstructive pulmonary disease, and is worthy of clinical promotion and application to improve health status and exercise endurance, also can improve lung function and reduce the degree of airway and systemic inflammatory response, which is worthy of clinical promotion and application.

R974

河南省衛(wèi)計委科研項目（201702811）