目的 探討痰熱清膠囊聯(lián)合烏美溴銨維蘭特羅吸入粉霧劑治療慢性阻塞性肺疾病穩(wěn)定期急性發(fā)作的臨床療效。方法 選取2020年6月—2022年2月首都醫(yī)科大學(xué)附屬北京潞河醫(yī)院收治的100例慢性阻塞性肺疾病患者，按隨機數(shù)字表法將100例分為對照組和治療組，每組各50例。對照組使用干粉吸入裝置經(jīng)口吸入烏美溴銨維蘭特羅吸入粉霧劑，1吸/次，1次/d。治療組在對照組治療的基礎(chǔ)上口服痰熱清膠囊，3粒/次，3次/d。7 d為1個療效，兩組連續(xù)治療2個療程統(tǒng)計療效。觀察兩組的臨床療效，比較兩組癥狀消失時間、肺功能、血清可溶性CD40配體（sCD40L）、粒細(xì)胞–巨噬細(xì)胞集落刺激因子（GM-CSF）、白三烯B₄（LTB₄）水平。結(jié)果 治療后，治療組總有效率為96.00%，高于對照組的總有效率84.00%，組間比較有顯著差異（P＜0.05）。治療后，治療組的肺啰音、咳嗽、咯痰消失時間均明顯短于對照組（P＜0.05）。治療后，兩組的1秒用力呼氣量（FEV₁）/用力肺活量（FVC）、一氧化碳彌散量（DLCO）、第1秒用力呼氣容積預(yù)測值（FEV₁% pred）均顯著增加（P＜0.05），治療組FEV₁/FVC、DLCO、FEV₁% pred明顯高于對照組（P＜0.05）。治療后，兩組的血清sCD40L、GM-CSF、LTB₄水平顯著降低（P＜0.05）；治療組患者的血清sCD40L、GM-CSF、LTB₄水平明顯低于對照組（P＜0.05）。結(jié)論 痰熱清膠囊聯(lián)合烏美溴銨維蘭特羅吸入粉霧劑治療慢性阻塞性肺疾病的療效確切，能改善臨床癥狀，提高肺功能，降低炎癥反應(yīng)。

Objective To investigate the clinical efficacy of Tanreqing Capsules combined with Umeclidinium Bromide and Vilanterol Trifenatate Powder for inhalation in treatment of acute exacerbation of chronic obstructive pulmonary disease in stable phase. Methods Patients (100 cases) with acute exacerbation of chronic obstructive pulmonary disease in stable phase in Beijing Luhe Hospital Affiliated to Capital Medical University from June 2020 to February 2022 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were inhalation administered with Umeclidinium Bromide and Vilanterol Trifenatate Powder for inhalation, 1 suction/times, once daily. Patients in the treatment group were po administered with Tanreqing Capsules on the basis of the control group, 3 grains/time, three times daily. A course of treatment had 7 days, and patients in two groups were treated for 2 course of treatment. After treatment, the clinical efficacies were evaluated, and the symptom disappearance time, pulmonary function, and the serum levels of sCD40L, GM-CSF, and LTB₄ in two groups were compared. Results After treatment, the total effective rate of the treatment group was 96.00%, which was higher than 84.00% of the control group, and there was significant difference between two groups (P < 0.05). After treatment, the disappearance time of pulmonary rales, cough, and expectoration in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the FEV₁/FVC, DLCO, and FEV₁% pred in two groups were significantly increased (P < 0.05), and the FEV₁/FVC, DLCO, and FEV₁% pred in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the serum levels of sCD40L, GM-CSF, and LTB₄ in two groups were significantly decreased (P < 0.05). The serum levels of sCD40L, GM-CSF, and LTB₄ in the treatment group were significantly lower than those in the control group (P < 0.05).Conclusion Tanreqing Capsules combined with Umeclidinium Bromide and Vilanterol Trifenatate Powder for inhalation has clinical curative effect in treatment of acute exacerbation of chronic obstructive pulmonary disease in stable phase, can improve clinical symptoms and lung function, and reduce inflammatory response.

R974

中國宋慶齡基金會呼吸疾病臨床研究公益基金慢阻肺專項(2018MZFH-005)