目的 探討益肺膠囊聯(lián)合布地格福治療慢性阻塞性肺疾?。璺危┑呐R床效果。方法 選取2019年3月—2021年8月攀鋼集團總醫(yī)院收治的124例慢阻肺患者，利用隨機數(shù)字表法將入選患者分成對照組和治療組，每組各62例。對照組經(jīng)口吸入布地格福吸入氣霧劑，2吸/次，2次/d。治療組在對照組基礎(chǔ)上口服益肺膠囊，4粒/次，3次/d。兩組均連續(xù)治療12周。觀察兩組的臨床療效，比較治療前后兩組患者典型表現(xiàn)（咳嗽、咳痰、喘息、胸悶、呼吸困難）評分、肺功能指標[第1秒用力呼氣容積（FEV₁）與用力肺活量（FVC）比值（FEV₁/FVC）、FEV₁占預(yù)計值百分比（FEV1%預(yù)計值）、殘氣量（RV）與肺總量（TLC）比值（RV/TLC）、一氧化碳彌散量（DLCO）與肺泡通氣量（VA）比值（DLCO/VA）]、慢阻肺評估測試（CAT）問卷評分、6 min步行距離（6MWD）、呼出氣一氧化氮（FeNO）水平、痰嗜酸性粒細胞（EOS）比例及血清γ干擾素（IFN-γ）、白細胞介素（IL）-1β水平。結(jié)果 治療后，治療組總有效率是95.2%，較對照組83.9%顯著提高（P＜0.05）。治療后，兩組咳嗽、咳痰、喘息、胸悶、呼吸困難評分均顯著降低（P＜0.05）；而治療組下降更顯著（P＜0.05）。治療后，兩組FEV₁/FVC、FEV₁%預(yù)計值和DLCO/VA均較治療前顯著上升，RV/TLC則均較治療前顯著降低（P＜0.05）；且均以治療組改善更顯著（P＜0.05）。治療后，兩組CAT問卷評分、FeNO水平及痰EOS比例均顯著降低，6MWD均顯著增加（P＜0.05）；且均以治療組改善更顯著（P＜0.05）。治療后，兩組患者血清IFN-γ、IL-1β水平均較治療前顯著下降（P＜0.05）；且治療后，治療組血清IFN-γ、IL-1β水平降低較對照組更顯著（P＜0.05）。結(jié)論 益肺膠囊聯(lián)合布地格福治療慢性阻塞性肺炎具有較好的療效，能安全、有效地改善患者臨床癥狀，提高肺功能及生活質(zhì)量，抑制體內(nèi)炎癥反應(yīng)，值得臨床推廣應(yīng)用。

Objective To investigate the clinical effect of Yifei Capsules combined with glycopyrronium bromide and formoterol fumarate in treatment of chronic obstructive pulmonary disease (COPD).Methods A total of 124 patients with COPD who were admitted to General Hospital of Panzhihua Steel Group from March 2019 to August 2021 were selected and divided into control and treatment group according to the random number table method,with 62 cases in each group.Patients in the control group were given Budesonide,Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol through the mouth,2 puffs/time,twice daily.Patients in the treatment group were po administered with Yifei Capsules on the basis of the control group,4 grains/time,three times daily.Patients in two groups were treated for 12 weeks.After treatment,the clinical efficacy was evaluated,the scores of typical manifestations (cough,expectoration,wheezing,chest tightness,dyspnea),and pulmonary function indicators[forced expiratory volume in 1 second (FEV₁) to forced vital capacity (FVC) ratio (FEV₁/FVC),FEV₁ percentage of predicted value (FEV₁% predicted value),residual capacity (RV) to total lung (TLC) ratio (RV/TLC),diffusing capacity for carbon monoxide (DLCO) to alveolar ventilation (VA) ratio (DLCO/VA)],COPD Assessment Test (CAT) questionnaire score,6 min walking distance (6MWD),exhaled nitric oxide (FeNO) level,sputum eosinophil (EOS) ratio and serum interferon-γ(IFN-γ),Interleukin (IL)-1β levels were compared.Results After treatment,the total effective rate of the treatment group was 95.2%,which was significantly higher than that of the control group (83.9%,P<0.05).After treatment,the scores of cough,expectoration,wheezing,chest tightness and dyspnea in the two groups were significantly decreased (P<0.05).The decrease was more significant in the treatment group (P<0.05).After treatment,the FEV₁/FVC,FEV₁% predicted value and DLCO/VA in two groups were significantly higher than those before treatment,but RV/TLC was significantly lower than those before treatment (P<0.05).The improvement was more significant in the treatment group (P<0.05).After treatment,CAT questionnaire score,FeNO level and sputum EOS proportion were significantly decreased,but 6MWD was significantly increased in both groups (P<0.05).The improvement was more significant in the treatment group (P<0.05).After treatment,the serum levels of IFN-γ and IL-1β in the two groups were significantly decreased compared with those before treatment (P<0.05).After treatment,the levels of serum IFN-γ and IL-1β in the treatment group decreased more significantly than those in the control group (P<0.05).Conclusion Yifei Capsules combined with glycopyrronium bromide and formoterol fumarate has good curative effect in treatment of chronic obstructive pulmonary disease,can safely and effectively improve the clinical symptoms of patients,improve the pulmonary function and quality of life,and can inhibit the inflammatory response in the body,which is worthy of clinical application.

R974

攀枝花市市級科技計劃項目(2011CY-G-19)