世界中医药

目的：观察三桑肾气汤煮散剂联合西药常规治疗对慢性阻塞性肺疾病（COPD）稳定期的临床疗效。方法：将符合标准的108例患者随机分为西药观察组、西药＋饮片组和西药＋煮散剂组。西药观察组36例采用布地奈德福莫特罗粉吸入剂治疗，西药＋饮片组36例则加用三桑肾气汤普通饮片治疗，西药＋煮散剂组36例则以三桑肾气汤煮散剂联合西药治疗。观察3组患者中医证候积分、肺功能、免疫功能及炎性反应因子、生命质量变化情况。结果：西药观察组总有效率为77.8%，低于西药+饮片组的97.2%及西药+煮散剂组的94.4%，差异有统计学意义（P<0.05）。西药+饮片组/煮散剂组治疗前后中医证候积分、生命质量积分、肺功能、免疫功能及炎性反应因子方面与西药观察组比较，差异均有统计学意义（P<0.05）,但治疗后3组比较，差异无统计学意义(P>0.05)。3组人均总费用比较显示，西药观察组人均费用为（6 415.85±1 360.36）元，西药+饮片组为（5 760.70±1 228.28）元，而西药+煮散剂组治疗总费用最低，人均为（5 065.63±932.44）元，与前2组比较差异有统计学意义（P<0.05）。结论：三桑肾气汤煮散剂联合西药治疗对COPD稳定期患者的临床疗效安全可靠，在改善临床症状和肺功能、提高生命质量、减少发作次数及降低气道炎性反应水平方面，优于单纯西药治，且相较于传统的中药饮片亦具有降低治疗总费用、节约药材及煎煮时间等明显优势。

English Summary:

Observing clinical efficacy and the changes in T cell subgroup and immunoglobulin with stable chronic obstructive pulmonary disease(COPD) after treating with cooked powder of Sansang Shenqi decoction combined with conventional therapy.Methods:A total of 108 stable COPD patients were randomly divided into three groups.Thirty-six patients in conventional therapy group was given symbicort turbuhaler as the basic treatment.Thirty-six patients in Sansang Shenqi decoction combined with conventional therapy group was treated with Sansangshenqi decoction on the basis of conventional therapy.The rest of the patients were treated with cooked powder of Sansangshenqi decoction combined with conventional therapy.To observe the clinical efficacy of three groups and the influence on pulmonary function and quality of life,and the differences in T cell subgroup and inflammatory factors of these groups,as well as the comparison of different treatment groups' differences in cost of treatment.Results:The clinic effective rates of conventional therapy group,Sansang Shenqi decoction combined with conventional therapy group and cooked powder of Sansangshenqi decoction combined with conventional therapy group were 77.8%,97.2% and 94.4% respectively,which had a statistical significance(P<0.05).TCM syndrome scoring,quality of living evaluation,pulmonary function index (FEV1、FVC、FEV1%、FEV1/FVC) and changes of T cell subgroup and inflammatory factors were improved in both Sansang Shenqi decoction combined with conventional therapy group and cooked powder of Sansang Shenqi decoction combined with conventional therapy group as compared with that of conventional therapy group(P<0.05).However,there were no statistical significance(P>0.05) when compared with these two groups,indicating that these two groups had equivalent efficacy in the TCM syndrome scoring,quality of living evaluation,pulmonary function index and changes of T cell subgroup and inflammatory factors.Total expenses yearly of routine treatment in cooked powder of Sansangshenqi decoction combined with conventional therapy group was 5065.63±932.44 RMB,significantly less than that of the other two groups,which were 6415.85±1360.36 and 5760.70±1228.28 RMB(P<0.05).Conclusion:Stable COPD patients treating with cooked powder of Sansangshenqi decoction combined with conventional therapy showed significantly improvement in clinical efficacy,pulmonary function and quality of life,which also improving T cell subgroup and decreasing inflammatory factors expression and restores corticosteroid responses in COPD.

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