目的 探讨苏子降气丸联合多索茶碱片治疗慢性阻塞性肺气肿的临床疗效和作用机制。方法 选取沈阳二四二医院2012年7月-2014年1月收治的慢性阻塞性肺气肿患者56例,随机分成对照组和治疗组,每组各28例。对照组在常规治疗的基础上口服多索茶碱片200 mg/次﹐2次/d;治疗组在对照组治疗的基础上加服苏子降气丸,6 g/次,2次/d。两组均连续治疗14 d,进行肺功能指标第1秒用力呼气容积(FEV₁)、用力肺活量(FVC)以及比值(FEV_l/FVC),血气动脉血氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)和血氧饱和度(SaO₂)分析,观察两组患者的临床疗效,比较两组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-8(IL-8)的水平变化,并进行不良反应的监测。结果 治疗后治疗组的FVC、FEV₁、FEV₁/FVC优于对照组(P<0.05)。治疗后治疗组PaO₂和SaO₂明显高于对照组,PaCO₂明显低于对照组(P<0.05)。治疗组和对照组的总有效率分别为85.71%、75.00%,两组总有效率比较的差异有统计学意义(P<0.05)。两组治疗后较治疗前血清中IL-4、IL-8、TNF-α水平均显著下降(P<0.05、0.01),并且治疗组血清中IL-4、IL-8、TNF-α水平明显低于对照组(P<0.05)。治疗过程中两组患者均未见明显的不良反应。结论 苏子降气丸联合多索茶碱片治疗慢性阻塞性肺气肿的疗效显著,安全可靠。可能与提高患者的肺功能、减轻炎症反应,改善缺氧及二氧化碳潴留的情况有关。

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.