目的 探讨痰热清胶囊联合乌美溴铵维兰特罗吸入粉雾剂治疗慢性阻塞性肺疾病稳定期急性发作的临床疗效。方法 选取2020年6月—2022年2月首都医科大学附属北京潞河医院收治的100例慢性阻塞性肺疾病患者，按随机数字表法将100例分为对照组和治疗组，每组各50例。对照组使用干粉吸入装置经口吸入乌美溴铵维兰特罗吸入粉雾剂，1吸/次，1次/d。治疗组在对照组治疗的基础上口服痰热清胶囊，3粒/次，3次/d。7 d为1个疗效，两组连续治疗2个疗程统计疗效。观察两组的临床疗效，比较两组症状消失时间、肺功能、血清可溶性CD40配体（sCD40L）、粒细胞–巨噬细胞集落刺激因子（GM-CSF）、白三烯B₄（LTB₄）水平。结果 治疗后，治疗组总有效率为96.00%，高于对照组的总有效率84.00%，组间比较有显著差异（P＜0.05）。治疗后，治疗组的肺啰音、咳嗽、咯痰消失时间均明显短于对照组（P＜0.05）。治疗后，两组的1秒用力呼气量（FEV₁）/用力肺活量（FVC）、一氧化碳弥散量（DLCO）、第1秒用力呼气容积预测值（FEV₁% pred）均显著增加（P＜0.05），治疗组FEV₁/FVC、DLCO、FEV₁% pred明显高于对照组（P＜0.05）。治疗后，两组的血清sCD40L、GM-CSF、LTB₄水平显著降低（P＜0.05）；治疗组患者的血清sCD40L、GM-CSF、LTB₄水平明显低于对照组（P＜0.05）。结论 痰热清胶囊联合乌美溴铵维兰特罗吸入粉雾剂治疗慢性阻塞性肺疾病的疗效确切，能改善临床症状，提高肺功能，降低炎症反应。

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

中国宋庆龄基金会呼吸疾病临床研究公益基金慢阻肺专项(2018MZFH-005)