目的 探讨益肺胶囊联合布地格福治疗慢性阻塞性肺疾病（慢阻肺）的临床效果。方法 选取2019年3月—2021年8月攀钢集团总医院收治的124例慢阻肺患者，利用随机数字表法将入选患者分成对照组和治疗组，每组各62例。对照组经口吸入布地格福吸入气雾剂，2吸/次，2次/d。治疗组在对照组基础上口服益肺胶囊，4粒/次，3次/d。两组均连续治疗12周。观察两组的临床疗效，比较治疗前后两组患者典型表现（咳嗽、咳痰、喘息、胸闷、呼吸困难）评分、肺功能指标[第1秒用力呼气容积（FEV₁）与用力肺活量（FVC）比值（FEV₁/FVC）、FEV₁占预计值百分比（FEV1%预计值）、残气量（RV）与肺总量（TLC）比值（RV/TLC）、一氧化碳弥散量（DLCO）与肺泡通气量（VA）比值（DLCO/VA）]、慢阻肺评估测试（CAT）问卷评分、6 min步行距离（6MWD）、呼出气一氧化氮（FeNO）水平、痰嗜酸性粒细胞（EOS）比例及血清γ干扰素（IFN-γ）、白细胞介素（IL）-1β水平。结果 治疗后，治疗组总有效率是95.2%，较对照组83.9%显著提高（P＜0.05）。治疗后，两组咳嗽、咳痰、喘息、胸闷、呼吸困难评分均显著降低（P＜0.05）；而治疗组下降更显著（P＜0.05）。治疗后，两组FEV₁/FVC、FEV₁%预计值和DLCO/VA均较治疗前显著上升，RV/TLC则均较治疗前显著降低（P＜0.05）；且均以治疗组改善更显著（P＜0.05）。治疗后，两组CAT问卷评分、FeNO水平及痰EOS比例均显著降低，6MWD均显著增加（P＜0.05）；且均以治疗组改善更显著（P＜0.05）。治疗后，两组患者血清IFN-γ、IL-1β水平均较治疗前显著下降（P＜0.05）；且治疗后，治疗组血清IFN-γ、IL-1β水平降低较对照组更显著（P＜0.05）。结论 益肺胶囊联合布地格福治疗慢性阻塞性肺炎具有较好的疗效，能安全、有效地改善患者临床症状，提高肺功能及生活质量，抑制体内炎症反应，值得临床推广应用。

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

攀枝花市市级科技计划项目(2011CY-G-19)