目的 探讨平喘益气颗粒联合沙美特罗替卡松气雾剂治疗慢性阻塞性肺疾病稳定期的临床疗效。方法 选取2017年6月-2018年6月在天津市黄河医院治疗的94例慢性阻塞性肺疾病稳定期患者为研究对象，将患者按随机数表法分为对照组和治疗组，每组各47例。对照组吸入沙美特罗替卡松吸入气雾剂，2揿/次，2次/d。治疗组在对照组基础上口服平喘益气颗粒，2袋/次，3次/d。两组患者连续治疗3个月。观察两组的临床疗效，比较两组的肺功能指标、SGRQ评分、6 min步行距离、免疫功能、炎症因子。结果 治疗后，对照组和治疗组的总有效率分别为76.60%、91.49%，两组比较差异有统计学意义（P<0.05）。治疗后，两组第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC均显著提高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组FEV1、FVC、FEV1/FVC明显高于对照组，差异有统计学意义（P<0.05）。治疗后，两组圣乔治呼吸问卷（SGRQ）评分显著降低，6 min步行距离显著增加，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组SGRQ评分低于对照组，6 min步行距离长于对照组，差异有统计学意义（P<0.05）。治疗后，治疗组CD3⁺、CD4⁺、CD4⁺/CD8⁺明显高于治疗前，且治疗组CD3⁺、CD4⁺、CD4⁺/CD8⁺明显高于对照组，差异有统计学意义（P<0.05）。治疗后，两组肿瘤坏死因子-α（TNF-α）、白细胞介素-8（IL-8）水平显著下降，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组炎症因子水平明显低于对照组，差异有统计学意义（P<0.05）。结论 平喘益气颗粒联合沙美特罗替卡松气雾剂治疗慢性阻塞性肺疾病稳定期具有较好的临床疗效，可改善患者临床症状及肺功能，调节免疫功能及相关炎症因子，提高生活质量，具有一定的临床推广应用价值。

Objective To explore the clinical value of Pingchuan Yiqi Granules combined with Salmeterol Xinafoate and Fluticasone Propionate Inhalation Aerosol in treatment of stable phase of chronic obstructive pulmonary disease. Methods Patients (94 cases) with stable phase of chronic obstructive pulmonary disease in Tianjin Huanghe Hospital from June 2017 to June 2018 were randomly divided into control and treatment groups, and each group had 47 cases. Patients in the control group were inhalation administered with Salmeterol Xinafoate and Fluticasone Propionate Inhalation Aerosol, 2 presses/time, twice daily. Patients in the treatment group were po administered with Pingchuan Yiqi Granules on the basis of the control group, 2 bags/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and pulmonary function indexes, SGRQ score, 6 min walking distance, immune function, and inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.60% and 91.49%, respectively, and there was difference between two groups (P<0.05). After treatment, FEV1, FVC, and FEV1/FVC in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the pulmonary function indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, SGRQ score in two groups were significantly decreased, but 6 min walking distance in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the treatment group were significantly increased, and the difference was statistically significant in the same group (P<0.05). And immune function levels in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of TNF-α and IL-8 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the inflammatory factors levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Pingchuan Yiqi Granules combined with Salmeterol Xinafoate and Fluticasone Propionate Inhalation Aerosol has clinical curative effect in treatment of stable phase of chronic obstructive pulmonary disease, can improve the clinical symptoms and pulmonary function of patients, regulate immune function and related inflammatory factors, and improve the quality of life, which has a certain clinical application value.

R974

天津市科委青年计划项目（17fychkd879）