目的 探讨补肺活血胶囊联合沙美特罗替卡松粉吸入剂治疗支气管哮喘慢性持续期的临床疗效。方法 选取2018年1月-2019年6月在沈阳市第一人民医院就诊的100例支气管哮喘慢性持续期患者为研究对象，将全部患者根据随机数字表法分为对照组和治疗组，每组各50例。对照组吸入沙美特罗替卡松粉吸入剂，1吸/次，2次/d。治疗组在对照组治疗的基础上口服补肺活血胶囊，1.4 g/次，3次/d。两组患者均连续治疗3个月。观察两组的临床疗效，比较两组的肺功能、生存质量、细胞因子水平。结果 治疗后，对照组和治疗组的总有效率分别为84.00%、96.00%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者的第一秒用力呼气容积（FEV1）、FEV1/FVC、最大呼气流量（PEF）、FEV1%预计值均明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组的肺功能指标明显高于对照组，两组差异有统计学意义（P<0.05）。治疗后，两组的呼吸症状评分、活动受限评分、疾病影响评分、圣乔治呼吸问卷（SGRQ）总分均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组的生存质量评分明显低于对照组，两组差异有统计学意义（P<0.05）。治疗后，两组的白细胞介素-17（IL-17）、白细胞介素-4（IL-4）、单核细胞趋化蛋白-1（MCP-1）水平均明显降低，干扰素-γ（IFN-γ）水平明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组的IL-17、IL-4、MCP-1水平明显低于对照组，IFN-γ水平明显高于对照组，两组差异有统计学意义（P<0.05）。结论 补肺活血胶囊联合沙美特罗替卡松粉吸入剂治疗支气管哮喘慢性持续期具有较好的临床疗效，能改善肺功能和生存质量，调节机体免疫应激反应，具有一定的临床推广应用价值。

Objective To explore the clinical effect of Bufei Huoxue Capsules combined with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation in treatment of chronic persistent bronchial asthma. Methods Patients (100 cases) with chronic persistent bronchial asthma in the First People's Hospital of Shenyang from January 2018 to June 2019 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were inhalation administered with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation, 1 suction/time, twice daily. Patients in the treatment group were po administered with Bufei Huoxue Capsules on the basis of the control group, 1.4 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and pulmonary function, quality of life, and cytokine levels in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 84.00% and 96.00%, respectively, and there was difference between two groups (P < 0.05). After treatment, FEV1, FEV1/FVC, FVC and FEV1% expected 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 lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, respiratory symptom score, activity restriction score, disease impact score, and SGRQ total score in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the quality of life scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of IL-17, IL-4, and MCP-1 in two groups were significantly decreased, but the levels of IFN-γ in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the levels of IL-17, IL-4, and MCP-1 in the treatment group were significantly lower than those in the control group, but the levels of IFN-γ in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Bufei Huoxue Capsules combined with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation has clinical curative effect in treatment of chronic persistent bronchial asthma, can improve lung function and quality of life, and regulate immune stress response, which has a certain clinical application value.

R974