目的 探讨金匮肾气丸联合沙美特罗替卡松粉吸入剂治疗慢性阻塞性肺疾病稳定期的临床疗效。方法 选取天津市宁河区医院在2018年1月-2019年10月收治的102例慢性阻塞性肺疾病稳定期患者作为研究对象，根据随机数字表法分为对照组和治疗组，每组各51例。对照组雾化吸入沙美特罗替卡松粉吸入剂，1吸/次，1次/d。治疗组患者在对照组治疗的基础上口服金匮肾气丸，20粒/次，2次/d。两组患者连续治疗3个月。对比两组的总有效率，评估两组治疗前后肺功能指标、呼吸困难程度和免疫细胞水平。结果 治疗后，治疗组患者的总有效率比对照组高，差异有统计学意义（P<0.05）。治疗后，两组的用力呼气量（FVC）、第1秒用力呼气容积（FEV1）/FVC、呼气峰值流速（PEF）、FEV1占预计值百分比（FEV1 predicted）均明显升高（P<0.05）；治疗后治疗组的FVC、FEV1/FVC、PEF、FEV1 predicted比对照组高，差异有统计学意义（P<0.05）。治疗后，两组患者改良呼吸困难指数（mMRC）评分明显低于治疗前（P<0.05），治疗后治疗组的mMRC评分比对照组低，差异有统计学意义（P<0.05）。治疗后，两组的Th17细胞、Th17细胞/Treg细胞比值均明显低于治疗前，Treg细胞明显高于治疗前（P<0.05）；治疗后治疗组的Th17细胞、Th17细胞/Treg细胞比值比对照组低，Treg细胞比对照组高，差异有统计学意义（P<0.05）。结论 金匮肾气丸联合沙美特罗替卡松粉吸入剂治疗慢性阻塞性肺疾病稳定期具有较好的临床疗效，可减轻呼吸困难症状，改善肺功能，调节Th17细胞、Treg细胞的分泌，具有一定的临床研究价值。

Objective To investigate the clinical effect of Jinkui Shenqi Pills combined with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation in treatment of stable stage of chronic obstructive pulmonary disease. Methods Patients (102 cases) with stable stage of chronic obstructive pulmonary disease in Tianjin Ninghe Hospital from January 2018 to October 2019 were divided into control and treatment groups according to the random number table methods, and each group had 51 cases. Patients in the control group were inhalation administered with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation, 1 suction/time, once daily. Patients in the treatment group were po administered with Jinkui Shenqi Pills on the basis of the control group, 20 pills/time, twice daily. Patients in two groups were treated for 3 months. After treatment, the total effective rate was compared, and the pulmonary function indexes, degree of dyspnea, and immune cell levels in two groups before and after treatment were evaluated. Results The total effective rate in the treatment group was higher than that in the control group (P<0.05). After treatment, the values of FVC, FEV1/FVC, PEF, and FEV1 predicted in the two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, the values of FVC, FEV1/FVC, PEF, and FEV1 predicted in the treatment group were higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, MMRC scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05), and MMRC 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 Th17 cells and Th17 cells/Treg cells in two groups were significantly decreased, but the levels of Treg cells were significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, Th17 cells and Th17 cells/Treg cells in the treatment group were lower than those in the control group, but Treg cells were higher than those in the control group, with significant difference between two groups (P<0.05). Conclusion Jinkui Shenqi Pills combined with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation has clinical curative effect in treatment of stable stage of chronic obstructive pulmonary disease, can alleviate symptoms of dyspnea, improve pulmonary function, regulate the secretion of Th17 cells and Treg cells, which has a certain clinical application value.

R974

天津市科技计划项目（16JCQNJC10600191072）