目的 探讨寒喘祖帕颗粒和噻托溴铵联用对慢性阻塞性肺病稳定期患者的治疗效果。方法 2021年11月—2023年6月河北省第七人民医院收治的100例慢性阻塞性肺疾病稳定期患者参与研究，按随机数字表法分为对照组和质量组，各50例。对照组吸入噻托溴铵吸入粉雾剂，1次/d。治疗组在对照组基础上口服寒喘祖帕颗粒，1袋/次，2次/d。两组疗程4周。观察两组患者临床疗效，比较治疗前后两组患者临床症状评分，肺功能指标[第1秒用力呼气容积占用力肺活量百分比（FEV1/FVC%）、最大呼气中期流量（MMEF）、FEV1占预计值百分比（FEV1%预计值）、每分钟最大通气量（MMV）]，肺功能状态和呼吸困难问卷修订版（PFSDQ-M）、慢性阻塞性肺疾病生存质量量表（COPD-QOL）和慢性阻塞性肺疾病自我效能感问卷（CSES）评分，及红细胞分布宽度（RDW）、中性粒细胞与淋巴细胞比值（NLR）和血清C反应蛋白（CRP）水平。结果 治疗后，治疗组总有效率明显高于对照组（96.00% vs 84.00%，P＜0.05）。治疗后，两组咳嗽评分、咳痰评分、喘息评分、胸闷评分、气短评分均明显降低（P＜0.05），且治疗组评分明显低于对照组（P＜0.05）。治疗后，两组FEV1/FVC%、MMEF、FEV1%预计值、MMV均高于组内治疗前（P＜0.05），且治疗组患者肺功能指标明显好于对照组（P＜0.05）。治疗后，两组患者PFSDQ-M、COPD-QOL评分均低于组内治疗前，而CSES评分显著增加（P＜0.05），且治疗后治疗组评分明显好于对照组（P＜0.05）。治疗后，两组RDW、NLR和血清CRP水平均低于组内治疗前（P＜0.05），且治疗组均低于对照组（P＜0.05）。结论 慢性阻塞性肺疾病稳定期使用寒喘祖帕颗粒和噻托溴铵联合治疗，能有效促进患者呼吸道症状缓解和肺功能改善，抑制慢性炎症状态，促进患者机体状态好转及生存质量和自我效能感提升。

Objective To investigate the clinical efficacy of Hanchuan Zupa Granules combined with tiotropium bromide in treatment of chronic obstructive pulmonary disease of stable stage.Methods Patients (100 cases) with chronic obstructive pulmonary disease of stable stage in the Seventh People’s Hospital of Hebei Province from November 2021 to June 2023 were divided into control and treatment group according to the random number table method, and each group had 50 cases. Patients in the control group were administered with Tiotropium Bromide Powder for inhalation, once daily. Patients in the treatment group were po administered with Hanchuan Zupa Granules on the basis of the control group, 1 bag/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, and the clinical symptom scores, lung function indicators FEV1/FVC%, MMEF, FEV1% predicted value, MMV, the scores of PFSDQ-M, COPD-QOL and CSES, and the RDW, NLR and CRP levels in two groups before and after treatment were compared.Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (96.00% vs 84.00%, P < 0.05). After treatment, cough score, expectoration score, wheezing score, chest tightness score and shortness of breath score of both groups were significantly decreased (P < 0.05), and score of treatment group was significantly lower than that of control group (P < 0.05). After treatment, FEV1/FVC%, MMEF, FEV1% predicted value, and MMV in two groups were higher than those in the same group before treatment (P < 0.05), and lung function indicators in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the PFSDQ-M and COPD-QOL scores in two groups were lower than those in the same group before treatment, while the CSES scores were significantly increased (P < 0.05), and the scores in the treatment group were significantly better than those in the control group after treatment (P < 0.05). After treatment, the levels of RDW, NLR and serum CRP in two groups were lower than those before treatment (P < 0.05), and the factors levels of the treatment group were lower than those in the control group (P < 0.05).Conclusion The combination of Hanchuan Zupa Granules and tiotropium bromide is safe for the treatment of chronic obstructive pulmonary disease of stable stage. It can effectively promote the relief of respiratory symptoms and improve lung function, inhibit chronic inflammation, promote the improvement of patients' physical condition, and enhance their quality of life and self-efficacy.

R974

河北省中医药管理局中医药类科研指令性课题（2022134）