基于培土生金理论探讨加味玉屏风散治疗支气管扩张症的临床疗效

Clinical Study of Modified Yupingfeng Powder in the Treatment of Bronchiectasis Based on the Theory of Spleen Invigorating and Lung Benefiting

摘要: 目的：基于培土生金理论探讨加味玉屏风散治疗支气管扩张症稳定期肺脾气虚证患者的临床疗效。方法：将支气管扩张症稳定期肺脾气虚证患者60例，随机分为对照组和治疗组，每组30例。对照组口服桉柠蒎0.3g/次，2次/d，治疗组在对照组基础上，加用加味玉屏风散治疗，疗程6个月。比较两组治疗前后的中医证候积分、急性加重风险、炎症因子(白介素6 (IL-6)、C反应蛋白(CRP)和降钙素原(PCT))和肺功能指标(呼气峰流量(PEF)、第1 s用力呼气容积(FEV1)、呼出25%肺活量时最大呼气流量(FEF25%)、呼出50%肺活量时最大呼气流量(FEF50%)和最大呼气中段流速(MMEF))。结果：两组患者治疗后中医证候积分、急性加重风险、IL-6、CRP均较治疗前显著性下降，且治疗组显著低于对照组，差异具有统计学意义。两组患者治疗后FEF50%、FEF25%和MMEF较治疗前显著升高，且治疗组显著高于对照组，差异具有统计学意义。结论：加味玉屏风散可显著改善支气管扩张症患者证候积分，减少急性加重风险，还可以减少各种炎症因子，改善小气道功能，这可能与减少呼吸道细菌、减轻气道分泌物阻塞有关。

Abstract: Objective: To explore the clinical effect of modified Yupingfeng Powder in the treatment of bron-chiectasis in stable phase of deficiency of lung and temper based on the theory of Spleen Invigo-rating and Lung benefiting. Methods: 60 patients with bronchiectasis in stable phase of deficiency of lung and temper were selected and divided into control group and treatment group via random number table, with 30 cases in each group. The control group was given eucalyptus pinase 0.3 g one time, twice one day, and the treatment group was additionally given modified Yupingfeng Powder, a course of 6 months. To compare syndrome scores, risk of acute exacerbation, inflammatory factors (interleukin-6 (IL-6), C-reactive protein (CRP) and procalcitonin (PCT)) and pulmonary function (peak expiratory flow (PEF), forced expiratory volume of 1s (FEV1), maximum expiratory flow at 25% of vital capacity (FEF25%), maximum expiratory flow at 50% of vital capacity (FEF50%) and maximum mid-expiratory flow (MMEF)), between the two groups before and after treatment. Results: Syndrome score, risk of acute exacerbation, IL-6 and CRP in 2 groups were significantly decreased after treatment, and the treatment group was significantly lower than the control group, and the difference was statistically significant. After treatment, FEF50%, FEF25% and MMEF in 2 groups were significantly higher than before treatment, and the treatment group was significantly higher than the control group, and the difference was statistically significant. Conclusion: Modified Yupingfeng Powder can significantly improve the syndrome scores, reduce the risk of acute exacerbation, reduce various inflammatory factors and improve the function of small airway of patients with bronchiectasis, which may be related to the reduction of respiratory bacteria and airway secretion obstruction.