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目的分析自拟宣肺升降方对慢性阻塞性肺疾病急性发作期(AECOPD)伴炎性反应综合征(SIRS)患者的影响。方法将240例AECOPD伴SIRS患者随机分为研究组与对照组各120例。对照组患者入院后均按照2010年慢性阻塞性肺疾病诊治指南给予积极的抗生素控制感染、解除支气管痉挛、化痰等综合处理。研究组在对照组治疗基础上加用自拟宣肺升降方治疗。治疗前及治疗后第5天晨空腹静脉血测血清C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平的变化,并同日评估患者当日急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)及肺功能,比较2组差异。结果治疗前2组FEV1/FVC及FEV1(%)和CRP、IL-β、TNF-α、APACHEⅡ评分差异无统计学意义(P>0.05)。治疗后2组FEV1/FVC及FEV1(%)高于治疗前,血清CRP、IL-β和TNF-α水平低于治疗前,APACHEⅡ评分低于治疗前,且研究组优于对照组,差异均有统计学意义(P>0.05)。结论自拟宣肺升降方对AECOPD伴SIRS患者具有改善肺功能水平作用,分析其机制与自拟宣肺升降方抑制血清中CRP、IL-1β及TNF-α水平有关。
Objective To analyze the effect of Xuanfei Shengqian Recipe on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and inflammatory response syndrome (SIRS). Methods A 240 patients with AECOPD and SIRS were randomly divided into study group and control group with 120 cases each. Patients in the control group were given active antibiotics to control infection according to the 2010 guidelines for diagnosis and treatment of chronic obstructive pulmonary disease after admission and were relieved of bronchial spasm and phlegm and other comprehensive treatment. Study group in the control group based on the addition of self-Xuanfei lifts. The levels of serum C-reactive protein (CRP), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the fasting venous blood before treatment and on the 5th day after treatment were measured. Day acute physiology and chronic health score Ⅱ (APACHE Ⅱ) and lung function, the difference between the two groups was compared. Results There was no significant difference in FEV1 / FVC, FEV1 (%) and CRP, IL-β, TNF-α and APACHEⅡ scores between the two groups before treatment (P> 0.05). After treatment, FEV1 / FVC and FEV1 (%) in two groups were higher than before treatment, serum CRP, IL-β and TNF-α levels were lower than before treatment, APACHE Ⅱ score was lower than before treatment, and the study group was better than the control group, There was statistical significance (P> 0.05). Conclusions Self-made Xuanfei Lifang Recipe has the effect of improving pulmonary function in AECOPD patients with SIRS, and its mechanism is related to suppressing the levels of CRP, IL-1β and TNF-α in serum by Xuanfei Lifting and Falling Recipe.