【摘要】 目的：观察三子养亲汤加味联合噻托溴铵治疗慢性阻塞性肺疾病（COPD）的临床疗效及对气道黏液高分泌状态的影响。方法：选取2022年1月—2024年1月丽水市人民医院收治的80例COPD患者，按随机数字表法分为噻托溴铵组和联合组各40例。噻托溴铵组在西医常规治疗的基础上加用噻托溴铵粉雾吸入治疗，联合组在噻托溴铵组的基础上加用三子养亲汤加味治疗。2组均治疗2周，比较2组临床疗效，以及治疗前后中医证候评分、肺功能[第1秒用力呼气容积（FEV₁）、最大通气量（MVV）、用力呼气量（FVC）]、气道黏液高分泌状态[黏蛋白5AC（MUC5AC）]、炎症指标[中性粒细胞（NEU）、降钙素原（PCT）、C-反应蛋白（CRP）]变化情况。结果：治疗后，联合组总有效率为95.00%（38/40），噻托溴铵组为80.00%（32/40），组间比较，差异有统计学意义（P<0.05）。治疗后，2组中医证候评分均较治疗前降低（P<0.05），且联合组评分低于噻托溴铵组（P<0.05）。治疗后，2组FEV₁、FVC、MVV水平均较治疗前升高（P<0.05），且联合组3项指标水平均高于噻托溴铵组（P<0.05）。治疗后，2组MUC5AC水平均较治疗前降低（P<0.05），且联合组低于噻托溴铵组（P<0.05）。治疗后，2组NEU、PCT及CRP水平均较治疗前降低（P<0.05），且联合组3项指标水平均低于噻托溴铵组（P<0.05）。治疗期间，2组均未出现严重不良反应。结论：三子养亲汤加味联合噻托溴铵治疗COPD可促进患者肺功能及中医证候改善，减轻炎症反应，缓解气道黏液高分泌状态，提高临床疗效。更多还原

【Abstract】 Objective:To observe the clinical efficacy of modified Sanzi Yangqin Decoction combined with Tiotropium Bromide in the treatment of chronic obstructive pulmonary disease（COPD）and its impact on airway mucus hypersecretion.Methods:A total of 80 COPD patients admitted to Lishui People’s Hospital from January 2022 to January 2024 were selected and divided into the Tiotropium Bromide group and the combined group using the random number table method,with 40 cases in each group. The Tiotropium Bromide group received Tiotropium Bromide Powder inhalation therapy on the basis of conventional western medicine treatment,while the combined group received modified Sanzi Yangqin Decoction in addition to the treatment of the Tiotropium Bromide group. Both groups were treated for two weeks. The clinical efficacy,changes in traditional Chinese medicine syndrome scores,lung function [forced expiratory volume in the first second（FEV₁）,maximum voluntary ventilation（MVV）,and forced vital capacity（FVC）],airway mucus hypersecretion [mucin 5 AC（MUC5AC）],and inflammatory indicators [neutrophil（NEU）,procalcitonin（PCT）,and C-reactive protein（CRP）] were compared before and after treatment between the two groups.Results:After treatment, the total effective rate was 95.00%（38/40）in the combined group and 80.00%（32/40）in the Tiotropium Bromide group, with a statistically significant difference between the two groups（P<0.05）. After treatment, the traditional Chinese medicine syndrome scores in both groups were decreased compared with those before treatment（P<0.05）,and the scores in the combined group were lower than those in the Tiotropium Bromide group（P<0.05）. After treatment,the levels of FEV₁,FVC,and MVV in both groups were increased compared with those before treatment（P<0.05）,and the levels of these three indicators in the combined group were higher than those in the Tiotropium Bromide group（P<0.05）. After treatment,the levels of MUC5AC in both groups were decreased compared with those before treatment（P<0.05）,and the levels in the combined group were lower than those in the Tiotropium Bromide group（P<0.05）. After treatment,the levels of NEU,PCT,and CRP in both groups were decreased compared with those before treatment（P<0.05）,and the levels of these three indicators in the combined group were lower than those in the Tiotropium Bromide group（P<0.05）. No severe adverse reactions were observed in either group during the treatment period.Conclusion:Modified Sanzi Yangqin Decoction combined with Tiotropium Bromide in the treatment of COPD can promote the improvement of lung function and traditional Chinese medicine syndrome, reduce inflammatory reactions,alleviate airway mucus hypersecretion,and improve clinical efficacy.更多还原