目的 探討寒喘祖帕顆粒和噻托溴銨聯(lián)用對(duì)慢性阻塞性肺病穩(wěn)定期患者的治療效果。方法 2021年11月—2023年6月河北省第七人民醫(yī)院收治的100例慢性阻塞性肺疾病穩(wěn)定期患者參與研究，按隨機(jī)數(shù)字表法分為對(duì)照組和質(zhì)量組，各50例。對(duì)照組吸入噻托溴銨吸入粉霧劑，1次/d。治療組在對(duì)照組基礎(chǔ)上口服寒喘祖帕顆粒，1袋/次，2次/d。兩組療程4周。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀評(píng)分，肺功能指標(biāo)[第1秒用力呼氣容積占用力肺活量百分比（FEV1/FVC%）、最大呼氣中期流量（MMEF）、FEV1占預(yù)計(jì)值百分比（FEV1%預(yù)計(jì)值）、每分鐘最大通氣量（MMV）]，肺功能狀態(tài)和呼吸困難問(wèn)卷修訂版（PFSDQ-M）、慢性阻塞性肺疾病生存質(zhì)量量表（COPD-QOL）和慢性阻塞性肺疾病自我效能感問(wèn)卷（CSES）評(píng)分，及紅細(xì)胞分布寬度（RDW）、中性粒細(xì)胞與淋巴細(xì)胞比值（NLR）和血清C反應(yīng)蛋白（CRP）水平。結(jié)果 治療后，治療組總有效率明顯高于對(duì)照組（96.00% vs 84.00%，P＜0.05）。治療后，兩組咳嗽評(píng)分、咳痰評(píng)分、喘息評(píng)分、胸悶評(píng)分、氣短評(píng)分均明顯降低（P＜0.05），且治療組評(píng)分明顯低于對(duì)照組（P＜0.05）。治療后，兩組FEV1/FVC%、MMEF、FEV1%預(yù)計(jì)值、MMV均高于組內(nèi)治療前（P＜0.05），且治療組患者肺功能指標(biāo)明顯好于對(duì)照組（P＜0.05）。治療后，兩組患者PFSDQ-M、COPD-QOL評(píng)分均低于組內(nèi)治療前，而CSES評(píng)分顯著增加（P＜0.05），且治療后治療組評(píng)分明顯好于對(duì)照組（P＜0.05）。治療后，兩組RDW、NLR和血清CRP水平均低于組內(nèi)治療前（P＜0.05），且治療組均低于對(duì)照組（P＜0.05）。結(jié)論 慢性阻塞性肺疾病穩(wěn)定期使用寒喘祖帕顆粒和噻托溴銨聯(lián)合治療，能有效促進(jìn)患者呼吸道癥狀緩解和肺功能改善，抑制慢性炎癥狀態(tài)，促進(jìn)患者機(jī)體狀態(tài)好轉(zhuǎn)及生存質(zhì)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

河北省中醫(yī)藥管理局中醫(yī)藥類(lèi)科研指令性課題（2022134）