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黄芳, 李玺, 蔡燕云, 卢肖霞, 彭洁贞, 罗允内, 陈海雄.益肺健脾方治疗老年肺脾气虚型慢性阻塞性肺疾病的临床研究[J].湖南中医药大学学报英文版,2026,46(1):168-173.[Click to copy
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| 益肺健脾方治疗老年肺脾气虚型慢性阻塞性肺疾病的临床研究 |
| 黄芳,李玺,蔡燕云,卢肖霞,彭洁贞,罗允内,陈海雄 |
| (南方医科大学第八附属医院(佛山市顺德区第一人民医院), 广东 佛山 528300) |
| 摘要: |
| 目的 探讨益肺健脾方在老年肺脾气虚型慢性阻塞性肺疾病（COPD）患者治疗中的应用效果。方法 选取2024年7月至2025年7月在南方医科大学第八附属医院（佛山市顺德区第一人民医院）诊疗的120例老年肺脾气虚型COPD患者为研究对象，随机分为对照A组、对照B组和观察组，每组40例。3组均行常规西医对症治疗（沙丁胺醇气雾剂，100~200 μg/次，4次/d）；对照A组另加肺康复训练治疗；对照B组另加益肺健脾方治疗；观察组联合肺康复训练、益肺健脾方进行治疗。以上治疗均以14 d为一个疗程，连续治疗2个疗程。比较3组患者治疗前后中医证候积分；评估治疗后3组患者临床疗效；ELISA检测3组患者血清中趋化因子配体18（CCL18）、几丁质酶3样蛋白1（CHI3L1）含量；流式细胞术检测3组患者血清中Th17/Treg比值、CD4+/CD8+比值；肺功能检测仪测定第一秒用力呼气容积（FEV1）、呼气峰值流量（PEF）值、FEV1与用力呼气量（FVC）（FEV1/FVC）比值。结果 与治疗前比较，治疗后3组患者中医证候积分、血清CCL18、CHI3L1含量均降低（P＜0.05），观察组患者Th17/Treg比值降低（P＜0.05）；治疗后3组患者CD4+/CD8+比值、FEV1值、PEF值、FEV1/FVC比值均升高（P＜0.05）。与对照A组、对照B组比较，观察组患者中医证候积分、血清CCL18、CHI3L1含量均降低（P＜0.05）；CD4+/CD8+比值、FEV1值、PEF值、FEV1/FVC比值均升高（P＜0.05）。观察组患者治疗总有效率高于对照A组、对照B组（P＜0.05）。结论 益肺健脾方在老年肺脾气虚型COPD患者治疗中应用效果显著，可提高临床疗效，降低炎症因子水平，调节免疫功能，提高患者肺功能，且安全性良好。 |
| 关键词: 慢性阻塞性肺疾病 肺脾气虚 肺康复训练 益肺健脾方 肺功能 |
| DOI：10.3969/j.issn.1674-070X.2026.01.024 |
| Received:September 25, 2025 |
| 基金项目:佛山市卫生健康局医学科研课题（202536030787）；广东省中医药局中医药科研项目（20251375）。 |
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| Clinical study on the treatment of elderly patients with chronic obstructive pulmonary disease of lung-spleen qi deficiency pattern using Yifei Jianpi Formula |
| HUANG Fang, LI Xi, CAI Yanyun, LU Xiaoxia, PENG Jiezhen, LUO Yunnei, CHEN Haixiong |
| (The Eighth Affiliated Hospital, Southern Medical University (The First People's Hospital of Snunde, Foshan), Guangdong 528300, China) |
| Abstract: |
| Objective To investigate the therapeutic efficacy of Yifei Jianpi Formula (YFJPF) in elderly patients with chronic obstructive pulmonary disease (COPD) of lung-spleen qi deficiency pattern. Methods A total of 120 elderly patients with COPD of lung-spleen qi deficiency pattern who received treatment at the Eighth Affiliated Hospital, Southern Medical University (The First People's Hospital of Snunde, Foshan) from July 2024 to July 2025 were enrolled as study subjects and randomly divided into control group A, control group B, and observation group, with 40 cases in each. All three groups received conventional western medicine symptomatic treatment (salbutamol aerosol, 100-200 μg/dose, 4 times/day). Control group A was additionally treated with pulmonary rehabilitation training, control group B was additionally treated with YFJPF, and the observation group received a combination of both. Each course of treatment lasted for 14 days, with two consecutive courses administered. The Chinese medicine pattern scores of patients in the three groups were compared before and after treatment, and their clinical efficacy was evaluated. ELISA was used to determine serum levels of pulmonary activation-regulated chemokine (CCL18) and chitinase 3-like 1 (CHI3L1) in all groups. Flow cytometry was utilized to determine serum Th17/Treg ratio and CD4+/CD8+ ratio in all groups. A pulmonary function analyzer was used to measure forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and FEV1/forced vital capacity (FEV1/FVC) ratio pre- and post-treatment in each group. Results Compared with pre-treatment conditions, post-treatment Chinese medicine pattern scores, serum CCL18 level, and CHI3L1 level decreased in all three groups (P＜0.05), and the Th17/Treg ratio reduced in the observation group (P＜0.05). After treatment, CD4+/CD8+ ratio, FEV1, PEF, and FEV1/FVC ratio were higher in all three groups (P＜0.05). Compared with control groups A and B, the observation group showed lower Chinese medicine pattern scores, serum CCL18 level, and CHI3L1 level (P＜0.05), but higher CD4+/CD8+ ratio, FEV1, PEF, and FEV1/FVC ratio (P＜0.05). The overall effective rate in the observation group was higher than that in control groups A and B (P＜0.05). Conclusion The application of YFJPF in the treatment of elderly patients with COPD of lung-spleen qi deficiency pattern demonstrated significant efficacy, which improved clinical outcomes, reduced inflammatory cytokine levels, modulated immune function, and enhanced pulmonary function with a good safety profile. |
| Key words: chronic obstructive pulmonary disease lung-spleen qi deficiency pulmonary rehabilitation training Yifei Jianpi Formula pulmonary function |
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