目的 探討?hù)~(yú)腥草注射液聯(lián)合噻托溴銨和沙美特羅替卡松治療緩解期慢性阻塞性肺疾病的臨床療效。方法 選取2013年1月-2016年1月在延安大學(xué)附屬醫(yī)院就診的緩解期慢性阻塞性肺疾病患者162例，隨機(jī)分為對(duì)照組（81例）和治療組（81例）。對(duì)照組患者吸入沙美特羅替卡松粉吸入劑，1泡/次，2次/d；同時(shí)霧化吸入噻托溴銨粉霧劑，1粒/次，1次/d。治療組患者在對(duì)照組的基礎(chǔ)上靜脈滴注魚(yú)腥草注射液，1 mL/kg加入5%～10%的葡萄糖注射液。兩組患者均連續(xù)治療12周。觀察兩組的臨床療效，同時(shí)比較兩組治療前后第1秒用力呼氣容積（FEV₁）、FEV₁/用力肺活量（FVC）、FEV₁%、C反應(yīng)蛋白（CRP）、腫瘤壞死因子-α（TNF-α）、外周白細(xì)胞（WBC）、血氧分壓（pO₂）、二氧化碳分壓（pCO₂）、6 min步行距離（6MWD）、呼吸困難癥狀評(píng)分的變化情況。結(jié)果 治療后，對(duì)照組和治療組總有效率分別為87.65%、93.83%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組FEV₁、FEV₁/FVC和FEV₁%水平均較同組治療前顯著升高，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后，治療組這些觀察指標(biāo)顯著高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組CRP、WBC和TNF-α水平均明顯降低，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后，治療組患者上述指標(biāo)水平改善情況優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，pO₂和pCO₂均好于同組治療前（P<0.05）；且治療后，治療組這些觀察指標(biāo)顯著優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者6MWD和呼吸困難癥狀評(píng)分較治療前均得到明顯改善（P<0.05）；且治療組上述指標(biāo)水平改善情況明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 魚(yú)腥草注射液聯(lián)合噻托溴銨和沙美特羅替卡松可有效改善緩解期慢性阻塞性肺疾病患者肺功能，緩解呼吸困難癥狀，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical curative effect of Yuxingcao Injection combined with tiotropium bromide and salmeterol xinafoate and fluticasone propionate in treatment of chronic obstructive pulmonary disease. Methods Patients (162 cases) with chronic obstructive pulmonary disease in Yan'an University Affiliated Hospital from January 2013 to January 2016 enrolled in this study were randomly divided into control group (81 cases) and treatment group (81 cases). The patients in the control group were inhalation administered with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation, 1 bubble/time, twice daily. And they were aerosol inhalation administered with Tiotropium Bromide Powder for inhalation, 1 grain/time, once daily. The patients in the treatment group were iv administered with Yuxingcao Injection on the basis of control group, 1 mL/kg added into 5%-10% glucose injection. The patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated, and the changes of FEV₁, FEV₁/FVC, FEV₁%, CRP, TNF-α, WBC, PaO₂, PaCO₂, 6MWD, and dyspnea symptom scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 87.65% and 93.83%, respectively, and there were differences between two groups (P<0.05). After treatment, FEV₁, FEV₁/FVC, and FEV₁% levels in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, CRP, WBC, and TNF-α in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). After treatment, the improvement of the indexes levels in the treatment group was better than those in the control group with significant difference between two groups (P<0.05). After treatment, pO₂ and pCO₂ in two groups were significantly improved (P<0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, 6MWD and dyspnea symptom scores in two groups were significantly improved (P<0.05). And the improvement of these indexes levels in treatment group was better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Yuxingcao Injection combined with tiotropium bromide and salmeterol xinafoate and fluticasone propionate can effectively improve the lung function of patients with chronic obstructive pulmonary disease, and relieve dyspnea symptoms, which has a certain clinical application value.