目的 探討補肺活血膠囊聯(lián)合沙美特羅替卡松粉吸入劑治療支氣管哮喘慢性持續(xù)期的臨床療效。方法 選取2018年1月-2019年6月在沈陽市第一人民醫(yī)院就診的100例支氣管哮喘慢性持續(xù)期患者為研究對象，將全部患者根據(jù)隨機數(shù)字表法分為對照組和治療組，每組各50例。對照組吸入沙美特羅替卡松粉吸入劑，1吸/次，2次/d。治療組在對照組治療的基礎上口服補肺活血膠囊，1.4 g/次，3次/d。兩組患者均連續(xù)治療3個月。觀察兩組的臨床療效，比較兩組的肺功能、生存質(zhì)量、細胞因子水平。結(jié)果 治療后，對照組和治療組的總有效率分別為84.00%、96.00%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組患者的第一秒用力呼氣容積（FEV1）、FEV1/FVC、最大呼氣流量（PEF）、FEV1%預計值均明顯升高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療后治療組的肺功能指標明顯高于對照組，兩組差異有統(tǒng)計學意義（P<0.05）。治療后，兩組的呼吸癥狀評分、活動受限評分、疾病影響評分、圣喬治呼吸問卷（SGRQ）總分均明顯降低，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療后治療組的生存質(zhì)量評分明顯低于對照組，兩組差異有統(tǒng)計學意義（P<0.05）。治療后，兩組的白細胞介素-17（IL-17）、白細胞介素-4（IL-4）、單核細胞趨化蛋白-1（MCP-1）水平均明顯降低，干擾素-γ（IFN-γ）水平明顯升高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療后治療組的IL-17、IL-4、MCP-1水平明顯低于對照組，IFN-γ水平明顯高于對照組，兩組差異有統(tǒng)計學意義（P<0.05）。結(jié)論 補肺活血膠囊聯(lián)合沙美特羅替卡松粉吸入劑治療支氣管哮喘慢性持續(xù)期具有較好的臨床療效，能改善肺功能和生存質(zhì)量，調(diào)節(jié)機體免疫應激反應，具有一定的臨床推廣應用價值。

Objective To explore the clinical effect of Bufei Huoxue Capsules combined with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation in treatment of chronic persistent bronchial asthma. Methods Patients (100 cases) with chronic persistent bronchial asthma in the First People's Hospital of Shenyang from January 2018 to June 2019 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were inhalation administered with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation, 1 suction/time, twice daily. Patients in the treatment group were po administered with Bufei Huoxue Capsules on the basis of the control group, 1.4 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and pulmonary function, quality of life, and cytokine levels in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 84.00% and 96.00%, respectively, and there was difference between two groups (P < 0.05). After treatment, FEV1, FEV1/FVC, FVC and FEV1% expected in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the pulmonary function indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, respiratory symptom score, activity restriction score, disease impact score, and SGRQ total score in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the quality of life scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of IL-17, IL-4, and MCP-1 in two groups were significantly decreased, but the levels of IFN-γ in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the levels of IL-17, IL-4, and MCP-1 in the treatment group were significantly lower than those in the control group, but the levels of IFN-γ in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Bufei Huoxue Capsules combined with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation has clinical curative effect in treatment of chronic persistent bronchial asthma, can improve lung function and quality of life, and regulate immune stress response, which has a certain clinical application value.

R974