目的 研究参苓白术散加减联合呼吸训练治疗稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease ,COPD)老年患者的疗效及对其血清炎性因子、心理状态及心力衰竭标志物的影响。方法 选取医院2016-01至2017-08收治的96例COPD稳定期老年患者,按随机数字表法分为对照组和治疗组,每组48例;对照组采取常规西药治疗,治疗组在对照组治疗的基础上应用参苓白术散加减联合呼吸训练治疗,治疗1个疗程后评估两组临床疗效,观察治疗前后心理状态、活动能力、心力衰竭标志物、血清炎性因子、6 min步行试验及血气分析指标的变化情况。结果 治疗组总有效率为95.83%,对照组总有效率为83.33%,差异有统计学意义(P＜0.05)。治疗后心理状态、活动能力两组均较治疗前改善(P＜0.05);治疗后两组hs-CRP、BNP、6MWT均较前改善(P＜0.05);治疗后治疗组各项指标均较对照组改善明显(P＜0.05)。治疗后两组PaO₂、SaO₂、PaCO₂均较前改善,但差异无统计学意义;治疗1个疗程后治疗组PaO₂、SaO₂、PaCO₂均优于对照组,差异有统计学意义(P＜0.05)。结论 参苓白术散联合呼吸训练能够提高稳定期COPD老年患者的临床疗效,降低血清炎性因子表达水平,缓解患者焦虑、抑郁的心理症状。

Objective To investigate the curative effect of Shenling Baishu powder combined with respiratory training on serum inflammatory cytokines levels, mental status and cardiac markers of elderly patients with stable chronic obstructive pulmonary disease(COPD). Methods The clinical data of 96 patients with stable COPD treated at Hebei People’s Hospital between January 2016 and August 2017 was retrospectively analyzed. These patients were divided into the control group and treatment group, with 48 cases in each. The control group was treated with western medicines, while the treatment group was additionally given Shenling Baishu powder combined with respiratory training. The mental status, capability of activity, cardiac markers, serum inflammatory cytokines levels, 6-minute walk test and arterial blood gas analysis were observed before and after treatment. Results The total effective rate was 95.83% in the treatment group, compared with 83.33% in the control group (P＜0.05). After one course of treatment, the mental status and ability of activity were improved in both groups (all P＜0.05), especially in the treatment group (P＜0.05). The hs-crp, BNP and results of 6-minute walk test were improved in both groups ( P＜0.05), especially in the treatment group (P＜0.05). PaO₂, SaO₂ and PaCO₂ were also improved in both groups (P＜0.05), especially in the treatment group (P＜0.05). Conclusions Shenling Baishu powder combined with respiratory training can improve the curative effect among elderly patients with stable COPD, reduce levels of serum inflammatory cytokines, and relieve the psychological symptoms of anxiety and depression.