The anti-inflammatory effect of integrated traditional Chinese and Western medicine pulmonary rehabilitation strategy on patients with chronic obstructive pulmonary disease

Abstract

Abstract:

ObjectiveTo investigate the efficacy and safety of integrated traditional Chinese and Western medicine pulmonary rehabilitation strategy for patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）.MethodsA total of 132 patients with AECOPD admitted to The Second Affiliated Hospital of Shandong First Medical University from May 2020 to June 2022 were selected as the study subjects. All patients were randomly divided into control group， acute phase group， and stable phase group by the method of random number table， with 44 cases in each group. The control group received routine treatment， the acute phase group received integrated traditional Chinese and Western medicine pulmonary rehabilitation strategy during the acute phase， and the stable phase group received integrated traditional Chinese and Western medicine pulmonary rehabilitation strategy after the disease stabilized in the stable phase. The activities of daily life， lung function， inflammatory factor levels， psychological status， and adverse reactions of the three groups of patients before and after treatment were compared.ResultsThe activities of daily life， lung function， inflammatory factor levels， and psychological status of the three groups of patients were significantly improved after treatment （P< 0.05）， and the improvement of the stable phase group and the acute phase group was more obvious than that of the control group （P< 0.05）， but there was no significant difference between the stable phase group and the acute phase group （P> 0.05）. There was no significant difference in the incidence of adverse reactions among the three groups during the treatment process （P> 0.05）.ConclusionIntegrated traditional Chinese and Western medicine pulmonary rehabilitation strategy has significant therapeutic value for COPD patients， which can effectively inhibit inflammatory response， improve lung function， enhance exercise capacity， improve quality of life and psychological status， and does not increase the risk of adverse events. In addition， integrated traditional Chinese and Western medicine pulmonary rehabilitation strategy should be implemented as early as possible to achieve the best rehabilitation effect.

Key words:chronic obstructive pulmonary disease,acute exacerbation,integrated traditional Chinese and Western medicine,pulmonary rehabilitation,efficacy,safety

摘要：

目的探讨中西医结合肺康复策略对慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）急性加重患者的疗效和安全性。方法选取2020年5月至2022年6月betway必威登陆网址第二附属医院呼吸与危重症医学科收治的132例COPD急性加重患者作为研究对象。通过随机数字表法将所有患者分为对照组、急性期组和稳定期组，每组44例。对照组患者进行常规治疗，急性期组患者在急性期时通过中西医结合肺康复策略进行治疗，稳定期组患者在常规治疗病情稳定后的稳定期开始中西医结合肺康复策略治疗。比较3组患者在治疗前后的日常生活活动能力、肺功能、炎症因子水平、心理状况和不良反应发生情况。结果3组患者在治疗后的日常生活活动能力、肺功能、炎症因子水平和心理状况均得到了显著改善，其中稳定期组和急性期组相较于对照组的改善更为明显，差异均有统计学意义（P< 0.05），但稳定期组和急性期组之间差异无统计学意义（P> 0.05）。3组患者在治疗过程中的不良反应发生率差异无统计学意义（P> 0.05）。结论中西医结合肺康复策略对COPD急性加重患者具有显著的治疗价值，该策略可有效抑制炎症反应，改善肺功能，提高运动能力，改善生活质量和心理状态，且不增加不良事件发生的风险。

关键词:慢性阻塞性肺疾病,急性加重,中西医结合,肺康复,疗效,安全性

Qian HAN, Wenwen CAO, Danting ZHAO, Qiling YIN. The anti-inflammatory effect of integrated traditional Chinese and Western medicine pulmonary rehabilitation strategy on patients with chronic obstructive pulmonary disease[J]. Journal of Shandong First Medical Unversity & Shandong Academy of Medical Sciences, 2023, 44(12): 904-909.

韩倩, 曹雯雯, 赵丹婷, 阴其玲. 中西医结合肺康复策略对慢性阻塞性肺疾病患者炎症的改善作用[J]. betway必威登陆网址（betway.com ）学报, 2023, 44(12): 904-909.

Figures/Tables5

组别	性别（男/女）	年龄/岁	BMI/（kg/m²）	吸烟史	病程/年
对照组（n= 44）	25（56.82）/19（43.18）	61.82 ± 4.85	26.12 ± 1.98	26（59.09）	10.09 ± 4.29
稳定期组（n= 44）	31（70.45）/13（29.55）	60.82 ± 4.93	26.05 ± 2.33	25（56.82）	10.09 ± 4.11
急性期组（n= 44）	30（68.18）/14（31.82）	61.66 ± 5.57	26.17 ± 1.93	29（65.91）	9.25 ± 5.09
χ²/F	2.067	0.483	0.040	0.825	0.508
P	0.377	0.618	0.961	0.732	0.603

组别	性别（男/女）	年龄/岁	BMI/（kg/m²）	吸烟史	病程/年
对照组（n= 44）	25（56.82）/19（43.18）	61.82 ± 4.85	26.12 ± 1.98	26（59.09）	10.09 ± 4.29
稳定期组（n= 44）	31（70.45）/13（29.55）	60.82 ± 4.93	26.05 ± 2.33	25（56.82）	10.09 ± 4.11
急性期组（n= 44）	30（68.18）/14（31.82）	61.66 ± 5.57	26.17 ± 1.93	29（65.91）	9.25 ± 5.09
χ²/F	2.067	0.483	0.040	0.825	0.508
P	0.377	0.618	0.961	0.732	0.603

组别	6MWD	mMRC	ADL评分
对照组（n= 44）	292.43 ± 51.77	326.59 ± 16.72	3.39 ± 0.62	3.00 ± 0.37	44.39 ± 8.29	78.86 ± 5.17
稳定期组（n= 44）	294.48 ± 46.81	383.41 ± 21.71^a	3.50 ± 0.63	2.41 ± 0.50^a	43.61 ± 7.09	83.89 ± 6.02^a
急性期组（n= 44）	290.91 ± 62.74	395.43 ± 29.21^ab	3.48 ± 0.59	2.16 ± 0.43^ab	46.73 ± 7.17	85.86 ± 6.65^a
F	0.048	111.235	0.424	43.159	2.034	16.025
P	0.953	< 0.001	0.655	< 0.001	0.135	< 0.001

组别	6MWD	mMRC	ADL评分
对照组（n= 44）	292.43 ± 51.77	326.59 ± 16.72	3.39 ± 0.62	3.00 ± 0.37	44.39 ± 8.29	78.86 ± 5.17
稳定期组（n= 44）	294.48 ± 46.81	383.41 ± 21.71^a	3.50 ± 0.63	2.41 ± 0.50^a	43.61 ± 7.09	83.89 ± 6.02^a
急性期组（n= 44）	290.91 ± 62.74	395.43 ± 29.21^ab	3.48 ± 0.59	2.16 ± 0.43^ab	46.73 ± 7.17	85.86 ± 6.65^a
F	0.048	111.235	0.424	43.159	2.034	16.025
P	0.953	< 0.001	0.655	< 0.001	0.135	< 0.001

组别	FEV1/L	FEV1/FVC/（%）	PEF/（L/s）
对照组（n= 44）	1.66 ± 0.29	1.95 ± 0.37	49.98 ± 5.18	59.82 ± 4.78	3.26 ± 0.53	4.26 ± 0.33
稳定期组（n= 44）	1.64 ± 0.28	2.36 ± 0.39^a	51.15 ± 4.46	65.74 ± 5.62^a	3.29 ± 0.44	4.88 ± 0.42^a
急性期组（n= 44）	1.61 ± 0.24	2.48 ± 0.31^a	50.37 ± 4.56	68.23 ± 5.78^ab	3.35 ± 0.43	5.22 ± 0.39^ab
F	0.471	26.724	0.693	28.058	0.368	70.874
P	0.625	< 0.001	0.502	< 0.001	0.693	< 0.001

组别	FEV1/L	FEV1/FVC/（%）	PEF/（L/s）
对照组（n= 44）	1.66 ± 0.29	1.95 ± 0.37	49.98 ± 5.18	59.82 ± 4.78	3.26 ± 0.53	4.26 ± 0.33
稳定期组（n= 44）	1.64 ± 0.28	2.36 ± 0.39^a	51.15 ± 4.46	65.74 ± 5.62^a	3.29 ± 0.44	4.88 ± 0.42^a
急性期组（n= 44）	1.61 ± 0.24	2.48 ± 0.31^a	50.37 ± 4.56	68.23 ± 5.78^ab	3.35 ± 0.43	5.22 ± 0.39^ab
F	0.471	26.724	0.693	28.058	0.368	70.874
P	0.625	< 0.001	0.502	< 0.001	0.693	< 0.001

组别	TNF-α/（μg/L）	IL-6/（ng/L）	IL-8/（ng/L）
对照组（n= 44）	2.95 ± 0.40	2.71 ± 0.36	2.37 ± 0.47	61.98 ± 6.06	57.70 ± 6.17	51.47 ± 4.14	62.20 ± 6.98	47.08 ± 9.25	48.80 ± 8.80
稳定期组（n= 44）	2.94 ± 0.44	2.47 ± 0.42^a	2.08 ± 0.31^a	60.21 ± 4.90	52.93 ± 5.05^a	50.44 ± 3.69^a	61.04 ± 7.39	45.27 ± 7.72	42.01 ± 9.07^a
急性期组（n= 44）	2.96 ± 0.41	2.33 ± 0.44^a	2.00 ± 0.33^a	60.95 ± 7.08	50.85 ± 5.38^a	47.50 ± 5.63^a	62.74 ± 9.35	48.66 ± 8.83	40.01 ± 6.67^a
F	0.034	9.494	11.464	0.948	17.610	8.974	0.520	12.845	13.717
P	0.967	< 0.001	< 0.001	0.390	< 0.001	< 0.001	0.596	< 0.001	< 0.001

组别	TNF-α/（μg/L）	IL-6/（ng/L）	IL-8/（ng/L）
对照组（n= 44）	2.95 ± 0.40	2.71 ± 0.36	2.37 ± 0.47	61.98 ± 6.06	57.70 ± 6.17	51.47 ± 4.14	62.20 ± 6.98	47.08 ± 9.25	48.80 ± 8.80
稳定期组（n= 44）	2.94 ± 0.44	2.47 ± 0.42^a	2.08 ± 0.31^a	60.21 ± 4.90	52.93 ± 5.05^a	50.44 ± 3.69^a	61.04 ± 7.39	45.27 ± 7.72	42.01 ± 9.07^a
急性期组（n= 44）	2.96 ± 0.41	2.33 ± 0.44^a	2.00 ± 0.33^a	60.95 ± 7.08	50.85 ± 5.38^a	47.50 ± 5.63^a	62.74 ± 9.35	48.66 ± 8.83	40.01 ± 6.67^a
F	0.034	9.494	11.464	0.948	17.610	8.974	0.520	12.845	13.717
P	0.967	< 0.001	< 0.001	0.390	< 0.001	< 0.001	0.596	< 0.001	< 0.001

组别	SAS评分	SDS评分
对照组（n= 44）	54.23 ± 5.30	49.43 ± 4.55	54.30 ± 4.63	51.45 ± 5.16
稳定期组（n= 44）	52.91 ± 5.02	26.91 ± 4.29^a	55.05 ± 5.27	27.23 ± 5.08^a
急性期组（n= 44）	53.64 ± 5.18	23.91 ± 3.89^ab	54.59 ± 4.29	21.43 ± 5.08^ab
F	0.718	474.075	0.278	428.563
P	0.490	< 0.001	0.757	< 0.001

组别	SAS评分	SDS评分
对照组（n= 44）	54.23 ± 5.30	49.43 ± 4.55	54.30 ± 4.63	51.45 ± 5.16
稳定期组（n= 44）	52.91 ± 5.02	26.91 ± 4.29^a	55.05 ± 5.27	27.23 ± 5.08^a
急性期组（n= 44）	53.64 ± 5.18	23.91 ± 3.89^ab	54.59 ± 4.29	21.43 ± 5.08^ab
F	0.718	474.075	0.278	428.563
P	0.490	< 0.001	0.757	< 0.001

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