广西医学

目的探讨补肾培元胶囊对肾阳虚型慢性阻塞性肺疾病（COPD）稳定期患者小气道阻抗指数及结构功能的影响。方法将300例肾阳虚型COPD稳定期患者随机分为对照组和观察组，每组150例。给予对照组常规方案治疗，观察组在对照组基础上给予口服补肾培元胶囊，两组患者均治疗3个月。比较治疗前后两组患者的小气道阻抗指数（R5⁃R20、Fres）、气管内壁直径（WT）、内壁旁肺动脉的直径（BWT）、WT/BWT值、第9级支气管管腔面积（9⁃LA）、第9级支气管气道面积（9⁃AA）、第9级支气管气管壁面积（9⁃WA）、9⁃LA/AA值、9⁃WA/AA值及6 min步行试验（6MWT）距离，比较两组患者治疗后中医证候疗效。结果治疗后，观察组R5⁃R20、Fres、WT、BWT、WT/BWT值低于治疗前及对照组，对照组R5⁃R20高于治疗前（P<0.05）；两组患者9⁃LA、9⁃LA/AA值较治疗前升高，且观察组高于对照组，两组患者9⁃WA、9⁃WA/AA值较治疗前降低，且观察组低于对照组（P<0.05）；两组患者的6MWT距离长于治疗前，且观察组长于对照组（P<0.05）。观察组中医证候的总有效率高于对照组（P<0.05）。结论在常规治疗基础上，加用补肾培元胶囊治疗肾阳虚型COPD稳定期患者可以降低小气道阻力，减轻小气道壁增厚，缓解小气道重构，值得应用推广。

Objective To investigate the effect of Bushen Peiyuan Capsules on small airway impedance index and structural function in patients with chronic obstructive pulmonary disease (COPD) in deficiency of kidney yang type at stable stage. Methods A total of 300 COPD patients in deficiency of kidney yang type were randomly assigned to control group or observation group, with 150 cases in each group. The control group received routine regimen for treatment, based on which the observation group received oral administration of Bushen Peiyuan Capsules. Both groups received treatment for 3 months. The pre⁃ and post⁃treatment small airway impedance index (R5⁃R20, Fres), tracheal wall thickness (WT), boundary wall thickness (BWT), and WT/BWT value; in addition, the grade 9 bronchial lumen area (9⁃LA), the grade 9 bronchial airway area (9⁃AA), the grade 9 bronchial wall area (9⁃WA), and 9⁃LA/AA, 9⁃WA/AA values, as well as 6⁃minute walk test (6MWT) distance were compared between patients of the two groups. The post⁃treatment Traditional Chinese Medicine symptoms efficacy was compared between patients of the two groups. Results After treatment, the observation group exhibited lower R5⁃R20, Fres, WT, BWT, WT/BWT value as compared with before treatment and the control group, and the control group exhibited a higher R5⁃R20 as compared with before treatment (P<0.05). Both group yielded elevated 9⁃LA and 9⁃LA/AA value, and the observation group was higher than the control group, whereas 9⁃WA and 9⁃WA/AA value were decreased as compared with before treatment, and the observation group was lower than the control group (P<0.05). Both groups expressed a longer 6MWT distance as compared with before treatment, and the observation group was longer than the control group (P<0.05). The observation group depicted a higher total effective rate of Traditional Chinese Medicine symptoms as compared with the control group (P<0.05). Conclusion On the basis of routine treatment, additionally employing Bushen Peiyuan Capsules for the treatment of COPD patients in deficiency of kidney yang type can decrease small airway impedance, relieve small airway wall thickening, alleviate small airway reconstruction, which is worthy of application and promotion.