健脾补肾益肺方联合布地格福治疗肺脾气虚型慢性阻塞性肺疾病稳定期患者疗效及对血清bFGF、COX-2水平的影响OA

Objective To investigate the efficacy of Jianpi Bushen Yifei Formula combined with Budesonide,Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol in patients with stable chronic obstructive pulmonary disease(COPD)of lung-spleen qi deficiency type,and to observe its effects on serum basic fibroblast growth factor(bFGF)and cyclooxygenase-2(COX-2)levels.Methods A total of 138 patients with stable COPD of lung-spleen qi deficiency type,admitted to Dongfang Hospital Beijing University of Chinese Medicine between February 2022 and January 2024,were randomized into a control group(n=69)and a trial group(n=69)using a random number table method.Both groups received conventional treatment,including nutritional support,rehabilitation exercise,and avoidance of harmful factors.The control group received additional Budesonide,Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol,while the trial group received Jianpi Bushen Yifei Formula in addition to the control group's treatment.The treatment course lasted 3 months.Changes in lung function,blood gas parameters,St.George's Respiratory Questionnaire(SGRQ)scores,6-minute walking distance(6MWD),and serum bFGF and COX-2 levels were observed before and after treatment.Clinical efficacy was compared between the two groups.Correlations between serum bFGF and COX-2 levels,arterial partial pressure of carbon dioxide(PaCO2),and arterial partial pressure of oxygen(PaO2)were analyzed.Multivariate logistic regression was used to identify influencing factors for COPD of lung-spleen qi deficiency type.Results(1)Regarding efficacy,after 3 months of treatment,the total effective rate was 94.20%(65/69)in the trial group and 78.26%(54/69)in the control group,with the trial group showing significantly superior efficacy(χ2=6.103,P＜0.05).(2)For serum bFGF and COX-2 levels,both groups exhibited significant decreases after treatment(P＜0.05),with the trial group demonstrating significantly greater reductions than the control group(P＜0.01).(3)In terms of lung function,both groups showed significant increases in peak expiratory flow(PEF),forced expiratory volume in one second(FEV1),and the ratio of FEV1 to forced vital capacity(FEV1/FVC)after treatment(P＜0.05),with the trial group showing significantly greater improvements than the control group(P＜0.01).(4)Regarding blood gas parameters,both groups exhibited significant decreases in PaCO2 and increases in PaO2 after treatment(P＜0.05),with the trial group demonstrating significantly greater changes than the control group(P＜0.01).(5)For quality of life,both groups showed significant decreases in SGRQ scores and increases in 6MWD after treatment(P＜0.05),with the trial group exhibiting significantly greater improvements than the control group(P＜0.01).(6)Correlation analysis revealed that,after adjusting for age,disease duration,smoking and alcohol history,diabetes history,and gender,serum bFGF was positively correlated with COX-2 and PaCO2(P＜0.01)and negatively correlated with PaO2(P＜0.01).(7)Multivariate logistic regression identified bFGF,COX-2,PaCO2,and SGRQ scores as protective factors(P＜0.01),while PEF,FEV1,FEV1/FVC,PaO2,and 6MWD were identified as risk factors(P＜0.01).Conclusion Jianpi Bushen Yifei Formula combined with Budesonide,Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol is effective in treating patients with stable COPD of lung-spleen qi deficiency type.It significantly improves lung function and blood gas parameters,enhances quality of life,and reduces serum bFGF and COX-2 levels.