目的：观察养肺益肾颗粒联合常规疗法治疗慢性阻塞性肺疾病（COPD） 稳定期的临床疗效及对生活质量、免疫功能的影响。方法：选取60 例稳定期COPD 患者，按随机数字表法分为对照组及治疗组各30 例。对照组按照相关指南给予常规治疗，治疗组在对照组基础上口服养肺益肾颗粒。2 组均连续观察治疗12 周。比较2 组治疗前后中医证候评分、改良呼吸困难指数（mMRC）、COPD 评估测试评分（CAT）、细胞因子［血清单核细胞趋化蛋白（MCP-1）、γ-干扰素（IFN-γ）、白细胞介素-4（IL-4）、白细胞介素-10（IL-10）］、用力肺活量（FVC）、第1 秒用力呼气容积（FEV1）、第1 秒用力呼气容积与用力肺活量的比值（FEV1/FVC） 的变化，观察2 组临床疗效。结果：治疗后，2 组咳嗽、喘息、胸闷、气短、乏力、紫绀评分均较治疗前降低；治疗组咳嗽、胸闷评分均低于对照组，差异均有统计学意义（P＜0.01）。治疗后，2 组mMRC、CAT 评分均较治疗前降低，治疗组上述2 项评分均低于对照组，差异均有统计学意义（P＜0.05）。治疗后，治疗组FVC、FEV1 水平均低于对照组，但差异无统计学意义（P＞0.05）；FEV1/FVC 水平高于对照组（P＜0.05）。治疗后，2 组MCP-1、IFN-γ 水平均较治疗前下降，IL-4 水平均较治疗前上升，差异均有统计学意义（P＜0.05）；治疗组MCP-1、IFN-γ 水平均低于对照组，IL-10 水平高于对照组，差异均有统计学意义（P＜0.05）。治疗组总有效率为90.00%，对照组总有效率为66.67%，2 组比较，差异有统计学意义（P＜0.05）。结论：养肺益肾颗粒联合常规疗法能缓解COPD 稳定期的临床症状，改善呼吸困难，延缓疾病进展。
Abstract：Objective：To observe the clinical effect of Yangfei Yishen granules combined with routine therapy for chronic obstructive pulmonary disease(COPD) at stable stage and its effect on quality of life and immune function. Methods：A total of 60 cases of patients with COPD at stable stage were selected and divided into the control group and the treatment group according to the random number table method，with 30 cases in each group. The control group was given routine treatment according to relevant guidelines， and the treatment group was additionally given the oral administration of Yangfei Yishen granules based on the treatment of the control group. Both groups were observed and treated for 12 weeks. Before and after treatment， the changes in Chinese medicine syndrome scores， modified Medical Research Council(mMRC)， COPD Assessment Test(CAT)，cytokines including monocyte chemoattractant protein(MCP-1)，γ-interferon(IFN-γ)，interleukin-4 (IL-4) and interleukin-10(IL-10) in serum，forced vital capacity(FVC)，the forced expiratory volume in one second(FEV1) and the ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC) in the two groups were compared. The clinical effects in the two groups were observed. Results： After treatment， the scores of coughing， wheezing， chest oppression， shortness of breath， lack of strength and cyanosis in the two groups were decreased when compared with those before treatment；the scores of coughing and chest oppression in the treatment group were lower than those in the control group，differences being significant(P＜0.01). After treatment，the scores of mMRC and CAT in the two groups were decreased when compared with those before treatment，and the above two scores in the treatment group were lower than those in the control group， differences being significant(P＜0.05). After treatment， the levels of FVC and FEV1 in the treatment group were lower than those in the control group， but the difference were not statistically significant(P＞0.05)， and the level of FEV1/FVC was higher(P＜0.05). After treatment， the levels of MCP- 1 and IFN- γ in the two groups were decreased when compared with those before treatment，and the levels of IL-4 were increased，differences being significant (P＜0.05)；the levels of MCP-1 and IFN-γ in the treatment group were lower than those in the control group，and the level of IL-10 was higher，differences being significant(P＜0.05). The total effective rate was 90.00% in the treatment group and 66.67% in the control group，the difference being significant(P＜0.05). Conclusion：The therapy of Yangfei Yishen granules combined with routine therapy for COPD at stable stage can improve dyspnea and delay the disease progression.