Abstract: Objective　To analyze the clinical effect of Juqin decoction combined with bronchoscopic alveolar lavage in the treatment of patients with bronchiectasis. Methods　A total of 80 patients with bronchiectasis in Jiamusi Hospital of Traditional Chinese Medicine from March to July 2021 were divided into a conventional group and a combined group with the random number table with 40 cases in each group. In the conventional group, there were 21 males and 19 females, aged (58.36±8.97) years, were treated with bronchoscopic alveolar lavage. In the combined group, there were 22 males and 18 females, aged (58.40±9.01) years, were treated with Juqin decoction on the basis of the conventional group. The clinical efficacy and adverse reactions were compared between the two groups, as well as sputum characteristics, lung function, and inflammation indexes before and after treatment. Independent sample t test was used for inter-group comparison of the measurement data, paired t test was used for intra-group comparison of the measurement data, and χ² test was used for the count data. Results　The total effective rate of the conventional group was 80.00% (32/40), which was significantly lower than that of the combined group [97.50% (39/40)] (P<0.05). After treatment, the sputum volume, sputum density, and purulent mucus indexes in the combined group were (109.54±10.95) ml, (0.51±0.14) points, and (0.49±0.12) points, which were significantly lower than those in the conventional group [(135.29±13.53) ml, (0.78±0.16) points, and (0.72±0.15) points], with statistically significant differences (all P<0.05). After treatment, the forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, and forced mid-expiratory flow rate (PEF25%-75%) in the combined group were (2.21±0.50) L, (2.82±0.43) L, (78.37±11.63)%, and (56.11±3.61), which were significantly higher than those in the conventional group [(1.71±0.41) L, (2.46±0.38) L, (69.51±10.79)%, and (54.06±3.40)], with statistically significant differences (all P<0.05). After treatment, the levels of interleukin-8 (IL-8), tumor necrosis factor -α (TNF-α), soluble intercellular adhesion molecule-1 (sICAM-1), and human secretory phospholipase A2-X (SPLA2-X) in the combined group were (52.11±4.98) pg/ml, (9.54±1.05) pg/ml, (178.44±17.84) ng/L, and (127.85±7.84) ng/L, which were lower than those in the conventional group [(57.25±5.48) pg/ml, (10.98±1.27) pg/ml, (202.55±20.26) ng/L, and (209.51±8.34) ng/L], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=0.157, P=0.692). Conclusion　The application of Juqin decoction combined with bronchoscopic alveolar lavage in the treatment of bronchiectasis has significant effect, which can significantly improve the sputum characteristics and lung function, reduce the inflammatory indexes, with high safety, which is worthy of promotion.

Key words: Juqin decoction, Bronchoscopic alveolar lavage, Bronchiectasia, Lung function

摘要： 目的　分析桔芩汤联合支气管镜肺泡灌洗术治疗支气管扩张患者的临床效果。方法　选取2021年3月至7月佳木斯市中医院收治的80例支气管扩张患者，依据随机数字表法均分为常规组和联合组，各40例。常规组男21例、女19例，年龄（58.36±8.97）岁，实施支气管镜肺泡灌洗术治疗；联合组男22例、女18例，年龄（58.40±9.01）岁，在常规组基础上加用桔芩汤治疗。比较两组患者治疗后临床疗效及不良反应发生情况，治疗前后的痰液性状指标、肺功能、炎症指标。计量资料组间比较采用独立样本t检验，组内采用配对t检验，计数资料采用χ²检验。结果　联合组临床总有效率为97.50%（39/40），高于常规组80.00%（32/40），差异有统计学意义（P<0.05）。治疗后，联合组痰液量、痰液密度、脓性黏液指标分别为（109.54±10.95）ml、（0.51±0.14）分、（0.49±0.12）分，均明显低于常规组的（135.29±13.53）ml、（0.78±0.16）分、（0.72±0.15）分，差异均有统计学意义（均P<0.05）。治疗后，联合组用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、FEV1/FVC、用力呼气中期流速（PEF25%～75%）分别为（2.21±0.50）L、（2.82±0.43）L、（78.37±11.63）%、（56.11±3.61），均高于常规组的（1.71±0.41）L、（2.46±0.38）L、（69.51±10.79）%、（54.06±3.40），差异均有统计学意义（均P<0.05）。治疗后，联合组白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）、可溶性细胞间黏附分子-1（sICAM-1）、人分泌型磷脂酶A2-X（sPLA2-X）水平分别为（52.11±4.98）pg/ml、（9.54±1.05）pg/ml、（178.44±17.84）ng/L、（127.85±7.84）ng/L，均低于常规组的（57.25±5.48）pg/ml、（10.98±1.27）pg/ml、（202.55±20.26）ng/L、（209.51±8.34）ng/L，差异均有统计学意义（均P<0.05）。两组支气管扩张患者不良反应发生率比较，差异无统计学意义（χ²=0.157，P=0.692）。结论　对支气管扩张患者应用桔芩汤联合支气管镜肺泡灌洗术治疗效果显著，明显改善患者痰液性状指标、肺功能，降低炎症指标，安全性较高，值得推广。

关键词: 桔芩汤, 支气管镜肺泡灌洗术, 支气管扩张, 肺功能