Efficacy And Immune Function In The Treatment Of Patients With Chronic Obstructive Pulmonary Disease In The Stable Stage Of COPD With Plus Flavor Kidney Qi Pill

Objective:To observe the clinical efficacy and the effect on immune function of Plus flavor kidney qi pill in the treatment of stable COPD patients and to investigate its possible mechanism of action.Methods:Sixty patients from the Department of Respiratory and Critical Care Medicine,Rui Kang Hospital,Guangxi University of Traditional Chinese Medicine,from January 2022 to December 2022,who were admitted to the outpatient and inpatient departments of the Department of Respiratory and Critical Care Medicine,Guangxi University of Traditional Chinese Medicine,and who were in group C in the comprehensive assessment of COPD,were collected.The patients were divided into control group（30cases）and treatment group（30 cases）by random number table method.The control group was given inhalation budesonide formoterol powder inhaler（specification:320ug:9.0ug,60 puffs/spray）;usage:1 puff once,every 12hours.In the treatment group,oral administration of Plus flavor kidney qi pill（composition of the formula:rehmanniae radix praeparata 15g,yam 15g,cornus officinalis sieb 10g,oriental waterplantain rhizome 6g,poria cocos10g,tree peony bark 6g,cassia twig 6g,radix aconiti praeparata 10g,Ginseng10g,largehead atractylodes rhizome 15g）was added to the treatment in the control group,and the drug was decocted by the herbal pharmacy of Rui Kang Hospital,Guangxi University of Traditional Chinese Medicine;usage:1 dose daily,decocted in water to 300ml.Vacuum divided into 2 bags,each bag150ml,divided into morning and dinner after warm.The duration of treatment was 4 weeks in both groups.Patients’TCM symptom scores,pulmonary function（FEV₁,FVC,FEV₁/FVC%）,quality of life（CAT score）and peripheral blood immune function indexes（Th17%,Treg%,Th17/Treg cell ratio）were evaluated before enrollment and at the end of 4 weeks of continuous treatment,respectively.Results:（1）A total of 60 cases completed this study at the end of treatment,30cases each in the treatment and control groups,with no cases of rejection or shedding.（2）Comparison of baseline data:The general data（gender,age,disease duration,smoking status,lung function classification）and efficacy indexes（TCM symptom score,lung function,CAT score,peripheral blood immune index）of the two groups before treatment were compared,and the differences were not statistically significant（P>0.05）and comparable.（3）Evaluation of treatment effect.（1）Comparison of the total clinical efficiency between the two groups:after treatment,the total efficiency of the control group was 90.0%and the total efficiency of the treatment group was 96.7%,the total efficiency of the treatment group was significantly better than that of the control group（P<0.05）.（2）Comparison of TCM symptom scores:after treatment,the symptoms of wheezing and shortness of breath in the control group were significantly relieved compared with those before treatment（P<0.05）,while the symptoms of weakness,weakness of the back and knees,tinnitus and nocturnal polyuria were not improved（P>0.05）;all the TCM symptoms in the treatment group were significantly improved compared with those before treatment（P<0.01）.When comparing the two groups after treatment,the treatment group was better than the control group in improving wheezing,shortness of breath,fatigue,lumbar and knee weakness,tinnitus and nocturia（P<0.05）.（3）Comparison of lung function:after treatment,FEV₁ in the control group increased compared with that before treatment（P<0.01）,and there was no change in FVC and FEV₁/FVC%（P>0.05）;FEV₁ and FVC in the treatment group increased compared with that before treatment（P<0.01）,and there was no change in FEV₁/FVC%（P>0.05）.When comparing the two groups after treatment,the improvement of FVC in the treatment group was better than that in the control group（P<0.05）.（4）Quality of life（CAT score）comparison:after treatment,5 CAT scores of cough,sputum,chest tightness,wheezing and confidence in going out were lower in the control group than before treatment（P<0.05）,and 3scores of daily activities,sleep and energy were unchanged（P>0.05）;all CAT scores were significantly lower in the treatment group than before treatment（P<0.01）.The treatment group was better than the control group in the four CAT scores of asthenia,daily activity,sleep and energy after treatment（P<0.05）.（5）Comparison of peripheral blood immune function indexes:after treatment,no significant changes were seen in Th17%,Treg%,and Th17/Treg levels in the control group compared with those before treatment（P>0.05）;Th17%and Th17/Treg levels in the treatment group were significantly lower（P<0.05）and Treg%levels were significantly higher（P<0.01）compared with those before treatment.When comparing the two groups after treatment,Th17%and Th17/Treg levels in the treatment group were lower than those in the control group（P<0.01）,and Treg%levels were higher than those in the control group（P<0.05）.Conclusion:Plus flavor kidney qi pill is effective in treating patients with stable kidney qi deficiency evidence in COPD,which can reduce clinical symptoms,enhance immune function and improve quality of life.