【目的】观察宣肺益脾方 （以《医方集解》中的健脾丸为基础方加减组方而成） 治疗脾胃虚弱型老年肌少症的临床疗效，并探讨其对患者微炎症状态的影响。 【方法】将70例脾胃虚弱型老年肌少症患者随机分为观察组和对照组，每组各35例。对照组给予运动及营养指导，观察组在对照组的基础上给予口服宣肺益脾方治疗，干预时间为8周。观察2组患者治疗前后中医证候积分、四肢骨骼肌指数 （ASMI） 、握力、6 m步速及血清C反应蛋白 （CRP） 、白细胞介素6 （IL-6） 、肿瘤坏死因子α （TNF-α）水平的变化情况，评价2组患者的临床疗效及干预方案的安全性。 【结果】（1） 疗效方面，治疗8周后，观察组的总有效率为94.29% （33/35） ，对照组为77.14% （27/35） ，组间比较 （χ2 检验） ，观察组的疗效明显优于对照组 （P＜0.05） 。 （2） 中医证候积分方面，治疗后，2组患者的中医证候积分均较治疗前显著降低 （P＜0.05） ，且观察组对中医证候积分的降低幅度明显优于对照组 （P＜0.01） 。 （3） 肌少症指标方面，治疗8周后，2组患者的ASMI、握力及6 m步速均较治疗前显著提高 （P＜0.05） ，且观察组对ASMI、握力的提高幅度均明显优于对照组 （P＜0.05） 。 （4） 血清微炎症指标方面，治疗8周后，2组患者血清CRP、IL-6、TNF-α水平均较治疗前明显下降 （P＜0.05） ，且观察组对血清CRP水平的下降幅度明显优于对照组 （P＜0.05） 。 （5） 安全性方面，治疗过程中，2组患者均未发生明显不良反应，患者的肝肾功能等安全性指标均在正常值范围。 【结论】宣肺益脾方可以改善老年肌少症患者的临床症状，其可能通过微炎症机制发挥作用。

Objective To investigate the clinical efficacy of Xuanfei Yipi Formula，a prescription derived from modified Jianpi Pill recorded in Yi Fang Ji Jie （A Collection of Prescriptions with Expositions） ，in treating senile sarcopenia with spleen-stomach weakness type，and to observe its effect on chronic low-grade inflammation of the patients. Methods Seventy cases of senile sarcopenia patients of spleen-stomach weakness type were randomly divided into an observation group and a control group，with 35 cases in each group. The control group was given exercise and nutritional guidance，while the observation group was treated with Xuanfei Yipi Formula orally on the basis of the control group，and the intervention time of both groups was eight weeks. The changes of traditional Chinese medicine （TCM） syndrome scores，appendicular skeletal muscle mass index （ASMI），grip strength，6-meter walking pace，and the serum levels of C-reactive protein （CRP） ，interleukin 6 （IL-6） ，tumor necrosis factor α （TNF-α） in the two groups before and after treatment were observed. After treatment，the clinical efficacy and safety of the patients in the two groups were evaluated. Results （1） After eight weeks of treatment，the total effective rate in the observation group was 94.29% （33/35） ，and that in the control group was 77.14% （27/35） ，the intergroup comparison （by chi-square test） showed that the efficacy of the observation group was significantly superior to that of the control group （P＜0.05） . （2） After treatment，the TCM syndrome scores in the two groups were significantly lower than those before treatment （P＜0.05），and the decrease of TCM syndrome score in the observation group was more obviously than that in the control group （P＜0.01） . （3） After eight weeks of treatment，the ASMI，grip strength and 6-meter walking pace in the two groups were significantly higher than those before treatment，and the increase of ASMI and grip strength in the observation group was more obviously than that in the control group （P＜0.05） . （4） After eight weeks of treatment，the levels of serum CRP，IL-6，and TNF-α in the two groups were decreased significantly compared with those before treatment （P＜0.05），and the decrease of serum CRP level in the observation group was more obviously than that in the control group （P＜0.05） . （5） During the treatment，no obvious adverse reactions occurred in both groups，and the safety indexes of liver and kidney functions of the patients were all within the normal range. Conclusion Xuanfei Yipi Formula can improve the clinical symptoms of senile sarcopenia patients，and its mechanism is probably related with the regulation of chronic low-grade inflammation.

R255.6

东莞市社会发展科技项目 （编号：20221800900132）