【目的】 基于肺肠同治理论探讨通腑泻肺方对慢性阻塞性肺疾病急性加重期（AECOPD）患者临床疗效及血清炎症细胞因 子的影响。【方法】 选取2020年12月至2022年12月期间在唐山市中医医院中医肺病科就诊的134例AECOPD患者展开回顾性 研究，根据治疗方案的不同将患者分为观察组和西药组，每组各67例。西药组给予常规西医治疗，观察组在西药组治疗的 基础上给予通腑泻肺方治疗，疗程为2周。观察2组患者治疗前后改良呼吸困难量表（mMRC）评分、慢阻肺评估测试（CAT） 评分、肺功能指标、动脉血气分析指标、血清炎症细胞因子水平的变化情况，比较2组患者的临床疗效、不良反应总发生率 和住院时间。【结果】（1）疗效方面，治疗2周后，观察组的总有效率为95.52%（64/67），西药组为79.10%（53/67），组间比较 （χ2 检验），观察组的疗效明显优于西药组（P＜0.01）。（2）相关量表评分方面，治疗后，2组患者的mMRC评分、CAT评分均较 治疗前明显降低（P＜0.05），且观察组的降低幅度均明显优于西药组（P＜0.01）。（3）肺功能指标方面，治疗后，2组患者的第 一秒用力呼气量（FEV1）、用力肺活量（FVC）及其比值（FEV1/FVC）均较治疗前升高（P＜0.05），且观察组的升高幅度均明显 优于西药组（P＜0.01）。（4）动脉血气分析指标方面，治疗后，2组患者的血氧饱和度（SaO2 ）、动脉血氧分压（PaO2 ）水平均较治 疗前升高（P＜0.05），动脉血二氧化碳分压（PaCO2 ）水平均较治疗前降低（P＜0.05），且观察组治疗后对SaO2、PaO2水平的升 高幅度及对PaCO2水平的降低幅度均明显优于西药组（P＜0.01）。（5）血清炎症细胞因子方面，治疗后，2组患者的血清肿瘤坏 死因子α（TNF-α）、C反应蛋白（CRP）、白细胞介素6（IL-6）水平均较治疗前明显降低（P＜0.05），且观察组的降低幅度均明 显优于西药组（P＜0.01）。（6）安全性方面，观察组的不良反应总发生率为 2.99%（2/67），西药组为 5.97%（4/67），组间比较， 差异无统计学意义（P＞0.05）。（7）住院时间方面，观察组的住院时间较西药组明显缩短，差异有统计学意义（P＜0.05）。【结论】 基于肺肠同治理论的通腑泻肺方可有效缓解 AECOPD患者呼吸困难等症状，改善患者肺功能，纠正动脉血气紊乱，抑制炎 症因子释放，缩短治疗时间，且未引发严重不良反应，安全有效。

Objective To investigate the clinical efficacy of Tongfu Xiefei Formula in treating patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） based on the theory of simultaneous treatment of lung and intestine，and to observe its effects on serum inflammatory cytokines. Methods A retrospective study was conducted on 134 AECOPD patients treated at the Department of Pulmonary Diseases of Traditional Chinese Medicine， Tangshan Hospital of Traditional Chinese Medicine from December 2020 to December 2022. The patients were divided into an observation group and a western medicine group based on the treatment plans，with 67 cases in each group. The western medicine group received conventional western medical treatment，while the observation group was given Tongfu Xiefei Formula orally in addition to the western medical treatment. The course of treatment covered 2 weeks. Before and after treatment， the two groups were observed in the changes of the modified Medical Research Council （mMRC） dyspnea scale scores，COPD Assessment Test （CAT） scores，lung function indicators，arterial blood gas analysis indicators，and serum inflammatory cytokine levels. The clinical efficacy，total incidence of adverse reactions，and hospitalization time were compared between the two groups. Results（1）After 2 weeks of treatment，the total effective rate in the observation group was 95.52% （64/67）， compared to 79.10%（53/67） in the western medicine group. The intergroup comparison （tested by the chi-square test） showed that the efficacy of the observation group was significantly superior to that of the western medicine group（P＜0.01）. （2）After treatment， the mMRC scores and CAT scores in both groups were significantly decreased（P＜0.05），and the decrease in the observation group was significantly superior to that in the western medicine group （P＜0.01）.（3） After treatment，lung function indicators of the forced expiratory volume in one second （FEV1）， forced vital capacity（FVC）， and their ratio （FEV1/FVC） in both groups were significantly increased （P＜0.05），and the increase in the observation group was significantly superior to that in the western medicine group （P＜0.01）.（4） After treatment，the oxygen saturation （SaO2 ） and arterial oxygen partial pressure （PaO2 ） levels in both groups significantly increased （P＜0.05），while the arterial carbon dioxide partial pressure （PaCO2 ） level was significantly decreased （P＜0.05）. The increase in SaO2 and PaO2 levels and the decrease in PaCO2 level in the observation group were significantly superior to those in the western medicine group （P＜0.01）. （5） After treatment，the levels of serum inflammatory cytokines of tumor necrosis factor α（TNF-α），C-reactive protein（CRP），and interleukin-6（IL-6） in both groups were significantly decreased（P＜0.05），and the decrease in the observation group was significantly superior to that in the western medicine group（P＜0.01）.（6） The total incidence of adverse reactions in the observation group was 2.99%（2/67）， compared to 5.97%（4/67） in the western medicine group，with no statistically significant difference between the two groups（P＞0.05）.（7） The observation group had a significantly shorter hospitalization time than the western medicine group， and the difference was statistically significant （P＜0.05）. Conclusion Tongfu Xiefei Formula，formulated based on theory of simultaneous treatment of lung and intestine，is effective and safe on relieving symptoms such as dyspnea in AECOPD patients， improving lung function， correcting arterial blood gas disorders， inhibiting the release of inflammatory factors，shortening treatment time，while causing no serious adverse reactions.

R259.63

国家重点研发计划“中医药现代化研究”重点专项（编号：2018YFC1704803）；河北省中医药管理局中医药类科研计划项目（编号： 2022543）