摘要
目的探讨化痰清肺汤联合布地奈德雾化吸入对慢性阻塞性肺疾病急性加重期(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者外周血炎症因子及气道重塑的影响。方法选取2018年6月—2019年10月期间于河南大学第一附属医院就诊的AECOPD患者116例作为研究对象,按简单随机化法分为联合组和对照组,每组各58例。常规治疗基础上,对照组予以布地奈德雾化吸入治疗,联合组予以化痰清肺汤联合布地奈德雾化吸入治疗,两组均治疗14 d。观察比较两组患者临床疗效与治疗前、治疗14 d后肺功能指标[第1秒呼气量(Forced expiratory volume in the first second,FEV1)、用力肺活量(Forced vital capacity,FVC)、呼气峰流速(Peak expiratory flow,PEF)]、免疫功能指标(CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+))、炎症因子指标[肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-8(Interleukin-8,IL-8)、白细胞介素-6(Interleukin-6,IL-6)]、氧化应激指标[超氧化物歧化酶(Superoxide dismutase,SOD)、丙二醛(Malondialdehyde,MDA)]、气道重塑指标[基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)、转化生长因子-β(Transforming growth factor-β,TGF-β)]水平。结果治疗14 d后联合组总有效率93.10%(54/58)明显高于对照组77.59%(45/58),差异有统计学意义(P<0.05)。治疗14 d后两组患者FEV1、FVC、PEF水平均较治疗前提高,差异有统计学意义(P<0.05);且联合组FEV1、FVC、PEF水平均高于对照组,差异有统计学意义(P<0.05)。治疗14 d后两组患者MDA、CD8^(+)水平均较治疗前降低,SOD、CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前升高,且联合组MDA、CD8^(+)水平均较对照组降低,SOD、CD4^(+)、CD4^(+)/CD8^(+)水平均较对照组升高,差异有统计学意义(P<0.05)。治疗14 d后两组患者血清TNF-α、IL-8、IL-6、MMP-9、TGF-β水平均较治疗前降低,差异有统计学意义(P<0.05);且联合组血清TNF-α、IL-8、IL-6、MMP-9、TGF-β水平均低于对照组,差异有统计学意义(P<0.05)。结论化痰清肺汤联合布地奈德雾化吸入治疗AECOPD,可明显降低患者外周血炎性因子水平,抑制气道重塑,改善免疫功能及肺功能,进一步提高治疗效果。
Objective To investigate the effect of Huatan Qingfei Decoction combined with budesonide inhalation on peripheral blood inflammatory cytokines and airway remodeling in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 116 AECOPD patients treated in the First Affiliated Hospital of Henan University from June 2018 to October 2019 were selected and assigned into a combination group and a control group according to simple randomization method,with 58 patients in each.On the basis of routine treatment,the control group was administrated with budesonide inhalation,and the combination group with Huatan Qingfei Decoction combined with budesonide inhalation.Both groups were treated for 14 days.The clinical efficacy was compared between the two groups.The pulmonaryfunction indexes[forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),and peak expiratory flow(PEF)],immune function indicators(CD8^(+),CD4^(+),and CD4^(+)/CD8^(+)),inflammatory cytokines[tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),and interleukin-6(IL-6)],oxidative stress indicators[superoxide dismutase(SOD)and malondialdehyde(MDA)],and airway remodeling index[matrix metalloproteinase-9(MMP-9)and transforming growth factor-β(TGF-β)]were compared between before and after treatment and between the two groups.Results After 14 days of treatment,the total effective rate of the combination group was 93.10%(54/58),which was higher than that[77.59%(45/58)]of the control group(P<0.05).After 14 days of treatment,the FEV1,FVC,and PEF in the two groups elevated compared with those before treatment(P<0.05)and were higher in the combination group than in the control group(P<0.05).After 14 days of treatment,the levels of MDA and CD8^(+)in the two groups were lower than those before treatment and lower in the combination group than in the control group;the levels of SOD,CD4^(+),CD4^(+)/CD8^(+)were higher than those before treatment and higher in the combination group than in the control group(P<0.05).After 14 days of treatment,the serum levels of TNF-α,IL-8,IL-6,MMP-9,and TGF-βin the two groups declined compared with those before treatment(P<0.05)and were lower in the combination group than in the control group(P<0.05).Conclusion Huatan Qingfei Decoction combined with budesonide inhalation can significantly lower the levels of inflammatory cytokines in peripheral blood,inhibit airway remodeling,and improve immune function and lung function,demonstrating good therapeutic effect for AECOPD.
作者
单远莹
秦文婧
齐红松
SHAN Yuan-ying;Qin Wen-jing;Qi Hong-song(Department of Respiratory Medicine,the First Affiliated Hospital of Henan University,Kaifeng Henan 475000)
出处
《世界中西医结合杂志》
2022年第5期931-935,940,共6页
World Journal of Integrated Traditional and Western Medicine
基金
开封市科技发展计划项目(1703015)。
关键词
慢性阻塞性肺病急性加重期
化痰清肺汤
布地奈德
炎症因子
气道重塑
氧化应激
Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD)
Huatan Qingfei Decoction
Budesonide
Inflammatory Cytokines
Airway Remodeling
Oxidative Stress
Immune Function
