摘要
目的观察温肺化痰汤口服联合穴位贴敷治疗支气管哮喘慢性持续期的临床疗效。方法将106例支气管哮喘慢性持续期患者随机分为2组,对照组53例(后退出3例)采用西药治疗,治疗组53例(后退出2例)在对照组基础上联合温肺化痰汤口服和穴位贴敷治疗。比较2组治疗前后中医证候评分、免疫因子[干扰素γ(IFN-γ)、白细胞介素4(IL-4)、辅助性T细胞17/调节性T细胞(Th17/Treg)]、气道重塑[基质金属蛋白酶9(MMP-9)、金属蛋白酶组织抑制因子1(TIMP-1)、转化生长因子β_(1)(TGF-β_(1))、血管内皮生长因子(VEGF)]、肺功能[第1 s用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气峰流速(PEF)和FEV_(1)/FVC]指标变化。随访6个月,记录哮喘发作次数。结果2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后IFN-γ、Treg均较本组治疗前升高(P<0.05),IL-4、Th17和Th17/Treg均降低(P<0.05),且治疗组治疗后IFN-γ、Treg均高于对照组(P<0.05),IL-4、Th17和Th17/Treg均低于对照组(P<0.05)。2组治疗后MMP-9、TIMP-1、TGF-β_(1)及VEGF水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后FVC、FEV_(1)、FEV_(1)/FVC及PEF均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。随访期间,治疗组哮喘发作次数少于对照组(P<0.05)。结论温肺化痰口服汤联合穴位贴敷能改善支气管哮喘慢性持续期患者症状,并能调节机体免疫平衡,减轻气道重塑,提高肺功能,减少哮喘发作次数。
Objective To observe the clinical effect of Wenfei Huatan Decoction combined with acupoint application on bronchial asthma.Methods A total of 106 patients with chronic persistent bronchial asthma were randomzied 1∶1 to receive Western medicine treatment(WMT,the control group,3 cases dropped off)or Wenfei Huatan Decoction combined with acupoint application plus WMT(the observation group,2 cases dropped off).The efficacy of traditional Chinese medicine(TCM)syndromes were calculated.The changes in immunofactors(interferon[IFN-γ],interleukin-4[IL-4],T helper 17 cells[Th17]/regulatory T cell[Treg]),airway remodeling(matrix metalloproteinase 9[MMP-9],tissue inhibitor of metalloproteinase-1[TIMP-1],transforming growth factor-beta1[TGF-β_(1)],and vascular endothelial growth factor[VEGF]),and lung function(forced expiratory volume in the first second[FEV_(1)],forced vital capacity[FVC],peak expiratory velocity[PEF]and the ratio of the first second forced expiratory volume of forced vital capacity[FEV_(1)/FVC])were included as comparators before and after treatment.The number of asthma attacks was recorded and the clinical efficacy was assessed.Results After treatment,the TCM syndromes scores in the both groups were significantly lower than those before treatment(P<0.05),and which were significantly lower in the treatment group than in the control group(P<0.05).After treatment,the levels of IFN-γ and Treg in the both groups were significantly increased(P<0.05),while IL-4,Th17 and Th17/Treg were significantly decreased(P<0.05),and there were significant differences in the above indexes between the two groups(all P<0.05).After treatment,the levels of MMP-9,TIMP-1,TGF-β_(1) and VEGF were significantly decreased in the both groups than those before treatment(P<0.05),and the decreases were more pronounced relative to the control group(P<0.05).After treatment,the indexes of FEV_(1),FVC,PEF and FEV_(1)/FVC in the both groups were significantly increased(P<0.05),and the increases were more common in treatment group compared to control group(P<0.05).The number of asthma attacks in the treatment group was significantly less than that that in the control group(P<0.05).Conclusion Wenfei Huatan Decoction combined with acupoint application can improve the symptoms of patients with chronic persistent bronchial asthma,maintain the body's immune balance,reduce airway remodeling,improve lung function,and reduce the number of asthma attacks,with outstanding efficacy.
作者
李月斌
LI Yuebin(First Department of Internal Medicine,Chiping District Hospital of Traditional Chinese Medicine,Liaocheng,Shandong 252100)
出处
《河北中医》
2024年第5期749-753,共5页
Hebei Journal of Traditional Chinese Medicine
关键词
支气管哮喘
慢性持续期
温肺化痰汤
穴位贴敷
Bronchial asthma
Chronic persistent
Wenfei Huatan Decoction
Acupoint application
