补肺益肾定喘方对慢性阻塞性肺疾病缓解期(肺肾亏虚型)患者miR-145、TGF-β1、IL-33及肺功能的影响  

Effects of Bufei Yishen Dingchuan Prescription on miR-145,TGF-β1,IL-33 and Lung Function of Patients with Chronic Obstructive Pulmonary Disease of Lung-kidney Deficiency Type in Remission Stage

作　　者：方翔宇 邱世光 吉贞料 李兰英 FANG Xiang-Yu;QIU Shi-Guang;JI Zhen-Liao;LI Lan-Ying(The Second Affiliated Hospital of Hainan Medical University,Haikou 570311 Hainan,China)

机构地区：[1]海南医学院第二附属医院,海南海口570311

出　　处：《广州中医药大学学报》2022年第5期1020-1026,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：海南省科技合作项目(编号:ZDYD2019210)

摘　　要：【目的】观察补肺益肾定喘方在慢性阻塞性肺疾病(COPD)稳定期(肺肾亏虚型)治疗中的应用价值。【方法】将118例COPD稳定期(肺肾亏虚型)患者随机分为观察组和对照组,每组各59例。对照组给予西医常规的噻托溴铵粉吸入剂吸入治疗,观察组在对照组基础上联合补肺益肾定喘方口服治疗,疗程为3个月。观察2组患者治疗前后中医证候评分、COPD评估测试(CAT)评分、用力肺活量(FVC)、第1秒用力呼气量占呼气量的比例(FEV1/FVC)及血浆微小核糖核酸145(miR-145)和血清白细胞介素33(IL-33)、白细胞介素6(IL-6)、转化生长因子β1(TGF-β1)、α1抗胰蛋白酶(α1-AT)水平的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗3个月后,观察组的总有效率为96.61%(57/59),对照组为77.97%(46/59),组间比较,观察组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的主症评分(包括胸闷气喘、咳嗽)和次症评分(包括自汗、腰膝酸软、乏力)均较治疗前明显降低(P<0.05),且观察组对主症评分和次症评分的降低作用均明显优于对照组(P<0.01)。(3)治疗后,2组患者的FEV1/FVC、FVC水平均较治疗前升高,CAT评分均较治疗前降低,差异均有统计学意义(P<0.05),且观察组对FEV1/FVC、FVC水平的升高作用和对CAT评分的降低作用均明显优于对照组(P<0.01)。(4)治疗后,2组患者的血浆miR-145和血清IL-6、IL-33、TGF-β1、α1-AT水平均较治疗前明显降低(P<0.05),且观察组对血浆miR-145和血清IL-6、IL-33、TGF-β1、α1-AT水平的降低作用均明显优于对照组,差异均有统计学意义(P<0.01)。【结论】在西医常规治疗基础上联合补肺益肾定喘方治疗COPD稳定期(肺肾亏虚型)患者疗效确切,可有效减轻气道炎症反应,预防气道重构,改善临床症状,提高患者肺功能。Objective To investigate the efficacy of Bufei Yishen Dingchuan Prescription in the treatment of chronic obstructive pulmonary disease(COPD)of lung-kidney deficiency type in remission stage.Methods A total of118 patients with stable COPD of lung-kidney deficiency type were randomly divided into observation group and control group,with 59 cases in each group.The control group was given conventional treatment of inhalation of tiotropium bromide powder,and the observation group was given oral use of Bufei Yishen Dingchuan Prescription together with inhalation of tiotropium bromide powder.The course of treatment covered 3 months.The changes of traditional Chinese medicine(TCM)syndrome scores,COPD assessment test(CAT)scores,forced vital capacity(FVC),ratio of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC),and plasma levels of microRNA 145(miR-145),serum interleukin 33(IL-33),interleukin 6(IL-6),transforming growth factorβ1(TGF-β1)and alpha-1 antitrypsin(α1-AT)in the two groups were observed before and after treatment.Meanwhile,the clinical efficacy of the two groups was evaluated.Results(1)After 3 months of treatment,the total effective rate of the observation group was 96.61%(57/59),and that of the control group was 77.97%(46/59).The intergroup comparison showed that the therapeutic effect of the observation group was significantly superior to that of the control group(P<0.01).(2)After treatment,the scores of primary symptoms of chest distress,asthma,and cough as well as the secondary symptoms of spontaneous sweating,soreness and weakness of waist and knee,and fatigue in the two groups were significantly lower than those before treatment(P<0.05),and the effect on reducing the scores of primary symptoms and secondary symptoms in the observation group was significantly superior to that in the control group(P<0.01).(3)After treatment,the levels of FEV1/FVC and FVC in the two groups were higher and the CAT scores were lower than those before treatment,the differences being statisticall

关 键 词：补肺益肾定喘方 慢性阻塞性肺疾病 缓解期 肺肾亏虚型 炎性因子 气道重构 肺功能 

分 类 号：R259[医药卫生—中西医结合]