参七蛤蚧散对老年COPD稳定期患者疗效及对炎症介质、VCAM-1和CD40L表达影响  

Effect of Shenqi Gejisan on inflammatory mediators,VCAM-1 and CD40L expression in elderly patients with stable COPD

作　　者：陈华群[1] 王灵俊 朱慧民[1] 许航宇[2] 章欣[3] CHEN Huaqun;WANG Lingjun;ZHU Huimin(Department of Geriatrics,Taizhou Central Hospital,Taizhou 318000,China)

机构地区：[1]台州市中心医院老年医学科,浙江台州318000 [2]台州市中心医院耳鼻喉科,浙江台州318000 [3]台州市中心医院药剂科,浙江台州318000

出　　处：《全科医学临床与教育》2019年第12期1072-1075,共4页Clinical Education of General Practice

摘　　要：目的探讨参七蛤蚧散对老年慢性阻塞性肺疾病(COPD)稳定期患者疗效及对患者炎症介质、血管细胞黏附分子-1(VCAM-1)和CD40L表达影响。方法选择98例老年COPD稳定期患者,采用随机数字表法随机分为观察组49例与对照组49例。对照组患者给予布地奈德福莫特罗粉吸入剂治疗,观察组在对照组基础上结合参七蛤蚧散治疗。两组疗程均为12周。比较两组治疗疗效及不良反应,治疗前后肺功能、炎症介质、血清VCAM-1和CD40L水平变化。结果观察组治疗总有效率高于对照组(χ2=8.61,P<0.05)。观察组和对照组治疗后最大肺活量(FVC)、呼气峰流连(PEF)和一秒钟用力呼气量占预计值百分比(FEV1%)较治疗前升高,血清白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)和IL-8水平较治疗前降低(t分别=17.79、16.05、18.86、-22.54、-23.25、-15.67;9.38、10.66、10.61、-9.53、-10.08、-9.01,P均<0.05);观察组治疗后FVC、PEF和FEV1%高于对照组治疗后,而血清IL-6、TNF-α和IL-8水平低于对照组治疗后(t分别=10.27、9.40、9.13、-11.55、-10.49、-8.79,P均<0.05)。观察组治疗后血清VCAM-1和CD40L表达均较治疗前和对照组治疗后降低(t分别=14.29、8.54;11.63、9.73,P均<0.05)。两组均未发生明显不良反应。结论参七蛤蚧散对老年COPD稳定期患者疗效良好,可改善患者肺功能,减轻炎症反应,降低VCAM-1和CD40L表达。Objective To investigate the effect of Shenqi Gejisan on inflammatory mediators,vascular cell adhesion molecule-1(VCAM-1)and CD40L expression in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods The 98 elderly patients with stable COPD were randomly divided into observation group(49 cases)and control group(49 cases)by random number table method.The patients in the control group were treated with budesonide formoterol powder inhalation,while the patients in the observation group were treated with Shenqi Gejisan on the basis of the control group.Both groups were treated for 12 weeks.The therapeutic effects,changes of pulmonary function,inflammatory mediators,serum VCAM-1 and CD40L levels,and adverse reactions were compared between the two groups before and after treatment.Results The total effective rate of the observation group was higher than that of the control group(χ2=8.61,P<0.05).After treatment,FVC,PEF and FEV1%in the observation group and the control group were higher than those before treatment,and the serum levels of IL-6,TNF-αand IL-8 were lower than those before treatment(t=17.79,16.05,18.86,-22.54,-23.25,-15.67;9.38,10.66,10.61,-9.53,-10.08,-9.01,P<0.05).After treatment,FVC,PEF and FEV1%in the observation group were higher than those in the control group,while the serum levels of IL-6,TNF-αand IL-8 were lower than those in the control group(t=10.27,9.40,9.13,-11.55,-10.49,-8.79,P<0.05).the expression of VCAM-1 and CD40L in the observation group after treatment was lower than that before treatment and the control group(t=14.29,8.54;11.63,9.73,P<0.05).No significant adverse reactions occurred in both groups.Conclusion Shenqi Gejisan has a good therapeutic effect on elderly patients with COPD in stable stage.It can improve lung function,alleviate inflammation and reduce the expression of VCAM-1 and CD40L,which is worthy of clinical reference.

关 键 词：参七蛤蚧散 老年慢性阻塞性肺疾病稳定期 肺功能 炎症介质 血管细胞黏附分子-1 

分 类 号：R56[医药卫生—呼吸系统]