千金麦门冬汤加减对肺阴虚证老年咳嗽变异性哮喘患者气道功能、炎症状态的影响  

Effect of Qianjin Maimendong decoction on airway function and inflammation in old patients with cough variant asthma with lung Yin deficiency syndrome

作　　者：章玲[1] 张专名 武煦峰 ZHANG Ling;ZHANG Zhuanming;WU Xufeng(Yangzhou Friendship Hospital,Yangzhou 225261,Jiangsu,China;Yangzhou Hospital of Traditional Chinese Medicine,Yangzhou 225002,Jiangsu,China;The People’s Hospital of Wuxi,Nanjing Medical University,Wuxi 214023,Jiangsu,China)

机构地区：[1]扬州友好医院,江苏扬州225261 [2]江苏省扬州市中医院,江苏扬州225002 [3]南京医科大学附属无锡人民医院,江苏无锡214023

出　　处：《现代中西医结合杂志》2020年第2期143-147,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：江苏省中医药局科技项目(LZ13189)

摘　　要：目的观察千金麦门冬汤加减对肺阴虚证老年咳嗽变异性哮喘患者气道功能、炎症状态的影响。方法选取2016年1月—2018年8月在扬州友好医院就诊的肺阴虚证老年咳嗽变异性哮喘患者90例,按照随机数字表法分为对照组和观察组各45例。对照组给予布地奈德福莫特罗粉吸入剂治疗,观察组则在对照组治疗基础上给予千金麦门冬汤加减内服,2组均治疗12周。观察2组治疗前后咽干、咳嗽积分及气道功能、细胞间黏附相关因子-1(ICAM-1)、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶抑制剂-1(TIMP-1)水平变化,比较2组治疗效果,记录患者咽干、咳嗽消失时间及治疗过程中的不良反应。结果观察组的有效率为91.1%(41/45),明显高于对照组的有效率75.6%(34/45)(P<0.05);治疗后2组患者咽干、咳嗽积分明显低于治疗前(P均<0.05),且观察组低于对照组(P均<0.05);2组治疗后FEV 1、FVC、FEV 1/FVC、FEF50均较治疗前明显改善(P均<0.05),且观察组改善程度明显优于对照组(P均<0.05);2组治疗后血清ICAM-1、MMP-2、TIMP-1水平均低于治疗前(P均<0.05),且观察组明显低于对照组(P均<0.05);观察组患者咽干、咳嗽消失时间均短于对照组(P均<0.05),不良反应发生率明显低于对照组(P<0.05)。结论千金麦门冬汤加减利于促进肺阴虚证老年咳嗽变异性哮喘患者临床症状的消退,改善气道功能,且安全,其机制可能与调控血清中ICAM-1、MMP-2、TIMP-1水平以减轻气道炎症反应有关。Objective It is to observe the clinical effect of Qianjin Maimendong decoction on airway function and inflammation in old patients with cough variant asthma(CVA)with lung Yin deficiency syndrome.Methods Ninety cases of elderly patients with CVA with lung Yin deficiency syndrome treated in Yangzhou Friendship Hospital from January 2016 to August 2018 were selected and divided into control group and observation group according to the random number table method,45 cases in each group.The control group was treated with budesonide formoterol powder inhalation.The observation group was treated with Qianjin Maimendong decoction on the basis of the control group.The changes of the scores of dry pharynx and cough and airway function,the levels of intercellular adhesion Molecule 1(ICAM-1),matrix metalloproteinase-2(MMP-2),tissue inhibitor of metalloproteinase(TIMP-1)before and after treatment were observed,the treatment effects were compared,and the disappearance time of dry pharynx and cough,the adverse reactions during treatment were recorded in the two groups.Results The effective rate of the observation group was(91.11%(41/45),which was significantly higher than that 75.56%(34/45)of the control group(P<0.05).After treatment,the TCM syndrome score of dry pharynx and cough in the two groups was lower than that before treatment in the two groups(P<0.05),and the scores in the observation group were lower than that in the control group(P<0.05);FEV 1,FVC,FEV 1/FVC and FEF50 were significantly improved in the two groups(P<0.05),and the improvements in the observation were more significant than those in the control group(P<0.05);the levels of serum ICAM-1,MMP-2 and TIMP-1 were lower than those before treatment in the two groups(P<0.05),and the above indexes in the observation group were lower than those in the control group(P<0.05);the disappearance time of dry pharynx and cough in the observation group was shorter and the incidence of adverse reactions was significantly lower than that in the control group(P<0.05).Conclusion

关 键 词：咳嗽变异性哮喘 肺阴虚证 千金麦门冬汤 气道功能 炎症状态 

分 类 号：R562.25[医药卫生—呼吸系统]