四君子汤加味联合热敏灸对慢性阻塞性肺疾病稳定期肺脾气虚型患者血清及呼出冷凝液中IL-17,IL-22,IL-1α,Cys-C的影响  

Effect and Mechanism of Modified Si Junzitang Combined with Heat-sensitive Moxibustion on IL-17,IL-22,IL-1αand Cys-C in Serum and Exhale Breath Condensate of Patients with Chronic Obstructive Pulmonary Disease at Stable Stage

作　　者：朱素有 廖为民[1,2] 许忠波 黄明儒 ZHU Su-you;LIAO Wei-min;XU Zhong-bo;HUANG Ming-ru(The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine(TCM),Nanchang 330006,China;Jiangxi University of TCM,Nanchang 330004,China)

机构地区：[1]江西中医药大学附属医院,南昌330006 [2]江西中医药大学,南昌330004

出　　处：《中国实验方剂学杂志》2020年第10期57-62,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家中医药管理局重点学科(中医全科医学);江西省研究生创新专项(YC-2018-S270)。

摘　　要：目的:观察四君子汤加味联合热敏灸对慢性阻塞性肺疾病(COPD)稳定期(肺脾气虚型)患者血清及呼出冷凝液(EBC)中白细胞介素-17(IL-17),白细胞介素-22(IL-22),白细胞介素-1α(IL-1α),血清胱抑素-C(Cys-C)的影响。方法:选取2019年1月到2019年6月江西省中医院肺病科及热敏灸科符合纳入标准和排除标准的住院COPD稳定期肺脾气虚型患者共120例,采用随机分配的方法用随机数字表分为中药组、热敏灸组、对照组,3组均按照指南予以吸氧、支气管舒张剂等基本治疗,中药组予四君子汤加味治疗,热敏灸组在中药组的基础上予以热敏灸疗法,对照组予以安慰剂治疗。3组均连续治疗3个疗程,20 d/疗程。3个疗程后,比较3组患者临床疗效,第1秒用力呼气容积(FEV1),第1秒用力呼气容积占预计值百分比(FEV1%),用力肺活量(FVC),血清及EBC中IL-17,IL-22,IL-1α,Cys-C的水平。结果:治疗前三组患者的一般临床资料,肺功能水平(FEV1,FEV1%,FVC),血清及EBC中IL-17,IL-22,IL-1α,Cys-C的水平比较无统计学差异。经3个疗程治疗后,临床有效率中药组优于对照组(P<0.05),热敏灸组优于中药组(P<0.05),且显著优于对照组(P<0.01)。与本组治疗前比较,3组患者的FEV1,FEV1%,FVC水平均明显升高(P<0.05),证候评分水平,血清及EBC中IL-17,IL-22,IL-1α,Cys-C水平均明显降低(P<0.05);其中中药组优于对照组,热敏灸组优于中药组(P<0.05),且显著优于对照组(P<0.01)。结论:四君子汤加味联合热敏灸通过激发人体经气,提升人体免疫力,抑制炎症细胞因子,降低COPD患者血清及呼出冷凝液(EBC)中IL-17,IL-22,IL-1α,Cys-C水平,减缓炎症反应的发生,增加肺容量,改善COPD患者的通气功能,提升COPD患者的肺功能,从而有效的缓解COPD患者胸闷气喘等症状,进而提高临床疗效。Objective:To observe the effect and mechanism of modified Si Junzitang combined with heatsensitive moxibustion on interleukin-17(IL-17),interleukin-22(IL-22),interleukin-1α(IL-1α)and serum cystatin C(Cys-C)in serum and exhale breath condensate(EBC)of patients with chronic obstructive pulmonary disease at stable stage(COPD,Qi deficiency of lung and spleen).Method:Totally 120 cases of COPD(Qi deficiency of lung and spleen)treated in pulmonary department and thermal moxibustion department of Affiliated Hospital of Jiangxi University of traditional Chinese medicine from January 2019 to June 2019 were included and randomly divided into traditional Chinese medicine group,heat-sensitive moxibustion group and control group.The patients in traditional Chinese medicine group were treated with Si Junzitang,the patients in heat-sensitive Moxibustion group were treated with heat-sensitive moxibustion in addition to traditional Chinese medicine group,and the patients in control group were treated with placebo.All of the 3 groups were treated with oxygen and bronchodilator according to the guidelines.All groups received 3 consecutive courses of treatment,20 days per course.After 3 courses of treatment,the clinical efficacy of the three groups,the forced expiratory volume in one second(FEV1),the forced expiratory volume in the estimated value in one second(FEV1%),the forced vital capacity(FVC),and IL-17,IL-22,IL-1αin serum and exhale breath condensate(EBC)were measured.Result:There were no statistically significant difference in general clinical data,lung function levels(FEV1,FEV1%,FVC),serum and EBC levels of IL-17,IL-22,IL-1αand Cys-C in the first three groups.The total clinical effective rate of traditional Chinese medicine group was better than the control group(P<0.05),the heatsensitive moxibustion group was better than the traditional Chinese medicine group(P<0.05)and significantly better than the control group(P<0.01).Compared with the patients before treatment,the level of lung function was improved,while IL-17,IL-22

关 键 词：慢性阻塞性肺疾病 稳定期 四君子汤 热敏灸 呼出冷凝液 炎症细胞因子 血清胱抑素C 临床观察 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]