喘可治注射液治疗哮喘-慢性阻塞性肺疾病重叠的临床研究  

Chuankezhi Injection in Treating Asthma-Chronic Obstructive Pulmonary Disease Overlap

作　　者：连乐燊[1] 叶小汉 钱旭胜 朱碧媛[1] 蒋紫云[1] 朱晓珏 LIAN Leshen;YE Xiaohan;QIAN Xusheng;ZHU Biyuan;JIANG Ziyun;ZHU Xiaojue(Dongguan TCM Hospital Affiliated to Guangzhou University of TCM,Dongguan 523000,China)

机构地区：[1]广州中医药大学附属东莞市中医院,东莞523000

出　　处：《世界中医药》2020年第16期2426-2429,2433,共5页World Chinese Medicine

基　　金：2018年广东省名中医传承工作室建设项目(粤中医办函〔2018〕5号);2019年东莞市社会科技发展一般项目(201950715002619)。

摘　　要：目的:观察喘可治注射液治疗哮喘-慢性阻塞性肺疾病重叠的临床疗效并探讨对NF-κB调控下炎性反应因子的表达水平及细胞免疫功能的影响。方法:选取2018年10月至2019年7月广州中医药大学附属东莞市中医院收治的ACO急性加重期肾虚不纳型患者60例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组30例。对照组予常规西医治疗,观察组在对照组基础上加用喘可治注射液。观察2组的总有效率,治疗前后中医证侯积分、外周血WBC、EOS、血气分析指标、NF-κB、IL-6、TNF-α、sICAM-1、细胞免疫功能指标的变化。结果:观察组总有效率显著高于对照组(P<0.05),2组治疗后中医证侯积分,外周血WBC、EOS、PaO2及PaCO2较前显著改善(P<0.05),且观察组的改善更为明显(P<0.05);治疗后2组NF-κB、IL-6、TNF-α、sICAM-1均较前显著降低(P<0.05),且观察组显著低于对照组(P<0.05);治疗后观察组能显著改善外周血T淋巴细胞亚群指标(P<0.05),而对照组治疗前后外周血T淋巴细胞亚群指标比较差异无统计学意义(P>0.05)。结论:喘可治注射液符合ACO肾虚不纳型的病机,通过抑制NF-κB信号水平,调控TNF-α、IL-6以及sICAM-1的表达,减轻ACO患者炎性反应并改善患者细胞免疫功能。Objective:To observe the clinical efficacy of Chuankezhi Injection in treating Asthma-Chronic Obstructive Pulmonary Disease Overlap(ACO)and to explore its influence on the expression level of inflammatory factors and cellular immune function under the regulation of NF-κB.Methods:A total of 60 patients with acute exacerbation of ACO(deficiency of kidney qi failing to control respiring qi type)who were admitted to the Dongguan TCM Hospital Affiliated to Guangzhou University of TCM from October 2018 to July 2019 were selected.According to the random number table method,they were randomly divided into a control group and an observation group,with 30 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Chuankezhi Injection on the basis of the control group.The total effective rate of the two groups,the changes of TCM syndrome scores,peripheral blood WBC,EOS,blood gas analysis indexes,NF-κB,IL-6,TNF-α,sICAM-1,and cellular immune function indexes before and after treatment were observed.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the scores of TCM syndromes,peripheral blood WBC,EOS,PaO2 and PaCO2 in the two groups were significantly improved(P<0.05),and the observation group improved more(P<0.05).NF-κB,IL-6,TNF-αand sICAM-1 in the two groups were significantly lower than before(P<0.05),and the observation group was significantly lower than the control group(P<0.05);After treatment,the peripheral blood T lymphocyte subgroup index were significantly improved in the observation group(P<0.05),which had no difference in the control group(P>0.05).Conclusion:Chuankezhi injection conforms to the pathogenesis of ACO(deficiency of kidney qi failing to control respiring qi type).By inhibiting the level of NF-κB signal,regulating the expression of TNF-α,IL-6 and sICAM-1,it reduces inflammation in ACO patients and improves the cellular immune function of patie

关 键 词：哮喘-慢性阻塞性肺疾病重叠 肾虚不纳型 喘可治注射液 核转录因子NF-ΚB 白细胞介素-6 肿瘤坏死因子-α 可溶性细胞间黏附分子-1 T淋巴细胞亚群 

分 类 号：R242[医药卫生—中医临床基础] R285.6[医药卫生—中医学]