加味桔梗汤加减治疗稳定期支气管扩张患者的效果及对支气管肺泡灌洗液炎症细胞和炎症因子的影响  

Therapeutic effects of modified Jiawei Jiegeng Decoction on patients with stable bronchiectasis and its impacts on inflammatory cells and factors in bronchoalveolar lavage fluid

作　　者：钱宇杰 蒋胜利 李波 季永华 QIAN Yu-jie;JIANG Sheng-li;LI Bo;JI Yong-hua(Department of Respiratory and Critical Care Medicine,Zhangjiagang Fifth People′s Hospital,Zhangjiagang 215621,China)

机构地区：[1]江苏省张家港市第五人民医院呼吸与危重症医学科,张家港市215621

出　　处：《广西医学》2022年第4期385-388,393,共5页Guangxi Medical Journal

基　　金：江苏省张家港市卫健委青年科技计划项目(ZJGQNKJ201917)。

摘　　要：目的探讨加味桔梗汤加减治疗稳定期支气管扩张患者的效果,以及其对支气管肺泡灌洗液(BALF)炎症细胞和炎症因子的影响。方法纳入60例稳定期支气管扩张患者,按照随机数字表法将其分为试验组与对照组各30例。两组患者均接受常规治疗,试验组患者同时接受加味桔梗汤加减治疗,两组均治疗1个月。比较两组治疗前后临床症状和体征积分,BALF中白细胞计数、淋巴细胞比例、中性粒细胞比例和白细胞介素6(IL-6)水平,以及肺功能指标(用力肺活量、1 s用力呼气容积、1 s用力呼气容积占用力肺活量比值)。评价两组的临床疗效及治疗期间不良反应的发生情况。结果治疗后,两组临床症状和体征积分和BALF中的白细胞计数、淋巴细胞比例、中性粒细胞比例、IL-6水平均较治疗前下降,肺功能指标均较治疗前改善,且试验组以上指标均优于对照组(均P<0.05)。试验组临床疗效总有效率高于对照组(P<0.05)。治疗期间,两组均无显著不良反应发生。结论在常规治疗的基础上使用加味桔梗汤加减可更有效地降低稳定期支气管扩张患者BALF中的炎症细胞计数和炎症因子水平,抑制肺部炎症反应,从而更好地改善患者的临床症状和体征,提高肺功能及临床疗效,且安全性高。Objective To explore the therapeutic effects of modified Jiawei Jiegeng Decoction on patients with stable bronchiectasis as well as its impacts on the inflammatory cells and factors in bronchoalveolar lavage fluid(BALF).Methods Sixty patients with stable bronchiectasis enrolled were divided into experimental group(n=30)and control group(n=30)according to the random number table method.Patients in both groups received conventional therapy,and patients in the experimental group were treated with modified Jiawei Jiegeng Decoction additionally.Both groups were treated for one month.Multiple indices before and after the treatment were compared between the two groups,including the scores for clinical symptoms and signs,white blood cell(WBC)count,lymphocyte proportion,neutrophil proportion,and interleukin 6(IL-6)level in BALF,as well as the indicators of pulmonary function(forced vital capacity,forced expiratory volume in one second,the ratio of forced expiratory volume in one second to forced vital capacity).The clinical efficacy and the incidence of treatment-emergent adverse reactions were assessed in the two groups.Results After the treatment,the scores for clinical symptoms and signs as well as WBC count,lymphocyte proportion,neutrophil proportion,and IL-6 level in BALF were decreased,and the indicators of pulmonary function were improved as compared with those before the treatment;moreover,the experimental group was superior to the control group in the aforementioned indices(all P<0.05).The experimental group had a higher total effective rate for clinical efficacy than the control group(P<0.05).During the treatment,no significant adverse reaction occurred in the two groups.Conclusion The utilization of modified Jiawei Jiegeng Decoction based on conventional therapy can reduce inflammatory cells counts and factors levels in BALF of patients with stable bronchiectasis more effectively,inhibit pulmonary inflammatory reactions,thus preferably ameliorating patients′clinical symptoms and signs,improving pulmonary func

关 键 词：支气管扩张 稳定期 加味桔梗汤加减 支气管肺泡灌洗液 炎症细胞 炎症因子 肺功能 

分 类 号：R562.22[医药卫生—呼吸系统]