止喘灵注射液联合噻托溴铵吸入粉雾剂对慢性阻塞性肺疾病急性加重期(痰浊阻肺证)患者T细胞17/调节性T细胞平衡的调节作用  

Regulating Effects of Zhichuanling Injection Combined with Tiotropium Bromide Powder for Inhalation on T cell 17 and Regulatory T cells Balance in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease(Phlegm Obstructing Lung Syndrome)

作　　者：热依汗古丽·阿肯 阿仙古丽·吐拉洪 REIHANGULI Aken;ASHANGULI Tulahun(Dept.of Respiratory and Critical Care Medicine,the Eighth Affiliated Hospital of Xinjiang Medical University,Urumqi 830001,China;Dept.of Emergency,the Eighth Affiliated Hospital of Xinjiang Medical University,Urumqi 830001,China)

机构地区：[1]新疆医科大学第八附属医院呼吸与危重症医学科,乌鲁木齐830001 [2]新疆医科大学第八附属医院急诊科,乌鲁木齐830001

出　　处：《中国医院用药评价与分析》2022年第4期407-410,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金项目(No.81660885)。

摘　　要：目的:探讨止喘灵注射液联合噻托溴铵吸入粉雾剂对慢性阻塞性肺疾病急性加重期(痰浊阻肺证)患者T细胞17(Th17)/调节性T细胞(Treg细胞)平衡的调节作用。方法:选取2018年6月至2020年6月该院收治的慢性阻塞性肺疾病急性加重期(痰浊阻肺证)患者100例,采用随机信封法分为对照组和观察组,每组50例。两组患者均给予常规治疗,在此基础上对照组患者雾化吸入噻托溴铵吸入粉雾剂,1次18μg,1日1次。观察组患者在对照组的基础上肌内注射止喘灵注射液2 mL,1日2次。两组患者的治疗时间为14 d。对两组患者的临床疗效、中医症状积分、肺功能、Th17/Treg细胞相关因子变化、圣乔治量表评分和不良反应发生情况进行比较。结果:观察组患者的总有效率为96.00%(48/50),与对照组(84.00%,42/50)比较显著升高,差异有统计学意义(P<0.05)。治疗后,观察组患者8项中医症状积分与对照组比较显著降低,第1秒用力呼气容积占预计值百分比与对照组比较显著升高,第1秒用力呼气容积占用力肺活量百分比与对照组比较显著降低,血清IL-10水平、Th17/Treg细胞比值与对照组比较显著升高,血清IL-17水平与对照组比较显著降低,差异均有统计学意义(P<0.05)。治疗后,观察组患者圣乔治量表各维度(症状、活动和影响)评分与对照组比较显著降低,差异均有统计学意义(P<0.05)。对照组、观察组患者的不良反应发生率分别为6.00%(3/50)、4.00%(2/50),差异无统计学意义(χ^(2)=0.21,P=0.65)。结论:止喘灵注射液联合噻托溴铵吸入粉雾剂治疗慢性阻塞性肺疾病急性加重期(痰浊阻肺证)患者的效果显著,能明显改善其临床症状及肺功能,纠正Th17/Treg细胞的免疫失衡,提高生活质量。OBJECTIVE:To probe into the regulating effects of Zhichuanling injection combined with tiotropium bromide powder for inhalation on T cell 17(Th17)and regulatory T cell(Treg)balance in patients with acute exacerbation chronic obstructive pulmonary disease(AECOPD)(phlegm obstructing lung syndrome).METHODS:A total of 100 patients with AECOPD(phlegm obstructing lung syndrome)admitted into this hospital from Jun.2018 to Jun.2020 were divided into the control group and the observation group via the random envelope method,with 50 cases in each group.Both groups were given conventional treatment,on that basis,the control group was given tiotropium bromide powder for inhalation,18μg/times for once a day.The observation group was given intramuscular injection of 2 mL Zhichuanling injection for twice a day on the basis of the control group.Both groups were treated for 14 d.The clinical efficacy,TCM symptom integral,pulmonary function,changes of Th17/Treg related factors,St.George’s respiratory questionnaire and incidence of adverse drug reactions were compared between two groups.RESULTS:The total effective rate of treatment group was 96.00%(48/50),significantly higher than 84.00%(42/50)of control group,with statistically significant difference(P<0.05).After treatment,totally 8 items of TCM symptom integral in the observation group were significantly low than those of the control group,the percentage of forced expiratory volume in 1 s accounted for the expected value was significantly higher in the observation group than the control group,the percentage of forced expiratory volume in 1 s accounted for the forced vital capacity was significantly lower in the observation group than the control group,the serum IL-10 level and Th17/Treg ratio were significantly higher in the observation group than the control group,and the serum IL-17 level was significantly lower in the observation group than the control group,with statistically significant differences(P<0.05).After treatment,the scores of all dimensions(symptoms,activities,

关 键 词：止喘灵注射液 噻托溴铵吸入粉雾剂 慢性阻塞性肺疾病 T细胞17/调节性T细胞 

分 类 号：R932[医药卫生—生药学] R974[医药卫生—药学]