超重或肥胖对哮喘患者气道炎症、哮喘控制水平及中医体质的影响  

Effects of overweight or obesity on airway inflammation,asthma control and TCM constitution in asthma patients

作　　者：韩静[1,2] 赵锐恒 王建新 韩泽璐[1,2] 尹则陶[1,2] 林江涛 HAN Jing;ZHAO Ruiheng;WANG Jianxin;HAN Zelu;YIN Zetao;LIN Jiangtao(Beijing University of Chinese Medicine,Beijing 100029,China;China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]中日友好医院,北京100029

出　　处：《现代中西医结合杂志》2022年第8期1023-1026,1033,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金资助项目(82170027)。

摘　　要：目的探究支气管哮喘患者超重或肥胖对诱导痰细胞学检查指标、呼出气一氧化氮(FeNO)、哮喘控制评分(ACT)及中医体质类型的影响。方法收集2020年10月—2021年6月就诊于中日友好医院呼吸部的208例支气管哮喘患者资料,根据体质指数(BMI)将患者分为正常体重组、超重组和肥胖组,比较3组诱导痰细胞学检查指标(中性粒细胞计数、嗜酸性粒细胞计数)、FeNO水平、ACT评分,分析不同气道炎症表型与BMI、血脂水平的关系及BMI与中医体质类型的关系。结果随着BMI增加,诱导痰中中性粒细胞计数增高,嗜酸性粒细胞计数降低,但3组间比较差异均无统计学意义(P均>0.05);3组间ACT评分比较差异均无统计学意义(P均>0.05);肥胖组FeNO水平明显高于正常体重组和超重组(P均<0.05)。不同气道炎症表型患者的BMI比较差异无统计学意义(P>0.05);混合细胞型患者的三酰甘油水平明显高于嗜酸粒细胞型(P<0.05),胆固醇水平明显高于寡细胞型(P<0.05)。208例患者中134例为偏颇体质,体质类型出现频次由高到低依次为特禀质、阳虚质、气虚质、痰湿质、气郁质、阴虚质、血瘀质、湿热质,兼痰湿质和(或)兼湿热质患者的BMI均明显高于兼阳虚质患者(P均<0.05)。结论肥胖的支气管哮喘患者气道炎症指标更差,可能是肥胖能够释放更多的炎性因子影响哮喘病情;支气管哮喘易感体质为特禀质、阳虚质、气虚质、痰湿质,兼痰湿质和(或)湿热质者应更加关注体重,预防支气管哮喘急性发作。Objective It is to explore the effects of overweight or obesity on induced sputum cytology indexes,fractional exhaled nitric oxide(FeNO),asthma control test(ACT)scores and traditional Chinese medicine(TCM)constitution types in patients with bronchial asthma.Methods The data of 208 patients with bronchial asthma who were treated in the Respiratory Department of China-Japan Friendship Hospital from October 2020 to June 2021 were collected,and the patients were divided into normal weight,overweight and obese groups according to body mass index(BMI).The sputum cytology indexes(neutrophil count,eosinophil count),FeNO level,ACT score of the 3 groups were compared,the relationship between different airway inflammation phenotypes and BMI,blood lipid levels and the relationship between BMI and TCM constitution types were analyzed.Results With the increase of BMI,the neutrophil count in the induced sputum increased and the eosinophil count decreased,but there was no significant difference among the 3 groups(P>0.05);there was no statistical difference in the ACT score among the 3 groups.The level of FeNO in the obese group was significantly higher than that in the normal weight group and the overweight group(all P<0.05).There was no significant difference in BMI among patients with different airway inflammation phenotypes(P>0.05);the level of triacylglycerol in the patients of mixed cell type was significantly higher than that of eosinophilic type(P<0.05),and the level of cholesterol was significantly higher than that of oligo-cell type(P<0.05).Among the 208 patients,134 had a biased constitution.The frequency of the constitution types from high to low was inherited special constitution,yang-deficiency constitution,qi-deficiency constitution,phlegm-dampness constitution,qi-stagnation constitution,yin-deficiency constitution,blood stasis constitution,and dampness-heat constitution.The BMI of patients with phlegm-dampness and damp-heat constitution was significantly higher than that of patients with yang deficiency constituti

关 键 词：支气管哮喘 体质指数 诱导痰细胞学检查 呼出气一氧化氮 哮喘控制评分 中医体质 

分 类 号：R562.25[医药卫生—呼吸系统]