活血化瘀方对血清中γ-干扰素诱导蛋白-10、单核细胞趋化蛋白-1、转化生长因子-β1水平的影响及结核性胸膜炎疗效的研究  

Effect of Huoxue Huayu recipe on serum levels of γ-interferon-inducible protein-10,monocyte chemoattractant protein-1 and transforming growth factor-β1 and the curative effect of tuberculous pleurisy

作　　者：李振云 崔俊伟 刘卫国 郗玉玲 王永亮 高景利 LI Zhenyun;CUI Junwei;LIU Weiguo;XI Yuling;WANG Yongliang;GAO Jingli(Department of Tuberculosis,The First Affiliated Hospital of Xinxiang Medical College(Henan Tuberculosis Hospital),Xinxiang,Henan 453100,China;Department of Clinical Pharmacy,The First Affiliated Hospital of Xinxiang Medical College(Henan Tuberculosis Hospital),Xinxiang,Henan 453100,China)

机构地区：[1]新乡医学院第一附属医院(河南省结核病医院)结核内一科,河南新乡453100 [2]新乡医学院第一附属医院(河南省结核病医院)临床药学办公室,河南新乡453100

出　　处：《安徽医药》2022年第7期1449-1453,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河南省医学科技攻关计划项目(2018020344)。

摘　　要：目的 观察活血化瘀方治疗结核性胸膜炎对病人胸膜厚度及血清中γ-干扰素诱导蛋白-10(IP-10)、单核细胞趋化蛋白-1(MCP-1)、转化生长因子-β1(TGF-β1)水平的影响。方法 收集新乡医学院第一附属医院2017年4月至2019年12月收治的结核性胸膜炎病人104例,采用随机数字表法分为常规组及中医组,每组52例。常规组给予胸腔穿刺抽液术+抗结核药物治疗,中医组在常规组基础上加用活血化瘀方(血府逐瘀汤加减)治疗。治疗8周后,比较两组治疗前后血清中细胞因子水平及胸膜厚度的变化,两组胸膜腔穿刺抽液次数、治疗总有效率和治疗期间不良反应情况。结果 治疗8周后,中医组总有效率(92.31%)高于常规组(76.92%);中医组胸膜腔穿刺次数少于对照组(P<0.05);治疗期间中医组不良反应率(69.2%)与常规组(71.2%)比较,差异无统计学意义(P>0.05)。治疗8周后,两组血清中IP-10、MCP-1、TGF-β1、肿瘤坏死因子-α(TNF-α)、白细胞介素-5(IL-5)、白细胞介素-10(IL-10)水平较治疗前下降,胸膜厚度较治疗前上升,中医组血清中IP-10、MCP-1、TGF-β1、TNF-α、IL-5、IL-10水平及胸膜厚度[(286.35±46.14)ng/L、(23.71±4.74)μg/L、(159.85±61.85)μg/L、(374.39±46.05)ng/L、(168.63±32.05)ng/L、(84.32±29.54)ng/L、(2.76±0.36)mm]低于常规组[(359.62±57.48)ng/L、(29.87±6.45)μg/L、(204.95±76.44)μg/L、(425.85±57.52)ng/L、(209.68±41.41)ng/L、(117.43±45.21)ng/L、(3.15±0.42)mm](均P<0.05)。结论 活血化瘀方治疗结核性胸膜炎可调节相关细胞因子的表达水平,减轻胸膜增厚程度,且不增加不良反应。Objective To observe the effect of Huoxue Huayu recipe on pleural thickness and serum levels of γ-interferon-induced protein-10(IP-10),monocyte chemoattractant protein-1(MCP-1) and transforming growth factor-β1(TGF-β1) in patients with tuberculous pleurisy.Methods A total of 104 patients with tuberculosis pleurisy who were admitted to the First Affiliated Hospital of Xinxiang Medical College from April 2017 to December 2019 were enrolled and divided into a routine group and a traditional Chinese medicine group by the random number table method,with 52 cases in each group.The routine group was treated with thoracentesis plus anti-tuberculosis drugs,and the traditional Chinese medicine group was treated with Huoxue Huayu recipe(Xuefu Zhuyu decoction) on the basis of the routine group.After 8 weeks of treatment,the changes in cytokine levels and pleural thickness,the number of pleural punctures,the total effective rate of treatment and the adverse reactions during treatment were compared between the two groups before and after treatment.Results After 8weeks of treatment,the total effective rate in the traditional Chinese medicine group(92.31%) was higher than that in the routine group(76.92%);the number of pleural punctures in the traditional Chinese medicine group was less than that in the control group(P < 0.05).During the treatment period,there was no significant difference in the adverse reaction rate between the traditional Chinese medicine group(69.2%) and the routine group(71.2%)(P > 0.05).After 8 weeks of treatment,the serum levels of IP-10,MCP-1,TGF-β1,tumor necrosis factor-α(TNF-α),interleukin-5(IL-5),and IL-10 decreased compared with before treatment,and pleural thickness increased.Serum levels of IP-10,MCP-1,TGF-β1,TNF-α,IL-5,IL-10 and pleural thickness in the traditional Chinese medicine group [(286.35±46.14)ng/L,(23.71±4.74)μg/L,(159.85±61.85)μg/L,(374.39±46.05)ng/L,(168.63±32.05)ng/L,(84.32±29.54)ng/L,(2.76±0.36) mm] were lower than those in the routine group [(359.62±57.48)ng/L,(29.

关 键 词：结核 胸膜 活血化瘀方 γ-干扰素诱导蛋白-10 单核细胞趋化蛋白-1(MCP-1) 转化生长因子-Β1 肿瘤坏死因子α 血府逐瘀汤 

分 类 号：R259[医药卫生—中西医结合]