搜剔肺络法对难治性哮喘患者诱导痰IL-1β水平的影响  

Effect of dredging pulmonary collaterals treatment on the level of IL-1βin induced sputum in patients with refractory asthma

作　　者：董燕萍[1] 张亚达 唐斌擎[2] Yanping Dong;Yada Zhang;Binqing Tang(Geriatric Department,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Department of Pulmonary Disease,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院老年科,上海200437 [2]上海中医药大学附属市中医医院肺病科,上海200071

出　　处：《中华航海医学与高气压医学杂志》2022年第3期375-379,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的:探讨搜剔肺络法(苏子降气汤加蜈蚣全蝎)对难治性哮喘患者诱导痰白细胞介素1β(IL-1β)水平的影响。方法:将上海中医药大学2所附属医院收治的60例难治性哮喘患者采用随机信封法分为治疗组和对照组每组30例。2组均给予西药三联吸入治疗,治疗组在此基础上给予苏子降气汤加蜈蚣全蝎中药汤剂治疗,对照组给予苏子降气汤治疗,疗程12周。比较2组患者哮喘控制测试(ACT)评分、肺功能、诱导痰IL-1β水平以及血常规、肝肾功能等安全性指标。结果:治疗后2组ACT评分、第1秒用力呼气量(FEV 1.0)、第1秒用力呼气量与用力肺活量比值(FEV 1.0/FVC)较治疗前升高,IL-1β较治疗前下降,治疗组改善程度明显优于对照组,差异均有统计学意义(P<0.05或P<0.01)。治疗前后,2组患者外周血嗜酸性粒细胞水平均未见明显变化,2组患者治疗后各项安全性指标均在正常范围内。结论:搜剔肺络法可有效改善难治性哮喘患者哮喘控制水平和肺功能,降低诱导痰IL-1β水平,其作用机制可能与抑制细胞焦亡有关。Objective To discuss the efficacy of dredging pulmonary collaterals treatment(Suzi Jiangqi decoction plus Scolopendra and Scorpio)on the level of IL-1βin induced sputum in patients with refractory asthma.Methods A total of 60 patients with refractory asthma,admitted to the two affiliated hospitals of Shanghai University of Tradition Chinese Medicine,were randomly assigned to control group and treatment group.Both groups were given aerosol inhalation of salmeterol,fluticasone,and tiotropium bromide.Additionally,the control group was given Suzi Jiangqi decoction,while the treatment group was given Suzi Jiangqi decoction plus Scolopendra and Scorpio.Both groups were treated for 12 weeks.Asthma control test(ACT)scores,IL-1βlevels in induced sputum,and safety indicators such as complete blood count,and lung,liver,and renal functions were compared between the two groups.Results After treatment,the ACT score,the forced expiratory volume in the first second(FEV1.0),and the ratio of FEV1.0 to the forced vital capacity(FEV1.0/FVC)all increased,while the IL-1βlevels decreased in both two groups.And the treatment group had significantly better improvements in the above-mentioned items than the control group,all with statistically significant differences(P<0.05 or P<0.01).Before and after treatment,there was no obvious change in the level of eosinophil in peripheral blood in either group.After treatment,all the safety indicators were within normal ranges in both groups.Conclusion Suzi Jiangqi decoction plus Scolopendra and Scorpio can effectively control the severity of asthma and improve the lung function in patients with refractory asthma by reducing the level of IL-1βin induced sputum,the mechanism of action may be related to the inhibition of cell pyroptosis.

关 键 词：搜剔肺络法 难治性哮喘 白细胞介素1Β 

分 类 号：R256.12[医药卫生—中医内科学]