健脾益胃化痰法对慢性阻塞性肺疾病急性加重期痰湿阻肺证患者肺功能及诱导痰嗜酸性粒细胞、可溶性晚期糖基化终末产物受体水平的影响  

Effect of Jianpi Yiwei Huatan therapy on pulmonary function of acute exacerbation of chronic obstructive pulmonary disease of phlegm-damp obstructing lung type and how to impact on induced sputum eosinophil and soluble receptor of advanced glycation end product

作　　者：巴提曼·克烈斯[1] 阿依古丽·艾尔肯 贾慧英[3] 古丽巴哈尔·热孜克 Batiman Keliesi;Ayiguli Aierken;JIA Huiying;Gulibahaer Rezike(Department of Respiratory and Critically Ill Cardiopulmonary Function,Xinjiang People's Hospital,Xinjiang,Urumqi 830000;Cadre Health Care Center,Xinjiang People's Hospital,Urumqi,Xinjiang 830000;Department of Respiratory Function Examination,XinjiangPeople's Hospital,Urumqi,Xinjiang 830000)

机构地区：[1]新疆维吾尔自治区人民医院呼吸与危重症中心肺功能室,新疆乌鲁木齐830000 [2]新疆维吾尔自治区人民医院干部保健中心,新疆乌鲁木齐830000 [3]新疆维吾尔自治区人民医院呼吸功能检查室,新疆乌鲁木齐830000

出　　处：《河北中医》2022年第7期1094-1097,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：新疆维吾尔自治区创新环境(人才、基地)建设专项(编号:PT1903)。

摘　　要：目的观察健脾益胃化痰法对慢性阻塞性肺疾病急性加重期(AECOPD)痰湿阻肺证患者肺功能及诱导痰嗜酸性粒细胞(EOS)、可溶性晚期糖基化终末产物受体(sRAGE)水平的影响。方法将84例AECOPD患者采取信封法随机分为2组,对照组42例予以西医常规治疗,治疗组42例在对照组基础上加用健脾益胃化痰中药治疗。2组均治疗1周后统计疗效,比较2组治疗前后中医症状(包括咳嗽、咯痰、喘息及胸闷)积分、肺功能指标[包括第1 s用力呼气容积占预计值的百分比(FEV%pred)、FEV/用力肺活量(FVC)(FEV/FVC)比值、每分钟最大通气量(MVV)]及诱导痰EOS百分数、sRAGE水平变化情况,比较2组不良反应总发生率情况。结果与本组治疗前比较,2组治疗后中医症状咳嗽、咯痰、喘息及胸闷评分均升高(P<0.05),且治疗组治疗后咳嗽、咯痰、喘息及胸闷评分均高于对照组(P<0.05)。与本组治疗前比较,2组治疗后肺功能指标FEV%pred、FEV/FVC及MVV水平均升高(P<0.05),且治疗组治疗后FEV%pred、FEV/FVC及MVV水平均高于对照组(P<0.05)。与本组治疗前比较,2组治疗后诱导痰中EOS百分数水平均降低(P<0.05),sRAGE水平均升高(P<0.05),且治疗组治疗后诱导痰中EOS百分数水平低于对照组(P<0.05),sRAGE水平高于对照组(P<0.05)。治疗组不良反应总发生率7.14%(3/42),对照组不良反应总发生率2.38%(1/42),2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论健脾益胃化痰法治疗AECOPD痰湿阻肺证疗效确切,可有效改善患者中医症状,改善肺功能,降低诱导痰中EOS水平,增加sRAGE水平,从而减轻炎性反应,促进病情康复,且安全可靠。Objective To observe the effect of Jianpi Yiwei Huatan therapy on pulmonary function,induced sputum eosinophil(EOS)counts and soluble receptor of advanced glycation end product(sRAGE)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)of phlegm-damp obstructing lung type.Methods Totally 84 AECOPD patients were randomly assigned into the treatment group(n=42)and the control group(n=42)by sealed envelopes method.All patients were managed by routine Western medicine,and those in the treatment group were additionally treated with traditional Chinese medicine(TCM)therapy of Jianpi Yiwei Huatan.Treated for 1 week,aiming to compare TCM symptom(cough,expectoration,wheezing and chest tightness)score,pulmonary function indexes(forced expiratory volume in one second in predictive value[FEV%pred],FEVto forced vital capacity[FVC]ratio[FEV/FVC],maximum ventilatory volume[MVV]),as well as induced sputum EOS,sRAGE.The curative effect and the total incidence of adverse events were assessed.Results After treatment,TCM symptom scores in groups were increased(P<0.05),which were increased in the treatment group compared with the control group(P<0.05);pulmonary function indexes in groups were increased(P<0.05),improvement of which in the treatment group were significantly better(P<0.05);EOS counts in groups was decreased(P<0.05),while sRAGE level in groups was increased(P<0.05);lower sputum EOS,and higher sRAGE were detected in the treatment group than those in the control group(all P<0.05).The total incidence of adverse events in the treatment group and the control group was 7.14%(3/42)and 2.38%(1/42),respectively,the difference of two groups being not significant(P>0.05).Conclusion For AECOPD patients(phlegm-damp obstructing lung type),Jianpi Yiwei Huatan therapy has definitely curative effect,which can effectively improve TCM symptoms and lung function,EOS,sRAGE,thereby reducing inflammatory response and promoting recovery,with safety and reliability.

关 键 词：肺疾病 慢性阻塞性 急性加重期 中药疗法 痰湿阻肺 

分 类 号：R256.12[医药卫生—中医内科学] R563.9[医药卫生—中医学]