小柴胡汤加味治疗慢性阻塞性肺疾病急性加重期疗效及对患者细胞免疫状态的影响  

Efficacy of modified Xiaochaihu decoction in the treatment of chronic obstructive pulmonary disease and its influence on cellular immune status

作　　者：向杰 杨峰 李强 高乐 XIANG Jie;YANG Feng;LI Qiang;GAO Le(Xi’an Traditional Chinese Medicine Hospital,Xi’an 710021,China)

机构地区：[1]西安市中医医院,陕西西安710021

出　　处：《陕西中医》2023年第5期591-594,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：陕西省自然科学基础研究计划项目(2014JM2-8202)。

摘　　要：目的:探究小柴胡汤加味对于慢性阻塞性肺疾病急性加重期(AECOPD)(少阳合并血瘀证)患者的治疗效果和对患者免疫细胞状态的影响。方法:选取120例AECOPD患者作为观察对象并分为两组(观察组和对照组),分组方法采用区组随机化法,每组60例。对照组采用常规西医方法进行治疗,观察组在其基础上采用小柴胡汤加味治疗,两组患者均治疗10 d。比较治疗后两组患者治疗有效率,对比治疗前和治疗1个月后两组患者中医症候积分、肺功能[用力第一秒呼气量(FEV1)、用力肺活量(FVC)、呼气峰值流速(PEF)]、免疫功能(CD4^(+)、CD8^(+)、NK细胞比例、CD4^(+)/CD8^(+)比值)、生活质量[生活质量测定表(WHOQOL-BREF)]的变化。结果:在治疗1个月后,观察组治疗效果明显优于对照组(P<0.05),两组治疗总有效率比较差异无统计学意义(P>0.05);两组患者在治疗1个月后中医症候积分、WHOQOL-BREF、FEV1、FVC、PEF水平均明显升高(均P<0.05),且观察组显著高于对照组(均P<0.05);治疗后两组患者CD4^(+)、NK比例、CD4^(+)/CD8^(+)比值均明显升高,且观察组显著高于对照组(均P<0.05),CD8^(+)比例明显降低,观察组CD8^(+)比例显著低于对照组(均P<0.05)。结论:小柴胡汤加味能显著改善AECOPD患者的肺功能和免疫功能,提高患者生活质量,有利于其预后。Objective:To explore the therapeutic effect of modified Xiaochaihu decoction on acute exacerbation of chronic obstructive pulmonary disease(AECOPD)(Shaoyang with blood stasis syndrome)in patients and its influence on cellular immune status.Methods:120 patients with AECOPD were divided into observation group(60 cases)and control group(60 cases)by block randomization grouping method.Both groups patients were treated for 10 days.The control group underwent conventional western medicine therapy while the observation group was treated with modified Xiaochaihu decoction on this basis.The effective rate of treatment after treatment,as well as scores of TCM symptoms,pulmonary function indicators[forced expiratory volume in 1 s(FEV1),forced vital capacity(FVC),peak expiratory flow(PEF)],immune function(CD4^(+),CD8^(+),NK cell proportion,CD4^(+)/CD8^(+)ratio)and quality of life[World Health Organization Quality of Life Brief Version(WHOQOL-BREF)]before treatment and after 1 month of treatment were compared between the two groups of patients.Results:After 1 month of treatment,the treatment effect was obviously better in observation group compared to control group(P<0.05),but there was no obvious difference in the effective rate of treatment between the two groups(P>0.05).The scores of TCM symptoms and WHOQOL-BREF,FEV1,FVC and PEF of the two groups of patients were significantly enhanced after 1 month of treatment(all P<0.05),and the above indicators of observation group were significantly higher compared with those of control group(all P<0.05).After treatment,the CD4^(+),NK proportion and CD4^(+)/CD8^(+)ratio of the two groups were significantly increased,and the indicators of observation group were significantly higher(all P<0.05),and the proportion of CD8^(+)was significantly reduced,and the indicator in observation group was significantly lower than that in control group(all P<0.05).Conclusion:Modified xiaochaihu decoction can significantly improve the pulmonary function and immune function and enhance the the quality of

关 键 词：慢性阻塞性肺疾病急性加重期 小柴胡汤加味 肺功能 NK细胞 CD4^(+)/CD8^(+)比值 生活质量 

分 类 号：R563.9[医药卫生—呼吸系统]