理肺汤治疗慢性阻塞性肺疾病的临床疗效及对患者肠道菌群和炎症因子的影响  

Effect of Lifei decoction in the treatment of chronic obstructive pulmonary disease and its influence on intestinal flora and inflammatory factors

作　　者：严明月 杨震 刘汶睿 张威 李宗广 朱筱慧 程改存 YAN Mingyue;YANG Zhen;LIU Wenrui;ZHANG Wei;LI Zongguang;ZHU Xiaohui;CHENG Gaicun(Department of Respiratory and Critical Care Medicine,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,China)

机构地区：[1]南京医科大学第四附属医院呼吸与危重症医学科,南京210031

出　　处：《吉林中医药》2023年第5期551-555,共5页Jilin Journal of Chinese Medicine

基　　金：江苏省高校重点实验室开放课题(XZSYSKF2021047)。

摘　　要：目的探讨理肺汤治疗慢性阻塞性肺疾病(COPD)的疗效及对患者肠道菌群和炎症因子的影响。方法采用随机数表法将于2021年1月-11月在南京医科大学第四附属医院接受治疗的60例COPD患者分为A组与B组,各30例。A组给予常规西医治疗,B组在A组的基础上给予理肺汤治疗。2组均持续治疗7 d。比较2组治疗7 d后的临床疗效,治疗前、治疗7 d后的中医症状积分、综合症状(CAT)评分、呼吸困难问卷(mMRC)评分、6 min步行距离(6 MWT)、肺功能、血气分析指标、肠道菌群及血清学指标。结果治疗7 d后,B组总有效率(93.33%,28/30)高于A组(70.00%,21/30)(P<0.05)。治疗7 d后,2组各项症状评分、中医症状积分、综合症状(CAT)评分、呼吸困难问卷(mMRC)评分、动脉血二氧化碳分压(PaCO_(2))、血清白细胞介素-6(IL-6)、白细胞介素-18(IL-18)、降钙素原(PCT)、可溶性髓系细胞触发受体-1(sTREM-1)及黏蛋白5AC(MUC5AC)水平均比治疗前低,B组低于A组(P<0.05);6 min步行距离(6 MWT)均比治疗前长,B组长于A组(P<0.05);第1秒用力呼气量(FEV1)、最大呼气流速(PEF)、第1秒用力呼气容积占预计值百分比(FEV1%pred),动脉血氧分压(PaO_(2))均比治疗前高,B组高于A组(P<0.05);肠道双歧杆菌、嗜酸乳杆菌、粪肠球菌数量均比治疗前多,B组多于A组(P<0.05);大肠埃希菌数量均比治疗前少,B组少于A组(P<0.05)。结论理肺汤有助于促进COPD患者临床症状的缓解,促进患者呼吸困难症状改善,抑制患者气道黏液高分泌情况,促进肠道微生态平衡,进一步改善患者肺功能、血气分析指标,减轻患者炎症反应,提高患者运动耐力,提高临床疗效。Objective To investigate the therapeutic effect of Lifei decoction in the treatment ofchronic obstructive pulmonary disease(COPD)and its influence on intestinal flora and inflammatory factors.Methods A total of 60 patients with COPD admitted to the Fourth Affiliated Hospital of Nanjing Medical University from January 2021 to November 2021 were divided into group A and group B by the random number table method,with 30 cases in each group.Group A was treated with conventional western medicine,while group B was treated with Lifei decoction on the basis of group A.Both groups were treated continuously for 7 days.The clinical efficacy of the two groups after 7 days of treatment,the scores of traditional Chinese medicine symptoms,comprehensive symptom(CAT),dyspnea questionnaire(mMRC),6-minute walking distance(6 MWT),pulmonary function,blood gas analysis index,intestinal flora and serological index before and after 7 days of treatment were compared between the two groups.Results After 7 days of treatment,the total effective rate in group B(93.33%,28/30)was higher than that in group A(70.00%,21/30)(P<0.05).After 7 days of treatment,the scores of symptoms,traditional Chinese medicine symptoms,comprehensive symptom(CAT),dyspnea questionnaire(mMRC),arterial blood partial pressure of carbon dioxide(PaCO_(2)),the levels of serum interleukin-6(IL-6),interleukin-18(IL-18),procalcitonin(PCT),soluble myeloid cell trigger receptor-1(sTREM-1)and mucin 5AC(MUC5AC)in both groups were lower than before treatment,and group B was lower than group A(P<0.05).The 6-minute walking distances(6 MWT)in both groups were longer than before treatment,and group B was longer than group A(P<0.05).The first second forced expiratory volume(FEV1),maximum expiratory flow rate(PEF),first second forced expiratory volume as a percentage ofpredicted value(FEV1%pred),and arterial partial oxygen pressure(PaO_(2))were all higher than before treatment,and group B was higher than group A.The number of intestinal bifidobacteria,lactobacillus acidophilus and enter

关 键 词：慢性阻塞性肺疾病 理肺汤 肺功能 炎症反应 

分 类 号：R256.14[医药卫生—中医内科学]