运气理论下温阳润肺膏方治疗慢性阻塞性肺疾病寒燥证的疗效及机制研究  

Study on the therapeutic effect and mechanism of Wenyang Runfei Ointment in the treatment of chronic obstructive pulmonary disease with cold and dryness syndrome under the theory of luck

作　　者：李英[1] 谢玉秀 李玲[1] 赵洪霄[1] Li Ying;Xie Yuxiu;Li Ling;Zhao Hongxiao(Department of Traditional Chinese Medicine,People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Province,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院中医科,乌鲁木齐830001

出　　处：《疑难病杂志》2023年第9期940-944,950,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(WJWY-202126)。

摘　　要：目的探讨温阳润肺膏方对慢性阻塞性肺疾病(COPD)西北寒燥证的治疗效果及对细胞外基质和黏附分子水平的影响。方法收集2021年1—12月新疆维吾尔自治区人民医院收治的COPD寒燥证患者100例为观察对象,采用计算机随机数字分组法分为对照组及观察组,各50例。对照组给予舒利迭(沙美特罗/丙酸氧替卡松)吸入剂治疗,观察组给予温阳润肺膏方口服,疗程均为8周。疗程结束后,评估2组临床疗效及中医证候评分变化,比较2组治疗前后肺功能指标[用力肺活量(FVC)、第1秒用力肺活量(FEV_(1))、第1秒用力肺活量占预计值百分比(FEV_(1)%)]、呼吸困难指数(mMRC)及COPD患者自我评估测试(CAT)评分,检测患者血清中透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(cⅣ)及细胞间黏附分子-1(ICAM-1)、血管细胞黏附分子1(VCAM-1)、E-选择素(E-selectin)水平的变化。结果治疗8周后观察组临床总有效率显著高于对照组(88.0%vs.72.0%,χ^(2)=8.016,P=0.018),观察组患者中医主症、次症总积分,mMRC评分、CAT评分及血清中HA、LN、cⅣ、ICAM-1、VCAM-1、E-selectin水平显著低于对照组(t/P=9.948/<0.001、6.969/<0.001、3.309/0.001、5.913/<0.001、10.017/<0.001、3.232/0.002、6.111/<0.001、5.909/<0.001、5.281/<0.001、2.156/0.034),FVC、FEV_(1)、FEV_(1)%指标明显高于对照组(t/P=4.213/<0.001、5.991/<0.001、4.572/<0.001)。结论温阳润肺膏方对COPD西北寒燥证患者临床疗效肯定,效果优于舒利迭吸入剂治疗,其作用机制可能与降低细胞外基质和黏附分子水平相关。Objective To explore the therapeutic effect of Wenyang Runfei Ointment on Northwest Cold and Dryness Syndrome of Chronic Obstructive Pulmonary Disease(COPD)and its impact on extracellular matrix and adhesion molecule levels.Methods Collect 100 COPD patients with cold and dryness syndrome admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January to December 2021 as observation subjects,and use computer random number grouping method to divide them into a control group and an observation group,with 50 cases in each group.The control group was treated with inhalation of suletide(salmeterol/oxyticasone propionate),while the observation group was treated with oral administration of Wenyang Runfei ointment for 8 weeks.After the course of treatment,evaluate the clinical efficacy and changes in traditional Chinese medicine syndrome scores of two groups.Compare the lung function indicators[forced vital capacity(FVC),forced vital capacity at first second(FEV_(1)),percentage of forced vital capacity at first second to expected value(FEV_(1)%)],respiratory distress index(mMRC),and COPD patient self-evaluation test(CAT)scores of the two groups before and after treatment.Measure the serum hyaluronic acid(HA),laminin(LN)Changes in levels of type IV collagen(cIV),intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),and E-selectin.Results After 8 weeks of treatment,the total clinical effective rate of the observation group was significantly higher than that of the control group(88.0%vs.72.0%,χ^(2)=8.016,P=0.018),the total score of main and secondary symptoms,mMRC score,CAT score,and serum levels of HA,LN,cIV,ICAM-1,VCAM-1,and E-selectin in the observation group were significantly lower than those in the control group(t/P=9.948/<0.001,6.969/<0.001,3.309/0.001,5.913/<0.001,10.017/<0.001,3.232/0.002,6.111/<0.001,5.909/<0.001,5.281/<0.001,2.156/0.034),FVC,FEV_(1) The FEV_(1)%index was significantly higher than the control group(t/P=4.213/<0.001,5.991/<0.001,4.572/<0.001).Conclus

关 键 词：慢性阻塞性肺疾病 西北寒燥证 五运六气 细胞外基质 细胞黏附分子 

分 类 号：R563.9[医药卫生—呼吸系统]