涤痰汤加减口服对阻塞性睡眠呼吸暂停低通气综合征患者临床症状改善及血清TNF-α、IL-6和ICAM-1水平的影响  

Effect of Ditan Decoction in patients with OSAHS on clinical symptoms and serum TNF-α IL-6 and ICAM-1levels

作　　者：张玲[1] 王俊峰 ZHANG Ling;WANG jun feng(Luzhou Hospitad of Troudionad Chinese Medicine,Luzhou Sichuan 646000,Chi-na;Southurest Medieal University,Iuzhou Sichuan 646000,China)

机构地区：[1]泸州市中医医院,四川泸州646000 [2]西南医科大学,四川泸州646000

出　　处：《四川中医》2023年第6期106-110,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：国家中医药管理局资助课题(课题号2019XZZX-LG007)。

摘　　要：目的:通过观察涤痰汤加减口服对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床症状改善及血清TNF-α、IL-6和ICAM-1水平的影响并探讨其临床意义。方法:选择2018年1月至2021年12月泸州市中医医院呼吸科收治并经多导睡眠监测(PSG)确诊的90例老年OSAHS患者,随机分为CPAP组、西药组、中药组三组,每组30例。CPAP组予以持续气道正压通气治疗;西药组在CPAP组的基础上加用普罗替林口服+黄体酮肌注治疗;中药组在西药组的基础上予以涤痰汤加减口服;在治疗前及治疗6个月后采用酶联免疫吸附测定法检测并比较血清TNF-α、IL-6及ICAM-1水平及临床症状改善情况,进行对比分析。结果:三组患者治疗前临床相关症状评分、血清TNF-α、IL-6及ICAM-1水平相比,差异无统计学意义(P>0.05)。治疗结束后三组患者临床相关症状评分,血清TNF-α、IL-6及ICAM-1与治疗前比较均下降(P<0.05);并且中药组较西药组、CPAP组改善明显(P<0.05)。结论:涤痰汤加减改善OSAHS患者相关临床症状,其机制可能通过抑制OSAHS患者血清TNF-α、IL-6及ICAM-1的表达及减轻血管内皮损伤有关。Objective:To observe the effect of Ditan decoction improvement of clinical symptoms and serum TNF-α、IL-6and ICAM-lin patients with OSAHS.Methods:9Oelderly patients with OSAHS diagnosed by PSG in the respiratory department of Luzhou TCM hospital were randomly divided into CPAP group,westerm medicine group and TCM group,with 3Ocases in each group.CPAP group was treated with NCPAP;The western medicine group was treated with protiline orally and progesterone intra-muscularly on the basis of CPAP group;The traditional Chinese medicine group was treated with Ditan Decoction on the basis of Western medicine group;Serum TNF-α、IL-6and ICAM-1was detected by enzyme-linked immunosorbent assay before treat-ment and after treatment,The improvement of clinical symptoms before treatment and after 6months of treatment were compared and analyzed.Results:There was no significant diference in the clinically relevant symptom scores,the levels of serum TNF-α、IL-6、ICAM-lin three groups before treatment(P>0.05).After treatment,the clinically relevant symptom scores,the levels of serum TNF-α、IL-6and ICAM-1decreased in all three groups(P<0.05).Compared with western medicine group and CPAP group,the traditional Chinese medicine group improved significantly(P<O.05).Conclusion:Ditan Decoction can improve the clinical symptoms of patients with OSAHS,and its mechanism may be related to inhibiting the expression of serum TNF-α,IL-6and ICAM-lin patients with OSAHS and reducing vascular endothelial injury.

关 键 词：睡眠呼吸暂停低通气综合征 老年 涤痰汤加减 IL-6 TNF-Α ICAM-1 

分 类 号：R563.9[医药卫生—呼吸系统]