足三里穴位注射黄芪注射液联合肺康复训练对老年慢性阻塞性肺疾病病人抗菌肽LL-37和免疫功能的影响  

Effect of Huangqi injection at Zusanli acupoint combined with pulmonary rehabilitation on antimicrobial peptide LL-37 and immune function in elderly patients with chronic obstructive pulmonary disease

作　　者：邓在勤 周海波[1] DENG Zaiqin;ZHOU Haibo(Department of Emergency Internal Medicine,Wuhan Hankou Hospital,Wuhan 430012,China)

机构地区：[1]武汉市汉口医院急诊内科

出　　处：《实用老年医学》2024年第1期44-48,共5页Practical Geriatrics

摘　　要：目的 研究足三里穴位注射黄芪注射液联合肺康复训练对老年COPD稳定期病人的疗效、血清抗菌肽LL-37水平、炎症因子及外周血T淋巴细胞亚群的影响。方法 选择98例老年COPD稳定期病人,根据治疗方法分为黄芪组(50例)和对照组(48例)。对照组予以肺康复训练及常规西药治疗,黄芪组在对照组基础上予以足三里穴位注射黄芪注射液,疗程均为12周。比较2组治疗前后肺功能、6分钟步行试验(6MWT)结果、改良版英国医学研究委员会呼吸问卷(mMRC)呼吸困难程度分级,血清抗菌肽LL-37、TNF-α、IL-6、CRP水平及T淋巴细胞亚群变化。结果 2组治疗后肺功能(FVC、FEV1、FEV1%pred、FEV1/FVC)、6MWT结果及mMRC分级均较治疗前明显改善(P<0.05),且黄芪组较对照组改善更为明显(P<0.05)。2组治疗后血清抗菌肽LL-37、CD3^(+)T淋巴细胞、CD4^(+)T淋巴细胞及CD4^(+)/CD8^(+)水平均较治疗前升高,且黄芪组高于对照组(P<0.05);2组治疗后TNF-α、IL-6、CRP水平均低于治疗前,且黄芪组低于对照组(P<0.05)。结论 足三里穴位注射黄芪注射液联合肺康复训练可改善老年COPD稳定期病人的肺功能和运动耐力,提高血清抗菌肽LL-37水平并改善免疫功能。Objective To investigate the efficacy of Huangqi injection at Zusanli acupoint combined with pulmonary rehabilitation in the elderly patients with stable chronic obstructive pulmonary disease(COPD),and to analyze the effects on serum antimicrobial peptide LL-37,inflammatory factors and T lymphocyte subsets.Methods A total of 98 elderly patients with stable COPD were divided into the Huangqi group and the control group.The control group(n=48)was given lung rehabilitation training and conventional western medicine,and the Huangqi group(n=50)received Huangqi injection at zusanli acupoint on the basis of the control group.Both groups were treated for 12 weeks.The lung function,the results of 6-minute walking test(6MWT)and dyspnea scale(mMRC),the levels of LL-37,tumor necrosis factor-α(TNF-α),interleukin 6(IL-6)and C-reaction protein(CRP),T lymphocyte subsets count were detected and compared between the two groups before and after treatment.Results After treatment,the levels of forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),the percentage of FEV1 in the predicted value(FEV1%pred),FEV1/FVC and the results of 6MWT and mMRC were significantly improved in both groups.The levels of LL-37,CD3^(+)T lymphocyte count,CD4^(+)T lymphocyte count and CD4^(+)/CD8^(+)were increased,and the levels of TNF-α,IL-6 and CRP were decreased in both groups,especially in the Huangqi group(P<0.05).Conclusions Huangqi injection at Zusanli acupoint combined with pulmonary rehabilitation training can improve the lung function and exercise endurance,increase antimicrobial peptide LL-37 level and improve the immune function in the elderly patients with stable COPD.

关 键 词：慢性阻塞性肺疾病 肺康复 抗菌肽LL-37 T淋巴细胞亚群 黄芪注射液 穴位注射 

分 类 号：R563.9[医药卫生—呼吸系统]