皱肺平喘胶囊对慢性阻塞性肺疾病稳定期肺肾气虚证患者外周血Th17/Treg平衡及相关炎症因子的影响  

Effects of Zhoufei Pingchuan Capsules on Th17/Treg Balance and Related Inflammatory Factors in Peripheral Blood of Patients with Stable Chronic Obstructive Pulmonary Disease with Lung-kidney Qi Deficiency Syndrome

作　　者：史捷 宁博 赵明君 谭曦舒 寇育乐 王旭红 王瑞哲 贺宏伟 SHI Jie;NING Bo;ZHAO Mingjun;TAN Xishu;KOU Yule;WANG Xuhong;WANG Ruizhe;HE Hongwei(Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China;Shaanxi University of Chinese Medicine,Xianyang 712000,China)

机构地区：[1]陕西中医药大学附属医院,陕西咸阳712000 [2]陕西中医药大学,陕西咸阳712000

出　　处：《中国中医药信息杂志》2024年第2期160-166,共7页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：陕西省省级院士工作站建设项目(201930);陕西省名中医传承工作室建设项目(2019007);陕西省重点研发计划项目(2017SF-277);咸阳市重点研发计划项目(2020k02-99)。

摘　　要：目的探讨皱肺平喘胶囊对慢性阻塞性肺疾病(COPD)稳定期肺肾气虚证患者外周血辅助性T淋巴细胞17/调节性T淋巴细胞(Th17/Treg)平衡及相关炎症因子的影响。方法采用随机数字表法将40例COPD患者分为研究组与对照组各20例,另设健康组20例。对照组予噻托溴铵粉吸入剂,18μg/次,1次/d,吸入;研究组在对照组基础上予皱肺平喘胶囊,3粒/次,3次/d,口服。2组均连续治疗8周。健康组未进行干预。比较治疗前后第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、最大呼气中段流量(MMEF)、一氧化碳弥散量/肺泡通气量(DLCO/VA)、动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、COPD患者自我评估测试(CAT)评分、外周血Th17/Treg比例、白细胞介素(IL)-17、IL-22、IL-10、转化生长因子-β1(TGF-β1)。结果与本组治疗前比较,研究组治疗后肺功能指标(FEV1、FEV1/FVC、MMEF、DLCO/VA)、动脉血气指标(PaO_(2)、PaCO_(2))和CAT评分明显改善(P<0.05)。2组治疗后比较,研究组MMEF、DLCO/VA、PaCO_(2)、CAT评分均优于对照组(P<0.05)。与本组治疗前比较,研究组治疗后Th17、IL-17、IL-22明显降低,Treg、IL-10、TGF-β1明显升高(P<0.05)。治疗后比较,3组Th17、Treg、IL-17、IL-22、IL-10、TGF-β1差异有统计学意义(P<0.01),进一步两两对比,Th17由高到低为对照组>研究组>健康组;Treg由高到低为健康组>研究组>对照组;IL-17、IL-22由高到低为对照组>研究组>健康组,IL-10、TGF-β1由高到低为健康组>研究组>对照组,差异均有统计学意义(P<0.05)。结论皱肺平喘胶囊可改善COPD稳定期肺肾气虚证患者的肺功能、动脉血气和CAT评分,其作用机制可能是调节Th17/Treg平衡,下调Th17、IL-17、IL-22水平,上调Treg、IL-10、TGF-β1水平,以降低气道炎性反应、调节免疫稳态。Objective To investigate the effects of Zhoufei Pingchuan Capsules on the balance of peripheral blood helper T lymphocyte 17 cell/regulatory T lymphocyte cell(Th17/Treg)and related inflammatory factors in peripheral blood of patients with stable chronic obstructive pulmonary disease(COPD)with lung-kidney qi deficiency syndrome.Methods Totally 40 COPD patients were randomly divided into the study group and the control group,with 20 cases in each group.Another 20 cases were in the healthy group.The control group was given tiotropium bromide powder inhalation,18μg/time,1 time/d,inhalation;on the basis of the control group,the study group was given Zhoufei Pingchuan Capsules,3 pills/time,3 times/d,orally.All patients were treated for 8 weeks.The healthy group was not given any intervention.Forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FEV1/FVC),maximum mid-expiratory flow(MMEF),carbon monoxide diffusing capacity/alveolar ventilation(DLCO/VA),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),COPD assessment test(CAT)score,Th17/Treg ratio,cytokines interleukin(IL)-17,IL-22,IL-10,and transforming growth factor-β1(TGF-β1)were compared before and after treatment.Results Compared with before treatment,the lung function indexes(FEV1,FEV1/FVC,MMEF,DLCO/VA),blood gas indexes(PaO_(2),PaCO_(2))and CAT score in the study group after treatment were significantly improved(P<0.05).After treatment,the mean values of MMEF,DLCO/VA,PaCO_(2) and CAT score in the study group were better than those in the control group(P<0.05).Compared with before treatment,the levels of Th17,IL-17 and IL-22 in the study group were significantly lower,and the levels of Treg,IL-10 and TGFβ1 were significantly higher(P<0.05).After treatment,there were significant differences in Th17,Treg,IL-17,IL-22,IL-10 and TGFβ1 among the three groups(P<0.01).Further pairwise comparison showed that Th17 ranked in the order of high and low was control group>study group>healthy group,Treg in th

关 键 词：慢性阻塞性肺疾病 皱肺平喘胶囊 Th17/Treg平衡 炎症因子 肺肾气虚 

分 类 号：R259.63[医药卫生—中西医结合]