基于培土生金法探讨六君子汤对慢性阻塞性肺疾病患者血清p-P38MAPK的影响  

Effect of Liujunzi Decoction Following the Method of Banking up Earth for Generating Metal on Serum Phosphorylated P38 Mitogen-Activated Protein Kinase in Patients with Chronic Obstructive Pulmonary Disease

作　　者：王珂 王玉喜 赖静 王昌明 WANG Ke;WANG Yu-Xi;LAI Jing;WANG Chang-Ming(Dept.of Intensive Care Medicine,Hangzhou Lin’an District Hospital of Traditional Chinese Medicine,Hangzhou 311300 Zhejiang,China;Dept.of Respiratory Medicine,Hangzhou Lin’an District Hospital of Traditional Chinese Medicine,Hangzhou 311300 Zhejiang,China)

机构地区：[1]杭州市临安区中医院重症医学科,浙江杭州311300 [2]杭州市临安区中医院呼吸科,浙江杭州311300

出　　处：《广州中医药大学学报》2024年第7期1687-1693,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:82160002);杭州市临安区农业与社会发展项目(编号:2020D011)。

摘　　要：【目的】分析六君子汤对慢性阻塞性肺疾病(COPD)患者血清磷酸化-P38丝裂原活化蛋白激酶(p-P38MAPK)水平的影响。【方法】选取杭州市临安区中医院2020年9月至2022年9月收治的112例COPD肺脾气虚型患者为研究对象,根据治疗方法的不同将其分为观察组和对照组,每组各56例。对照组给予常规西医治疗,观察组在对照组的基础上给予六君子汤治疗,每疗程为7 d,共治疗3个月。观察2组患者治疗前后肺功能指标、6 min步行距离(6MWD)、慢阻肺临床问卷(CCQ)评分、血清炎症因子和p-P38MAPK水平的变化情况,比较2组患者的临床疗效、不良反应发生率和1年内急性发作次数。【结果】(1)治疗3个月后,观察组的总有效率为94.64%(53/56),对照组为73.21%(41/56),组间比较(χ^(2)检验),观察组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、FEV_(1)/FVC、6MWD均较治疗前升高(P<0.05),CCQ评分均较治疗前降低(P<0.05),且观察组对FVC、FEV_(1)、FEV_(1)/FVC、6MWD的升高幅度及对CCQ评分的降低幅度均明显优于对照组(P<0.01)。(3)治疗后,2组患者血清白细胞介素4(IL-4)、白细胞介素6(IL-6)、白细胞介素8(IL-8)及p-P38MAPK水平均较治疗前降低(P<0.05),且观察组的降低幅度均明显优于对照组(P<0.01)。(4)观察组的不良反应发生率为3.57%(2/56),对照组为7.14%(4/56),组间比较,差异无统计学意义(P>0.05)。(5)观察组1年内急性发作次数为(0.68±0.12)次,明显低于对照组的(1.46±0.37)次,差异有统计学意义(P<0.01)。【结论】六君子汤治疗COPD肺脾气虚型患者疗效确切,可有效抑制p-P38MAPK信号通路活化,缓解咳痰、呼吸困难等症状,改善肺功能,减轻炎症反应,降低急性发作次数,且具有较高的安全性。Objective To analyze the effect of Liujunzi Decoction on serum phosphorylated P38 mitogen-activated protein kinase (p-P38MAPK) in patients with chronic obstructive pulmonary disease (COPD).Methods A total of112 patients with COPD of lung-spleen qi deficiency type who were treated in Hangzhou Lin’an District Hospital of Traditional Chinese Medicine from September 2020 to September 2022 were selected as the research objects.According to the treatment method,the patients were divided into an observation group and a control group,with56 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Liujunzi Decoction on the basis of treatment for the control group.Seven days constituted a course of treatment,and the two groups were treated for 3 months.The changes of lung function indicators,6-minute walking distance (6MWD),clinical chronic obstructive pulmonary disease questionnaire (CCQ) score,and serum levels of inflammatory factors and p-P38MAPK in the two groups were observed before and after treatment.Moreover,the clinical efficacy,incidence of adverse reactions and number of acute episodes within one year were compared between the two groups.Results (1) After 3 months of treatment,the total effective rate of the observation group was 94.64%(53/56),and that of the control group was 73.21%(41/56).The intergroup comparison (tested by chi-square test) showed that the curative effect of the observation group was significantly superior to that of the control group (P<0.01).(2) After treatment,the forced vital capacity (FVC),forced expiratory volume in one second (FEV_1),FEV_1/FVC and 6MWD in the two groups were increased (P<0.05),and the CCQ scores were decreased (P<0.05) when compared with those before treatment,and the increase of FVC,FEV_1,FEV_1/FVC and 6 MWD and the decrease of CCQ scores in the observation group were significantly superior to those in the control group (P<0.01).(3) After treatment,the levels of serum interleukin 4 (IL-4),interle

关 键 词：六君子汤 慢性阻塞性肺疾病 肺功能 炎症反应 磷酸化-P38丝裂原活化蛋白激酶(p-P38MAPK) 

分 类 号：R259.414[医药卫生—中西医结合]