中药雾化联合针刺对痰热郁肺型AECOPD患者炎症反应和痰液菌群的影响  

Effects of traditional Chinese medicine atomization combined with acupuncture on inflammatory reaction and sputum flora in patients with phlegm-heat stagnation lung-type AECOPD

作　　者：王凯 沈芬 成一星 WANG Kai;SHEN Fen;CHENG Yixing(Department of Pulmonary and Critical Care Medicine,Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University,Huzhou,Zhejiang 313000,China;不详)

机构地区：[1]浙江中医药大学附属湖州中医院呼吸与危重症医学科,浙江湖州313000

出　　处：《中国微生态学杂志》2024年第9期1048-1053,1065,共7页Chinese Journal of Microecology

基　　金：湖州市科技局(2019GY40)。

摘　　要：目的本研究旨在探讨中药雾化与针刺治疗联合应用,对于改善痰热郁肺型慢性阻塞性肺疾病急性加重期(AECOPD)患者的炎症状态及其痰液菌群结构变化上的效果与机制。方法选择2022年3月至2023年9月就诊于本院的100例痰热郁肺型AECOPD患者,按随机对照原则分为对照组(50例,开展常规西药治疗)和研究组(50例,开展常规西药+针刺+中药雾化治疗),共治疗4周。比较两组的临床效果、炎症反应、肺功能、痰液菌群和不良反应等。结果研究组总有效率较对照组高(P<0.05)。治疗后,与对照组相比:研究组血清C反应蛋白(CRP)(t=19.926,P<0.001)、白细胞介素-6(IL-6)(t=31.111,P<0.001)水平降低(P<0.05),1秒用力呼气容积(FEV1)(t=4.633,P<0.001)、每分钟最大通气量(MMV)(t=12.698,P<0.001)、FEV1/用力肺活量(FVC)(FEV1/FVC)(t=6.449,P<0.001)均升高(P<0.05);Chao1指数、Ace指数、Shannon指数升高(P<0.05),Simpson指数降低(P<0.05);在门水平上,拟杆菌门相对丰度升高;在属水平上,假单胞菌属、韦荣球菌属和伯克霍尔德菌属相对丰度降低,奈瑟菌属、嗜血杆菌属、拟普雷沃菌属、普雷沃菌属-7和卟啉单胞菌属相对丰度升高(均P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论中药雾化联合针刺治疗能显著提高痰热郁肺型AECOPD患者,可显著提高痰热郁肺型AECOPD患者的临床总有效率,降低炎症标志物CRP和IL-6,改善FEV1、FEV1/FVC和MMV等肺功能指标。且改善了痰液菌群多样性,增加有益菌群,减少致病菌。两组不良反应无显著差异,安全性良好。Objective To observe the effects and mechanisms of combined application of herbal nebulisation and acupuncture therapy for improving the inflammatory state and structural changes of sputum flora in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with phlegm-heat stagnation lungs.Methods One hundred patients with AECOPD of phlegm-heat stagnation type admitted to our hospital between March 2022 and September 2023 were randomly divided into the observation group(50 cases,receiving treatment with conventional Western medicine,acupuncture and traditional Chinese medicine atomization),and the control group(50 cases,receiving treatment with conventional Western medicine and acupuncture).Clinical efficacy,inflammatory response,lung function,relative abundance and diversity of sputum flora and incidence of adverse reactions were compared between the two groups.Results Compared to the control group,the overall efficiency rate in the observation group was higher(P<0.05).The levels of serum C-react ive protein(CRP)(t=19.926,P<0.001)and interleukin-6(IL-6)(t=31.111,P<0.001)in the observation group were lower than those in the control group after treatment(P<0.05).The observation group exhibited higher values of forced expiratory volume(FEV1)(t=4.633,P<0.001),forced vital capacity(FVC)(t=6.449,P<0.001)(FEV1/FVC)(t=6.449,P<0.001),and maximum ventilation volume per minute(MMV)(t=12.698,P<0.001)in comparison to the control group(P<0.05).At the phylum level,the relative abundance of Bacteroidetes in the observation group was higher than that in the control group after treatment.At the genus level,the relative abundances of Porphyromonas,Veillonella and Burkholderia in the observation group were lower,while those of Neisseria,Haemophilus,Alloprevotella,Prevotella-7 and Porphyromonas were lower than in the control group respectively after treatment.After treatment,the Chao1 index,Ace index and Shannon index in the observation group were higher,while Simpson index was lower than those in the control g

关 键 词：慢性阻塞性肺疾病 急性加重期 中药 雾化 针刺 痰热郁肺型 痰液菌群 炎症反应 

分 类 号：R563[医药卫生—呼吸系统]