生脉地黄汤联合西药吸入治疗肺肾气虚型COPD稳定期的临床研究及对PI3K/AKT通路相关因子表达的影响  

Clinical Study on the Treatment of Stable COPD of Lung-Kidney Qi Deficiency Type Using Shengmai Dihuang Decoction Combined with Western Medicine Inhalation and Its Effect on the Expression of PI3K/AKT Pathway-Related Factors

作　　者：何权 马小梅 封伟奇 陆旭之 凌婷 范倩 陈子[2] HE Quan;MA Xiaomei;FENG Weiqi;LU Xuzhi;LING Ting;FAN Qian;CHEN Zi(Zhenjiang Hospital of Integrated Traditional Chinese and Western Medicine,Zhenjiang 212000,China;Department of Respiratory and Critical Care Medicine,Jiangsu Provincial People's Hospital,Nanjing 210029,China)

机构地区：[1]镇江市中西医结合医院,江苏镇江212000 [2]江苏省人民医院呼吸与危重症医学科,江苏南京210029

出　　处：《中医药学报》2024年第11期98-102,共5页Acta Chinese Medicine and Pharmacology

基　　金：江苏省老年健康科研项目(LK2021057);镇江市科技创新资金重点研发计划项目(SH2022081,SH2023034);江苏省中医药科技发展计划项目(MS2022125);镇江市社会发展指导性项目(FZ2018039)。

摘　　要：目的:探究稳定期肺肾气虚型慢性阻塞性肺疾病(COPD)应用生脉地黄汤联合西药治疗的临床疗效及对PI3K/AKT通路相关因子表达的影响。方法:前瞻性随机选取镇江市中西医结合医院2020年6月—2023年3月收治的64例肺肾气虚型稳定期COPD患者纳入研究,将其用随机数字表法分成对照组和观察组,每组32例。对照组予以西药吸入治疗,观察组予以中药生脉地黄汤联合西药吸入治疗。比较两组临床疗效、肺功能、免疫炎症水平、PI3K/AKT通路相关因子表达水平以及不良反应。结果:观察组疗效优于对照组(P<0.05)。治疗后,两组第一秒用力呼气容积(FEV 1)/用力肺活量(FVC)、CD3^(+)、CD4^(+)/CD8^(+)、6 min步行试验(6 MWT)、呼气流量峰值(PEF)水平增加(P<0.05),且观察组高于对照组(P<0.05)。两组干扰素-γ(IFN-γ)、白细胞介素-6(IL-6)、PI3K、AKT水平降低(P<0.05),观察组低于对照组(P<0.05)。结论:生脉地黄汤联合西药吸入治疗用于肺肾气虚型稳定期COPD患者,可有效提升疗效,提升肺功能及免疫功能,下调PI3K/AKT通路表达,减轻炎症水平,且用药安全。Objective:To explore the clinical effects of Shengmai Dihuang Decoction combined with Western medicine inhalation therapy on stable chronic obstructive pulmonary disease(COPD)with lung-kidney Qi deficiency and its influence on the expression of PI3K/AKT pathway-related factors.Methods:A prospective,randomized study was conducted,enrolling 64 patients with stable COPD with lung-kidney Qi deficiency,admitted to Zhenjiang Hospital of Integrated Traditional Chinese and Western Medicine from June 2020 to March 2023.Patients were randomly divided into a control group and an observation group,with 32 cases in each group.The control group received Western medicine inhalation therapy,while the observation group received the same plus Shengmai Dihuang Decoction.Clinical efficacy,lung function,immune-inflammatory levels,expression levels of PI3K/AKT pathway-related factors,and adverse reactions were compared between the two groups.Results:The clinical efficacy in the observation group was superior to that in the control group(P<0.05).After treatment,the levels of forced expiratory volume in one second(FEV1)/forced vital capacity(FVC),CD3^(+),CD4^(+)/CD8^(+)ratio,6-minute walk test(6MWT),and peak expiratory flow(PEF)increased in both groups,with higher levels in the observation group(P<0.05).Levels of interferon-gamma(IFN-γ),interleukin-6(IL-6),PI3K,and AKT decreased in both groups(P<0.05),with lower levels in the observation group(P<0.05).Conclusion:Shengmai Dihuang Decoction combined with Western medicine inhalation therapy for stable COPD patients of lung-kidney Qi deficiency type can effectively improve clinical efficacy,enhance lung function and immune function,downregulate PI3K/AKT pathway expression,reduce inflammation,and ensure medication safety.

关 键 词：慢性阻塞性肺疾病 肺肾气虚型 生脉地黄汤 PI3K/AKT通路 

分 类 号：R256.12[医药卫生—中医内科学]