温肺汤联合西药对慢性阻塞性肺疾病急性发作期难治性细菌感染肺纤毛运动、气道高反应性的影响  

Effect of Wenfei Decoction Combined with Western Medicine on Pulmonary CiliaryMovement and Airway Hyperresponsiveness of Patients with Refractory BacterialInfection Complicated with Acute Exacerbation of Chronic Pulmonary Heart Disease

作　　者：朱松杰 钱巍 魏居瑞 李炯 任剑峰 ZHU Songjie;QIAN Wei;WEI Jurui;LI Jiong;REN Jianfeng(Department of General Practice,The First People's Hospital of Hangzhou Lin'an District,Hangzhou Zhejiang 311300,China)

机构地区：[1]杭州市临安区第一人民医院全科医疗科,浙江杭州311300

出　　处：《新中医》2024年第13期28-33,共6页New Chinese Medicine

摘　　要：目的:观察温肺汤联合西药对慢性阻塞性肺疾病(COPD)急性发作期(AECOPD)难治性细菌感染患者肺纤毛运动、气道高反应性及辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡的影响。方法:选取94例AECOPD难治性细菌感染患者,按随机数字表法分为中药组及常规组各47例。常规组予以常规西药对症治疗,中药组在其基础上予温肺汤联合治疗。2组均连续治疗14 d。比较2组临床疗效及不良反应发生率,比较2组治疗前后肺功能指标值[第1秒用力呼气容积(FEV_(1))/肺活量(FVC)、动脉血氧分压(PaO_(2))、黏膜纤毛清除时间(MCT)]、气道反应性指标值[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)]以及免疫功能指标值[Th17/Treg、白细胞介素-17(IL-17)、转化生长因子-β_(1)(TGF-β_(1))]的变化。结果:中药组临床疗效总有效率为95.75%,常规组为82.98%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组FEV_(1)/FVC、PaO_(2)指标值均较治疗前上升(P<0.05),MCT均较治疗前减少(P<0.05);中药组FEV_(1)/FVC、PaO_(2)指标值均高于常规组(P<0.05),MCT少于常规组(P<0.05)。治疗后,2组SOD、GSH-Px指标值均较治疗前上升(P<0.05),MDA指标值均较治疗前下降(P<0.05);中药组SOD、GSH-Px指标值均高于常规组(P<0.05),MDA指标值低于常规组(P<0.05)。治疗后,2组Th17/Treg、IL-17及TGF-β_(1)指标值均较治疗前下降(P<0.05),中药组上述3项指标值均低于常规组(P<0.05)。治疗期间,中药组不良反应发生率为10.64%,常规组为8.51%,2组比较,差异无统计学意义(P>0.05)。结论:温肺汤联合西药治疗AECOPD难治性细菌感染的临床疗效较好,能增强患者肺纤毛运动,降低气道高反应性,调节免疫功能,减少气道损伤,提升肺功能,安全性高。Objective:To observe the effect of the therapy of Wenfei Decoction combined with western medicine on pulmonary ciliary movement,airway hyperresponsiveness and balance of T helper cell(Th17)/regulatory cell(Treg)of patients with refractory bacterial infection complicated with acute exacerbation of chronic pulmonary heart disease(AECOPD).Methods:A total of 94 AECOPD patients with refractory bacterial infection were selected and divided into the Chinese medicine group and the routine group according to the random number table method,with 47 cases in each group.The routine group was givensymptomatic treatment with routine western medicine,and the Chinese medicine group was additionallytreated with Wenfei Decoction based on the treatment of the routine group.The two groups were treatedfor 14 days.The clinical effects and incidence of adverse reactions,and the changes of lung functionindexes[forced expiratory volume in the first second(FEV_(1))/forced vital capacity(FVC),partial pressure ofoxygen in arterial blood(PaO_(2))and mucociliary clearance time(MCT)],airway responsiveness indexes[superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)and malondialdehyde(MDA)]and immunefunction indexes[Th17/Treg,interleukin-17(IL-17),and transforming growth factor-β_(1)(TGF-β_(1))]werecompared before and after treatment between the two groups.Results:The total clinical effective rate was95.75%in the Chinese medicine group,and 82.98%in the routine group,the difference being significant(P<0.05).After treatment,the levels of FEV_(1)/FVC and PaO_(2)in the two groups were increased whencompared with those before treatment(P<0.05),the MCT levels were reduced when compared withthose before treatment(P<0.05);the levels of FEV_(1)/FVC and PaO_(2)in the Chinese medicine group werehigher than those in the routine group(P<0.05),and the MCT was less than that in the routine group(P<0.05).After treatment,the levels of SOD and GSH-Px in the two groups were increased when comparedwith those before treatment(P<0.05),and the MDA levels were de

关 键 词：慢性阻塞性肺疾病急性发作期 难治性细菌感染 温肺汤 肺纤毛运动 气道高反应性 

分 类 号：R563[医药卫生—呼吸系统]