平喘汤加减治疗支气管哮喘急性发作期患者的临床疗效及对其气道炎症因子的影响  

Effect of Modified Pingchuan Decoction on Acute Exacerbation of Bronchial Asthma Based on Airway Inflammatory Factors

作　　者：周卫军 曹健 冯高华[1] 沈王丰 ZHOU Wei-jun;CAO Jian;FENG Gao-hua;SHEN Wang-feng(Department of Respiratory and Critical Care Medicine,Zhangjiagang Hospital of Traditional Chinese Medicine Affiliated to Yangzhou University Medical College,Zhangjiagang Jiangsu 215600)

机构地区：[1]扬州大学医学院附属张家港市中医医院呼吸与危重医学科,江苏张家港215600

出　　处：《世界中西医结合杂志》2024年第12期2490-2495,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：张家港市科技局医疗卫生科技创新指导性项目(ZKYL2249);苏州市“科教兴卫”青年科技项目(KJXW2022063)。

摘　　要：目的观察平喘汤加减治疗支气管哮喘(Bronchial asthma,BA)急性发作期患者的临床疗效及对其气道炎症因子的影响。方法选取2021年1月—2023年12月期间扬州大学医学院附属张家港市中医医院呼吸内科门诊或住院的BA急性发作期患者180例,按照1∶1原则随机分为对照组和观察组,每组各90例。对照组采取西药治疗,观察组在对照组治疗基础上联合平喘汤加减治疗。治疗14 d后,观察比较两组患者临床疗效、安全性,治疗前后主要中医证候评分、哮喘控制测试(Asthma control test,ACT)评分,检测肺功能指标[第1s用力呼气容积占预计值百分比(First second forced expiratory volume percentage of expected value,FEV1%)、FEV1占用力肺活量(Forced vital capacity,FVC)百分比(FEV1/FVC)、呼气峰值流量(Peak expiratory flow,PEF)],检测血清嗜酸性粒细胞(Eosinophil,EOS)计数、呼出气一氧化氮(Fractional exhaled nitric oxide,FeNO)、免疫球蛋白E(Immunoglobulin E,IgE)、白介素-6(Interleukin-6,IL-6)和白介素-17(Interleukin-17,IL-17)水平。结果治疗后两组患者中医证候积分较治疗前降低,ACT评分较治疗前升高,差异有统计学意义(P<0.05);且观察组中医证候积分低于对照组,ACT评分高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者FEV1、FEV1/FVC、PEF均较治疗前明显升高,差异有统计学意义(P<0.05);且观察组肺功能指标高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者FeNO、EOS、IgE、IL-6和IL-17水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组气道炎症相关因子均低于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床疗效96.67%(87/90)明显高于对照组81.11%(73/90),差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论平喘汤加减治疗BA急性发作期能够改善临床症状体征,保护肺通气功能并抑制气道炎症,Objective To observe the therapeutic effect of modified Pingchuan Decoction on acute exacerbation of bronchial asthma(BA)based on airway inflammatory factors.Methods A total of 180 patients with acute exacerbation of BA treated in the Department of Respiratory Medicine of Zhangjiagang Hospital of Traditional Chinese Medicine Affiliated to Yangzhou University Medical College between January 2021 and December 2023 were selected and randomized into a control group and an observation group according to the 1∶1 ratio,with 90 patients in each group.The control group was treated with Western medicine,and the observation group was treated with modified Pingchuan Decoction on the basis of the therapy in the control group.The treatment course was 14 days in both groups.The clinical efficacy and safety were compared between the two groups.Before and after treatment,the main traditional Chinese medical(TCM)symptom scores and asthma control test(ACT)score were evaluated.In addition,the pulmonary function indicators[first second forced expiratory volume percentage of expected value(FEV1%),FEV1 to forced vital capacity(FVC)percentage(FEV1/FVC),and peak expiratory flow(PEF)]and serum levels of eosinophils(EOS),fractional exhaled nitric oxide(FeNO),immunoglobulin E(IgE),interleukin-6(IL-6),and interleukin-17(IL-17)were measured.Results After treatment,both groups showed declined TCM symptom scores and increased ACT scores(P<0.05),and the observation group had lower TCM symptom scores and higher ACT score than the control group(P<0.05).After treatment,FEV1,FEV1/FVC,and PEF in both groups increased(P<0.05),and they were higher in the observation group than in the control group(P<0.05).After treatment,the levels of FeNO,EOS,IgE,IL-6,and IL-17 declined in both groups(P<0.05),and they were lower in the observation group than in the control group(P<0.05).The total response rate in the observation group after treatment was 96.67%(87/90),which was higher than that(81.11%,73/90)in the control group(P<0.05).During the treatment period,th

关 键 词：支气管哮喘急性发作 平喘汤 气道炎症 肺功能 

分 类 号：R562.2[医药卫生—呼吸系统]