玉屏风颗粒联合乙酰半胱氨酸治疗慢性阻塞性肺疾病稳定期肺气虚证临床研究
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Clinical Study on Yupingfeng Granules Combined with Acetylcysteine for Chronic Obstructive Pulmonary Disease with Lung Qi Deficiency Syndrome at Stable Stage
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    摘要:

    目的:观察玉屏风颗粒联合乙酰半胱氨酸治疗慢性阻塞性肺疾病(COPD) 稳定期肺气虚证的临床疗效及对患者肺功能、炎症因子和外周血T 淋巴细胞亚群的影响。方法:选取274 例COPD 稳定期肺气虚证患者,按随机数字表法分为观察组和对照组,每组137 例。对照组给予乙酰半胱氨酸泡腾片治疗,观察组在对照组基础上联合玉屏风颗粒治疗,2 组均治疗12 周。比较2 组临床疗效和不良反应发生率,比较2 组治疗前后肺功能、COPD 患者自我评估测试问卷(CAT) 评分、血清炎症因子及外周血T 淋巴细胞亚群水平。结果:观察组总有效率为95.6%,高于对照组的85.4%(P<0.05)。治疗后,2 组第1 秒用力呼气容积占预计值百分比(FEV1%pred)、呼气峰值流速(PEF)、深吸气量/肺总量(IC/TLC) 值均较治疗前升高(P<0.05),CAT 评分均较治疗前降低(P<0.05);观察组FEV1%pred、PEF、IC/TLC 值均高于对照组(P<0.05),CAT 评分低于对照组(P<0.05)。治疗后,2 组血清肿瘤坏死因子-α (TNF-α)、白细胞介素-17 (IL-17)、CD8+水平均较治疗前降低(P<0.05),观察组血清TNF-α、IL-17、CD8+水平均低于对照组(P<0.05);2 组CD4+水平和CD4+/CD8+值均较治疗前升高(P<0.05),观察组CD4+水平和CD4+/CD8+值均高于对照组(P<0.05)。观察组不良反应发生率为4.4%,对照组不良反应发生率为2.9%,2 组比较,差异无统计学意义(P>0.05)。结论:玉屏风颗粒联合乙酰半胱氨酸治疗COPD 稳定期肺气虚证,可明显改善患者的临床症状和肺功能,作用机制可能与下调血清炎症因子表达水平和纠正外周血T 淋巴细胞亚群紊乱有关。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Yupingfeng granules combined with acetylcysteine for chronic obstructive pulmonary disease(COPD) with lung qi deficiency syndrome at stable stage,and its effect on the lung function, inflammatory factors,and T-lymphocyte subsets in peripheral blood. Methods:A total of 274 cases of COPD patients with lung qi deficiency syndrome at stable stage were selected and divided into the observation group and the control group according to the random number table method, 137 cases in each group. The control group was given acetylcysteine effervescent tablets, and the observation group was additionally given Yupingfeng granules based on the treatment of the control group. Both groups were treated for 12 weeks. The clinical effect and the incidence of adverse reactions were compared between the two groups. Before and after treatment, the changes in the lung function, the score of COPD Assessment Test(CAT),inflammatory factors and T-lymphocyte subsets in peripheral blood in serum were observed in the two groups. Results:The total effective rate was 95.6% in the observation group,higher than that of 85.4% in the control group(P<0.05). After treatment, the percentages of forced expiratory volume in one second to the predicted value(FEV1% pred),peak expiratory flow(PEF),and the ratios of inspiratory capacity to total lung capacity(IC/TLC) in the two groups were increased when compared with those before treatment(P<0.05), and the scores of CAT were decreased(P<0.05). After treatment, FEV1% pred, PEF, and IC/TLC ratio in the observation group were higher than those in the control group(P< 0.05),and the score of CAT was lower(P<0.05). After treatment,levels of tumor necrosis factor-α(TNF-α),interleukin-17 (IL-17),and CD8+ in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the three levels in serum above in the observation group were lower than those in the control group(P<0.05). After treatment, levels of CD4 + and CD4 +/CD8 + values in the two groups were increased when compared with those before treatment(P<0.05),and the two indexes in the observation group were higher than those in the control group(P<0.05). The incidence of adverse reactions was 4.4% in the observation group,and 2.9% in the control group;there was no significance in difference(P>0.05). Conclusion:In the treatment of COPD with lung qi deficiency syndrome at stable stage,the therapy of Yupingfeng granules combined with acetylcysteine can significantly improve clinical symptoms and the lung function. Its mechanism may be related to down- regulation of expression levels of inflammatory factors in serum and rectification of Tlymphocyte subset disorder in peripheral blood.

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陈晶,朱丹,陈慧,袁菲,王临英,徐继林.玉屏风颗粒联合乙酰半胱氨酸治疗慢性阻塞性肺疾病稳定期肺气虚证临床研究[J].新中医,2021,53(15):20-24

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  • 在线发布日期: 2021-08-10
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