[1]蒙 绮,周 进.益气宣肺汤治疗老年哮喘疗效及对患者炎症因子和免疫功能的影响[J].陕西中医,2024,(10):1345-1348.[doi:DOI:10.3969/j.issn.1000-7369.2024.10.010]
 MENG Qi,ZHOU Jin.The therapeutic effect of Yiqi Xuanfei decoction on elderly asthmatic patients and its role in regulating inflammatory factors and immune function[J].,2024,(10):1345-1348.[doi:DOI:10.3969/j.issn.1000-7369.2024.10.010]
点击复制

益气宣肺汤治疗老年哮喘疗效及对患者炎症因子和免疫功能的影响
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年10期
页码:
1345-1348
栏目:
临床研究
出版日期:
2024-10-05

文章信息/Info

Title:
The therapeutic effect of Yiqi Xuanfei decoction on elderly asthmatic patients and its role in regulating inflammatory factors and immune function
作者:
蒙 绮1周 进2
(1.贵州中医药大学第二附属医院,贵州 贵阳 550003; 2.北京中医药大学东方医院秦皇岛医院,河北 秦皇岛 066499)
Author(s):
MENG QiZHOU Jin
(The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550003,China)
关键词:
哮喘 益气宣肺汤 炎症 超敏C反应蛋白 免疫功能 中医症候积分
Keywords:
Asthma Yiqi Xuanfei decoction Inflammation Hypersensitive C-reactive protein Immune function Traditional Chinese medicine syndrome score
分类号:
R 256.12
DOI:
DOI:10.3969/j.issn.1000-7369.2024.10.010
文献标志码:
A
摘要:
目的:观察益气宣肺汤对老年哮喘患者的治疗效果及在调节炎症和免疫功能中的作用。方法:纳入120例慢性持续期老年哮喘患者,随机分为对照组和益气宣肺组。对照组采用常规西医治疗,益气宣肺组在对照组基础上加服益气宣肺汤。观察两组治疗前后临床症状评分及临床疗效; 比较患者治疗前后哮喘控制测试评分及实验室检查指标[白介素(IL)-4、IL-10、超敏C反应蛋白(hs-CRP)和干扰素γ(IFN-γ)]水平变化以及患者免疫指标(CD4+、CD8+和CD4+/CD8+)变化。记录两组治疗后不良反应及具体不良事件。结果:对照组临床总有效率为70.00%,益气宣肺组为88.33%,益气宣肺组高于对照组(P<0.05)。治疗后,两组中医症候积分明显低于治疗前,哮喘控制测试评分则高于治疗前; 益气宣肺组改善优于对照组(均P<0.05)。治疗后3个月两组IL-4、IL-10、CD4+水平和CD4+/CD8+比值明显高于治疗前,hs-CRP、IFN-γ和CD8+水平明显降低; 并且益气宣肺组的IL-4、IL-10、CD4+水平和CD4+/CD8+比值明显高于对照组,而hs-CRP、IFN-γ和CD8+水平明显低于对照组(均P<0.05)。结论:慢性持续期老年哮喘患者采用常规西药联用益气宣肺汤可改善哮喘症状并控制其复发,可能与该组方具有宣肺、抗炎、益气、调节免疫系统功能的作用有关。
Abstract:
Objective:To observe the therapeutic effect of Yiqi Xuanfei decoction on elderly asthmatic patients and its role in regulating inflammation and immune function.Methods:The research subjects were 120 elderly patients with chronic persistent asthma.Eligible patients were randomly divided into a control group and a Yiqi Xuanfei group.Patients in the control group received conventional western medicine treatment; while those in Yiqi Xuanfei group were given Yiqi Xuanfei decoction on the basis of treatment in the control group.This study further observed clinical symptom scores and clinical efficacy before and after treatment in the two groups; compared the asthma control test scores of patients before and after treatment,and changes in levels of laboratory indicators including interleukin(IL)-4,IL-10,hs-CRP,IFN-γ in patients before and after treatment; as well as patient immune indicators of CD4+,CD8+ and CD4+/CD8+.Adverse reactions and specific adverse events were recorded after treatment in the two groups.Results:The clinical effective rate of the control group was 70.00%,that of the Yiqi Xuanfei group was 88.33%,which was higher than that in the control group(P<0.05).The post-treatment syndrome scores of TCM in both groups were significantly lower than the pre-treatment scores,while the asthma control test scores were higher than before treatment; with obvious improvement in the Yiqi Xuanfei group in particular(all P<0.05).Compared with before treatment,the levels of IL-4,IL-10,CD4+ and CD4+/CD8+ were significantly increased,while those of hs-CRP,IFN-γ and CD8+ were obviously decreased in both groups after 3 months of treatment.Moreover,Yiqi Xuanfei group had highly increased levels of IL-4,IL-10,CD4+ and CD4+/CD8+,but decreased levels of hs-CRP,IFN-γ and CD8+(all P<0.05).Conclusion:For elderly patients with chronic persistent asthma,conventional western medicine combined with Yiqi Xuanfei decoction can improve asthma symptoms and control its recurrence,which may be related to the effects of this formula in promoting lung function,preventing inflammation,nourishing Qi,and regulating immune system.

参考文献/References:

[1] 郭静,刘泮力.肿瘤坏死因子-α、内皮素-1、免疫球蛋白E和血栓素B2水平与肺炎支原体感染老年哮喘患者病情严重程度的关系[J].陕西医学杂志,2022,51(7):863-865,869.
[2] 董兰东,王洋,陈旭,等.王洋教授诊治哮喘经验总结[J].中医临床研究,2023,15(13):137-141.
[3] HOCH H E,HOUIN P R,STILLWELL P C.Asthma in children:A brief review for primary care providers[J].Pediatr Ann,2019,48(3):103-109.
[4] GEMICIOLU B,MUSELLIM B,DEIRMENCI B,et al.Clinical challenges in elderly asthma[J].Tuberk Toraks,2019,67(1):31-38.
[5] 刘平湖.急诊治疗严重哮喘呼吸衰竭的临床效果观察[J].临床医药文献电子杂志,2020,7(28):2.
[6] 王宗禄.试论哮喘之“宿根”[J].内蒙古中医药,2013,32(6):144.
[7] 黄舒然,姚宏凤,丁海拔,等.参苓白术散联合沙美特罗氟替卡松治疗支气管哮喘慢性持续期疗效及对患者机体氧化-抗氧化平衡的影响[J].陕西中医,2023,44(6):730-733.
[8] YUAN J Y,TONG Z Y,DONG Y C,et al.Research progress on icariin,a traditional Chinese medicine extract,in the treatment of asthm[J].Allergol Immunopathol(Madr),2022,50(1):9-16.
[9] 黄芳,张梦.益气宣肺汤联合穴位贴敷治疗老年慢性支气管炎急性发作临床研究[J].陕西中医,2021,42(6):716-720.
[10] BANNO A,REDDY A T,LAKSHMI S P,et al.Bidirectional interaction of airway epithelial remodeling and inflammation in asthma[J].Clin Sci(Lond),2020,134(9):1063-1079.
[11] 周新,张旻.中国支气管哮喘防治指南(2020年版)解读[J].诊断学理论与实践,2021,20(2):138-143.
[12] 佚名.哮病的诊断依据、症候分类、疗效评定——中华人民共和国中医药行业标准《中医内科病证诊断疗效标准》(ZY/T001.1-94)[J].辽宁中医药大学学报,2015,17(8):145.
[13] 石晓岚,赵龙,王宁,等.miR-542-3p对脂多糖诱导的人支气管上皮细胞增殖和迁移的影响及机制研究[J].陕西医学杂志,2021,50(10):1218-1222.
[14] LIAO P F,WANG Y T,WANG Y H,et al.Traditional Chinese medicine use may reduce medical utility in patients with asthma:A nationwide population-based retrospective cohort study[J].QJM-An International Journal of Medicine,2022,114(12):857-864.
[15] 位军义,马丙祥.冬病夏治穴位贴敷联合中药治疗痰湿蕴肺型小儿咳嗽变异性哮喘的临床观察[J].首都食品与医药,2021,28(22):157-159.
[16] FAN Y,WANG W,HE Z,et al.Transcriptome analysis of traditional Chinese medicine kechuanning plaster in the treatment of asthma[J].Comb Chem High Throughput Screen,2023,26(4):778-788.
[17] 蒋紫云,孟星汝,周谨希,等.基于NF-κB通路调控Th1/Th2平衡探讨三子汤治疗支气管哮喘急性发作期的临床研究[J].现代中西医结合杂志,2023,32(20):2817-2821,2828.
[18] WANG M H,CHEN C,YEH M L,et al.Using traditional Chinese medicine to relieve asthma symptoms:A systematic review and meta-analysis[J].Am J Chin Med,2019,47(8):1659-1674.
[19] PENG Y,XU X,YE T,et al.The effect of pterostilbene and its active ingredients on experimental pulmonary fibrosis in asthma:A meta-analysis[J].Postepy Dermatol Alergol,2022,39(5):838-844.
[20] LE FLOCH A,ALLINNE J,NAGASHIMA K,et al.Dual blockade of IL-4 and IL-13 with dupilumab,an IL-4Rα antibody,is required to broadly inhibit type 2 inflammation[J].Allergy,2020,75(5):1188-1204.
[21] CHEN S,CHEN B,WEN Z,et al.IL-33/ST2-mediated inflammation in macrophages is directly abrogated by IL-10 during rheumatoid arthritis[J].Oncotarget,2017,8(20):32407-32418.
[22] 李晖,冯传杰,张宏峰,等.复春散Ⅱ号、凉血解毒方联合重组人生长激素对重度烧伤患者血清促炎因子TNF-α、CRP、IL-6蛋白质代谢及免疫功能的影响[J].中华中医药学刊,2020,38(6):33-36.
[23] 李丹,李龙,刘梦玉,等.针刺“百会”透“曲鬓”对大鼠脑出血后脑水肿及炎症反应影响的研究[J].中医药学报,2023,51(2):56-61.
[24] PAINTER M M,MATHEW D,GOEL R R,et al.Rapid induction of antigen-specific CD4+ T cells is associated with coordinated humoral and cellular immunity to SARS-CoV-2 mRNA vaccination[J].Immunity,2021,54(9):2133-2142.
[25] BAHAROM F,RAMIREZ V R,KHALILNEZHAD A,et al.Systemic vaccination induces CD8+ T cells and remodels the tumor microenvironment[J].Cell,2022,185(23):4317-4332.

相似文献/References:

[1]李艳,曾晓翠.加味射干麻黄汤对小儿咳嗽变异性哮喘的疗效观察[J].陕西中医,2016,(10):1311.
[2]伍 磊.紫苏子汤对哮喘小鼠TNFα、白细胞介素8、白介素1β表达的影响*[J].陕西中医,2019,(2):152.
 WU Lei..Effects of Zisuzi decoction on expression of TNF α,interleukin 8 and interleukin 1 β in asthmatic mice[J].,2019,(10):152.
[3]王玉梅,袁向东,李四保.止咳平喘糖浆联合异丙托溴铵治疗哮喘疗效及对患儿肺功能和内环境的影响*[J].陕西中医,2019,(4):428.
 WANG Yumei,YUAN Xiangdong,LI Sibao..Curative effect of cough relieving asthma syrup combined with ipratropium bromide on children with asthma and its influence on pulmonary function and internal environment[J].,2019,(10):428.
[4]汪 伟,赵跃萍,张亚明.补中益气方联合针灸治疗哮喘疗效及对患儿大气道功能相关指标的影响*[J].陕西中医,2020,(11):1611.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.025]
 WANG Wei,ZHAO Yueping,ZHANG Yaming..Effect of Buzhong Yiqi recipe combined with acupuncture and moxibustion on therapeutic effect and changes of large airway function indexes in children with asthma[J].,2020,(10):1611.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.025]
[5]黄 芳,张 梦.益气宣肺汤联合穴位贴敷治疗老年慢性支气管炎急性发作临床研究[J].陕西中医,2021,(6):716.[doi:DOI:10.3969/j.issn.1000-7369.2020.06.009]
 HUANG Fang,ZHANG Meng.Clinical study on Yiqi Xuanfei decoction combined with acupoint application in treatment of acute attack of chronic bronchitis in the elderly[J].,2021,(10):716.[doi:DOI:10.3969/j.issn.1000-7369.2020.06.009]
[6]陈训春,李名兰,潘碧云,等.白芥子散对哮喘大鼠免疫稳态重建及RhoA基因表达的影响[J].陕西中医,2021,(7):836.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.005]
 CHEN Xunchun,LI Minglan,PAN Biyun,et al.Immune steady-state reconstruction of sputum drug Baijiezi powder on asthmatic rats and its effect on RhoA gene expression[J].,2021,(10):836.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.005]
[7]苏 平,曹利平,蔡绪明,等.益气宣肺汤治疗老年功能性便秘气虚证临床研究[J].陕西中医,2021,(9):1257.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.028]
 SU Ping,CAO Liping,CAI Xuming,et al.Clinical study on Yiqi Xuanfei decoction in treating functional constipation with Qixu syndrome in old age[J].,2021,(10):1257.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.028]
[8]刘 健,王佳丽,曹慧丹,等.补肺颗粒对哮喘小鼠气道重塑的影响及机制研究[J].陕西中医,2022,(5):559.[doi:DOI:10.3969/j.issn.1000-7369.2022.05.004]
 LIU Jian,WANG Jiali,CAO Huidan,et al.Mechanism of Bufei granule inhibiting airway remodeling in asthmatic mice[J].,2022,(10):559.[doi:DOI:10.3969/j.issn.1000-7369.2022.05.004]
[9]陆振瑜,庄 承.益气补肾止喘汤联合布地奈德治疗小儿哮喘疗效研究[J].陕西中医,2022,(6):728.[doi:DOI:10.3969/j.issn.1000-7369.2022.06.012]
 LU Zhenyu,ZHUANG Cheng.Effect research on Yiqi Bushen Zhichuan decoction combined with budesonide treatment of children with asthma[J].,2022,(10):728.[doi:DOI:10.3969/j.issn.1000-7369.2022.06.012]
[10]李 星,田春燕,王丽洁,等.李竹英教授治疗哮喘经验[J].陕西中医,2022,(7):936.[doi:DOI:10.3969/j.issn.1000-7369.2022.07.030]
 LI Xing,TIAN Chunyan,WANG Lijie,et al.Professor LI Zhuying's experience in treating asthma[J].,2022,(10):936.[doi:DOI:10.3969/j.issn.1000-7369.2022.07.030]

备注/Memo

备注/Memo:
基金项目:河北省中医药管理局科研项目(2022538)
更新日期/Last Update: 2024-10-08