自拟平喘汤治疗哮喘慢性持续期患者的疗效及可能机制

Clinical efficacy and possible mechanism of Zini Pinchuan decoction in treatment of patients with asthma of chronic duration

目的探讨自拟平喘汤治疗哮喘慢性持续期患者的临床疗效及可能机制。方法选择哮喘慢性持续期患者150例,随机分为治疗组(75例)和对照组(75例)。对照组给予常规西药治疗,治疗组在常规西药治疗的基础上给予自拟平喘汤治疗,两组均连续治疗4周。比较两组临床疗效。评价并比较两组治疗前后的中医症候积分、哮喘控制测试表(ACT)评分、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰值流速(PEF)及血清白介素-17(IL-17)、白介素-23(IL-23)水平。并比较两组治疗过程中不良反应的发生情况。结果治疗组的临床总有效率为97.33%高于对照组85.33%,差异有统计学意义(χ^(2)=6.82,P<0.05)。治疗后,治疗组中医症候积分低于对照组、ACT评分高于对照组,差异均有统计学意义(t分别=-12.16、6.97,P均<0.05),治疗组的FEV1、FVC、PEF高于对照组,血清IL-17、IL-23水平均低于对照组,差异均有统计学意义(t分别=12.82、5.17、10.98、-12.56、-15.78,P均<0.05)。治疗期间,两组均无严重的不良反应发生。结论自拟平喘汤治疗哮喘慢性持续期患者的临床疗效显著,有助于临床症状的改善和哮喘的控制,能够明显改善患者的肺功能,抑制炎症反应,且安全性较好。

Objective To explore the clinical efficacy of Zini Pinchuan decoction in treatment of patients with asthma of chronic duration.Methods Totally 150 patients with chronic asthma were randomly divided into treatment group(75 cases)and control group(75 cases).Patients of the control group were treated with western medicine,while the observation group were treated with Zini Pinchuan decoction combined with western medicine.The two groups were treated for 4 weeks.The clinical efficacy between the two groups was compared.The TCM syndrome scores,asthma control test(ACT)score,FEV1,FVC,PEF and serum levels of IL-17,IL-23 of the two groups were compared.The occurrence of adverse reactions between the two groups was compared.Results Total effective rate of observation group was 97.33%,which was higher than 85.33%of the control group,and the difference was statistically significant(χ^(2)=6.82,P<0.05).After treatment,the TCM symptom score of the treatment group was lower than that of the control group,while the ACT score was higher than that of the control group,the differences were statistically significant(t=-12.16,6.97,P<0.05).FEV1,FVC,and PEF of the treatment group were higher than those of the control group,while the serum IL-17,IL-23 levels were lower than those of the control group(t=12.82,5.17,10.98,-12.56,-15.78,P<0.05).There was no serious adverse reaction occurred in the two groups.Conclusion Zini Pinchuan decoction has a significant clinical effect in the treatment of asthma of chronic duration,which is helpful to the improvement of clinical symptoms and asthma control.It can significantly improve the lung function and inhibit the inflammatory response with a good safety.