宣肺解痉方治疗支气管哮喘的临床疗效及对血清TGF-β_(1)、MMP-9、TNF-α水平的影响

Clinical Efficacy of Xuanfei Jiejing Formula(宣肺解痉方)on Bronchial Asthma and Its Influence on Levels of Serum Inflammatory Factors TGF-β_(1),MMP-9 and TNF-α

目的观察宣肺解痉方治疗支气管哮喘患者的临床疗效,及对肺功能和血清嗜酸性粒细胞(EOS)计数、免疫球蛋白E(IgE)、TGF-β_(1)、MMP-9、TNF-α表达水平的作用,探究宣肺解痉方对哮喘气道重塑的影响。方法将纳入的60例支气管哮喘患者随机分为对照组和治疗组,每组各30例;对照组予布地奈德福莫特罗粉吸入剂(160μg/4.5μg)治疗;治疗组在对照组基础上给予宣肺解痉方加减治疗;两组均持续治疗4周。观察两组临床疗效及治疗前后哮喘临床症状体征评分、ACT评分、SGRQ评分,肺功能指标FEV_(1)、FEV_(1)/FVC、PEF变异率,以及血清EOS计数、IgE、TGF-β_(1)、MMP-9、TNF-α水平。结果治疗组临床疗效显著优于对照组(P<0.05);治疗后两组ACT评分、FEV_(1)、FEV_(1)/FVC较治疗前明显升高(P<0.05),且治疗组明显高于对照组(P<0.05);治疗后两组临床症状体征评分、SGRQ评分以及PEF变异率、血清EOS计数、IgE、TGF-β_(1)、MMP-9、TNF-α水平较治疗前明显降低(P<0.05),且治疗组明显低于对照组(P<0.05)。结论宣肺解痉方联合布地奈德福莫特罗粉吸入剂可有效降低哮喘气道重塑相关炎症因子水平,改善哮喘患者肺功能,控制哮喘发作,提高临床治愈率并有效改善哮喘患者生活质量。

Objective To observe the clinical efficacy of Xuanfei Jiejing Formula(宣肺解痉方)in the treatment of bronchial asthma as well as its effect on the pulmonary function and the expression levels of serum eosinophils(EOS)count,immunoglobulin E(IgE),TGF-β_(1),MMP-9 and TNF-αand explore the effect of Xuanfei Jiejing Formula on airway remodeling in asthma.Methods Sixty patients with bronchial asthma were randomly divided into control group and treatment group with 30 patients in each group.The control group was given Budesonide Formotero Powder Inhaler(160μg/4.5μg).On the basis of the control group,the treatment group was given Modified Xuanfei Jiejing Formula.Both groups were treated continuously for 4 weeks.The clinical efficacy was assessed,and the clinical symptoms and signs score of asthma,ACT score,SGRQ score and pulmonary function indexes(FEV_(1),FEV_(1)/FVC,PEF variation rates),and the levels of serum EOS count,IgE,TGF-β_(1),MMP-9 and TNF-αwere observed in the two groups before and after treatment.Results The clinical efficacy of the treatment group was significantly better than that of the control group(P<0.05).After treatment,ACT scores,FEV_(1)and FEV_(1)/FVC were significantly higher than those before treatment between the two groups(P<0.05),and those of the treatment group were significantly higher than those of the control group(P<0.05).After treatment,the clinical symptoms and signs score,SGRQ score,PEF variation rate,serum EOS count,and the levels of IgE,TGF-β_(1),MMP-9 and TNF-αwere significantly reduced than those before treatment in the two groups(P<0.05),and those of the treatment group were significantly lower than those of the control group(P<0.05).Conclusion Xuanfei Jiejing Formula combined with Budesonide Formoterol Powder Inhaler can effectively reduce the levels of inflammatory factors related to airway remodeling,improve the pulmonary function of asthmatic patients,control asthma attacks,improve the clinical cure rate and effectively improve the quality of life of asthmatic patients.