保肺汤对慢性阻塞性肺病患者肠道菌群的影响

目的 探索保肺汤作用于慢性阻塞性肺病(COPD)患者后对其肠道菌群的影响.方法 随机纳入60例2017年1月至6月诊断为COPD的患者,随机均分为治疗组与对照组,对照组给予基础治疗,治疗组给予基础治疗加保肺汤,收集各组干预前后的血液及粪便,检测其肺功能、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)变化以及应用qPCR绝对定量检测肠道菌群(肠杆菌、肠球菌、乳杆菌、双歧杆菌和总菌)数量变化.结果 相对于对照组,保肺汤治疗组干预后炎症指标CRP及TNF-α水平明显降低(P<0.05),肠杆菌、肠球菌明显减少(P<0.05),双歧杆菌明显增加(P<0.05);且相对于干预前,保肺汤治疗后患者肺功能明显提高、CRP及TNF-α水平降低(P<0.05),肠肠球菌和增加双歧杆菌的数量明显减少(P<0.05).结论 保肺汤主要通过减少肠杆菌、肠球菌和增加双歧杆菌调节肠道菌群,从而降低COPD慢性炎症,最终改善COPD,其可能是中医药保肺汤经'肺与大肠相表里'作用于COPD的内在机制之一.

Objective To explore the effect of Baofei decoction on intestinal flora in patients with chronic obstructive pulmonary disease(COPD).Methods Sixty patients with COPD diagnosed at our hospital from January to June in 2017 were randomly divided into treatment group and control group,the control group was given basic treatment,and the treatment group was given basic treatment plus Baofei decoction.The blood and feces were collected before and after intervention,and their lung function,C-reactive protein(CRP)and tumor necrosis-αfactor(TNF-α)were measured and quantitative detection of intestinal flora(Enterobacteriaceae,Enterococci,Lactobacilli,Bifidobacteria,and total bacteria)using qPCR in two groups.Results Compared with the control group,the levels of CRP and TNF-αin the treatment group with Baofei decoction were significantly decreased(P<0.05),Enterobacter and Enterococci were significantly decreased(P<0.05),and Bifidobacterium were significantly increased(P<0.05).Compared with before treatment with Baofei decoction,the lung function of patients was improved significantly,CRP and TNF-αlevels(P<0.05)were decreased.Compared with before intervention,Baofei decoction significantly reduced Enterococci and increased Bifidobacterium after treatment(P<0.05).Conclusion Baofei Decoction can reduce the intestinal flora by reducing Enterobacter and Enterococci and increasing Bifidobacterium,thus reducing the chronic inflammation of COPD and ultimately improving COPD.It may be the one of the intrinsic mechanisms that traditional Chinese medicine for protecting the lungs and acting on COPD based on lung-large intestine axis.