痰热清注射液对慢性阻塞性肺疾病患者血浆白三烯B_4、IL-17水平和免疫失衡状态的影响

Effect of Tanreqing Injection on Plasma Leukotriene B4, IL-17 Levels and Immune Imbalance in Patients with Chronic Obstructive Pulmonary Diseases

目的:探究痰热清对慢性阻塞性肺疾病(COPD)患者血浆白三烯(LT)B_4、白介素(IL)-17水平和免疫失衡状态的影响。方法:按随机数字表法将2015年05月—2017年05月于我院呼吸科住院治疗的116例COPD患者分为治疗组与对照组,各58例。对照组接受常规治疗,观察组在对照组基础上给予痰热清注射液(20 mL加入5%葡萄糖注射液250 mL,ivgtt,qd)治疗,比较两组治疗效果及安全性,治疗前后肺功能,血浆IL-17、LTB_4水平及白细胞总数(WBC)、中性粒细胞值(neutroPhil)、T淋巴细胞亚群等指标水平。结果:观察组总有效率显著高于对照组,差异有统计学意义(P <0.05);治疗后两组第一秒用力呼吸容积(FEV1)、FEV1/用力肺活量(FVC)较治疗前升高,且观察组高于对照组,改良版英国医学研究委员会呼吸问卷(mMRC)评分较治疗前降低,且观察组低于对照组,差异有统计学意义(P <0.05);治疗后两组IL-17与LTB_4水平较治疗前显著降低,且观察组低于对照组,差异有统计学意义(P <0.05);两组治疗后WBC、NeutroPhil、CD8^+较治疗前显著下降,且观察组低于对照组,差异有统计学意义(P <0.05);两组治疗后CD3+、CD4^+、CD4^+/CD8^+较治疗前显著升高,且观察组高于对照组,差异有统计学意义(P <0.05);两组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论:痰热清注射液治疗COPD的效果显著,可调节炎症因子IL-17与LTB_4水平,提高患者免疫力。

Objective:To investigate the effect of tanreqing injection on plasma leukotriene(LT)B4,interleukin(IL)-17 levels and immune imbalance in patients with chronic obstructive pulmonary diseases(COPD).Methods:116 patients with COPD hospitalized in Respiratory Department of our hospital from May 2015 to May 2017 were divided into a treatment group and a control group,58 cases each.The patients in the control group received conventional treatment,and the patients in the observation group were treated with tanreqing injection(20 mL injection was added to 5%glucose injection 250 mL,ivgtt,qd)on the basis of the control group.The therapeutic effect,safety,lung functions,plasma IL-17,LTB4 levels,total white blood cell count(WBC),neutrophil value,T lymphocyte subsets and other indexes before and after treatment were compared between the two groups.Results:The total effective rate in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The levels of forced expiratory volume in one second(FEV1)and FEV1/forced vital capacity(FVC)after treatment in two group were higher than those before treatment and the levels in the observation group were higher than those in the control group,and the scores of improved British Medical Research Council Respiratory Questionnaire(mMRC)after treatment in two group were lower than those before treatment and the scores in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The levels of IL-17 and LTB4 after treatment in two group were significantly lower than those before treatment,and the levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The levels of WBC,NeutroPhil and CD8+after treatment in two group were significantly lower than those before treatment,and the levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Tanreqing has a significant therapeutic effect on COPD,which can regulate the levels of inflammatory factors IL-17 and LTB4 and improve the immunity of the patients.