观察雷公藤多甙联合舒利迭治疗哮喘的临床疗效及探讨其治疗机制

Observation of the Therapeutic Efficacy of TP Joint SERETIDE and to Explore Its Mechanism

观察雷公藤多甙(TP)联合舒利迭(SERETIDE)与单纯吸入舒利迭对哮喘患者的治疗效果,并比较两种治疗后患者外周血中CD4+CD2+5调节性T(Treg)细胞的变化。选取西京医院呼吸内科门诊已确诊为哮喘的患者42例,随机分成甲、乙两组。甲组给予舒利迭(沙美特罗替卡松)吸入治疗,乙组给予舒利迭吸入治疗联合服用雷公藤多甙片治疗。采用流式细胞技术检测患者治疗前后外周血中CD4+CD2+5Treg细胞,同时测定哮喘患者肺功能并填写ACQ评分表。结果甲乙两组哮喘患者治疗前外周血中CD4+CD2+5Treg细胞占CD4+T细胞的百分比分别为1.45±0.56,1.44±0.58(P>0.05)无显著性差异。甲乙两种方法治疗4周后哮喘患者外周血中CD4+CD2+5Treg细胞占CD4+T细胞的百分比分别为5.35±0.54,6.97±0.87(P<0.05);FEV1占预计值百分比分别为98.8±13.8,103.6±16.8(P<0.05),ACQ评分表平均得分0.81±0.5,0.28±0.3(P<0.05)。发作期患者外周血CD4+CD2+5Treg细胞百分率与FEV1呈显著正相关(r=0.5982,P<0.01)。雷公藤多甙片联合舒利迭可有效治疗哮喘的发作,疗效明显优于单纯吸入舒利迭。

Compare with the therapeutic efficacy of anti--inflammatory and anti-asthmatic action of TP associate with SERETIDE and simply take in the SERETIDE, and evaluate the changes of CD4^＋ CD25^＋T cells in peripheral blood from patients with asthma, forty-two patients with asthma were included and are distributed to two groups （A or B） in random. （ Group A used the therapy of breathe in SERETIDE and group B used the method of TP associate with SERETIDE-treatment）. The proportion of CD4^＋ CD25^＋T cells population in total T ceils was evaluated by flow cytometric analysis. Pulmonary function was measured in forty-two patients. Then these patients completed with the ACQ. The population of CD4^＋CD25^＋ T cells in peripheral blood from patients of A group with asthma accounted for 5.35 ± 0.54% of the total number of CD4^＋T lymphocytes, and was much lower in comparison with B group （ P 〈 0.05 ）. The B group fig of FEV1 % prepared was 103.6 ± 16.8, and was much higher than A group （ P 〈 0.05 ）. The correlation analysis showed that CD4^＋ CD25^＋T cells from patients during acute attacks had significantly positive relation with FEV1 （ r = 0. 598 2, P 〈 0. 01 ）. It is conclused that TP joint SERETIDE is effective in the treatment of asthma, more effective than SERETIDE-treatment alone.