加味玉屏风散对慢性阻塞性肺疾病急性加重期患者肺功能和细胞因子的影响

Influence of modified Yupingfeng Pulvis on lung function and cytokines in patients with chronic obstructive pulmonary disease at acute exacerbation stage

目的观察加味玉屏风散对慢性阻塞性肺疾病(COPD)急性加重期患者肺功能和血清中白细胞介素(IL)-17和IL-8的影响,为加味玉屏风散干预治疗COPD提供理论依据。方法将62例急性COPD患者随机分为加味玉屏风散治疗组(31例)和病例对照组(31例)。对照组给予常规治疗;治疗组在常规治疗基础上加用加味玉屏风散,8周后观察2组临床疗效以及治疗前后的肺功能第1秒用力呼气量占预计值百分比(FEV1%)、总气道阻力(R5)和共振频率变化;采用酶联免疫吸附试验法(ELISA)测定血清IL-8I、L-17的水平。结果①加味玉屏风散治疗组的总有效率(87%)较对照组总有效率(68%)升高,且差异有统计学意义(P<0.05)。②2组的FEV1%经过治疗后,均较治疗前升高,差异有统计学意义(P<0.05);治疗组较对照组FEV1%升高,且差异有统计学意义(P<0.05);R5、共振频率2组治疗后较治疗前明显下降,且治疗组较病例对照组下降,差异有统计学意义(P<0.05)。③2组血清IL-17I、L-8水平治疗后均较治疗前明显下降(P<0.05);治疗后治疗组较对照组有明显下降,差异有统计学意义(P<0.05)。结论中药玉屏风散对COPD患者可下调IL-17I、L-8水平,并改善患者肺功能。

Objective To observe the effect of Yupingfeng Pulvis on pulmonary function and serum cytokines in patients with acute exacerbation chronic obstructive pulmonary diseases（AECOPD）, so as to provide theoretic basis for Yupingfeng Pulvis to cure COPD. Methods （1）Sixty-two patients with AECOPD were selected from Department of Respiration. They were randomly divided into two groups： case control group （conventional therapy） and therapy group （conventional therapy combined with modified Yupingfeng Pulvis）. Meanwhile 30 healthy volunteers, who underwent physical examination, were taken as the normal control group. （2）the percentage of FEV1/anticipated value（FEV1 %）and total airway resistance value（R5 ） and resonance frequency value（Fres）were measured by the pulmonary function meter; Changes of serum cytokines of AECOPD patients were determined with the method of enzyme-linked immunoabsordent assay （ELISA） before and after treatment respectively. Resuits （1）The total effective rates were 87% and 68%0 in the therapy group and the case control group, respectively. （2）In AECOPD patients before treatment, FEV1%were significantly lower than those of normal control group; while R5, Fres, IL-17 and IL-8 levels were significantly higher than those of normal control group（P〈0.05）. In case control group and therapy group after treatment, FEV1% with AECOPD patients was significantly higher than those before treatment（P〈0. 05） ; while R5 and Fres in case control group or therapy group after treatment were significantly lower than those of before treatment（P〈0. 05）. FEV1 % were obviously higher while R5 and Fres were obviously lower in therapy group after 8 weeks treatment than in case control group（P〈0. 05）. （3）In case control group and therapy group after treatment, IL-8 and IL-17 levels in AECOPD patients were obviously lower than those before treatment（P〈0. 05）. IL-17 and IL-8 levels were obviously lower in therapy group after 8 weeks treatment than in case control group（P〈0. 05）. Conclusion Yupingfeng Pulvis can down-regulate the IL- 17 and IL-8 levels, and improve pulmonary function in AECOPD patients.