益气养阴活血化痰法对COPD稳定期免疫功能的影响及评价

Effect of the therapy of replenishing qi and nourishing yin and activating blood circulation to removing phlegm on the immunologic function in patients chronic obstructive pulmonary disease at stable phase.

目的：探讨益气养阴活血化痰法对慢性阻塞性肺疾病（COPD）患者体液免疫、细胞免疫功能及细胞因子的影响，为COPD稳定期的治疗提供依据。方法：采用单克隆抗体法、放射免疫法测定66例COPD稳定期患者服用益气养阴活血化痰中药3个月、6个月后和正常对照组（60例）免疫球蛋白IgA、IgG、IgM、T淋巴细胞亚群、白细胞介素-2（IL-2），肿瘤坏死因子α（TNF—α）的变化。结果：COPD稳定期CI）3、CD4、CD4／CD8低，与正常对照组比较有极显著性差异（p〈0．01），CD8^＋高，与正常对照组比较有极显著性差异（p〈0．01）；IgA、IgG、IgM均低，与正常对照组比较有极显著性差异（p〈0．01）；IL-2低，与正常对照组比较有显著性差异（p〈0．05），TNF—α高，与正常对照组比较有显著性差异（p〈0．05）。治疗后，治疗组上述各种指标均有明显改善（p〈0．05，p〈0．01）。结论：COPD稳定期存在体液和细胞免疫功能以及细胞因子的异常，益气养阴活血化痰法能改善COPD患者的免疫功能。

Objective To investigate the effects of the therapy of replenishing qi and nourishing yin and activating blood circulation to removing phlegm on the humoral immunity, cellular immunity and cytokines in patients with chronic obstructive pulmonary disease （COPD）, and to provide the basis for the treatment of COPD at stable phase. Methods The changes of immunoglobulin a （IgA）, IgG IgM, T lymphocyte subpopulation CD3 , CD4, CD8, CD4/CD8＋ ,IL-2 and TNF-α in 66 patients with chronic obstructive pulmonary disease at stable phase were detected by monoclonal antibody method and radioimmunoassay. The patients were orally given the traditional Chinese medicine with the effects of replenish qi and mourish yin and activate blood circulation to remove phlegm for six months. 60 healthy subjects served as the control group. Results The leved of CD3, CD4, CD4/CD8 in patients with COPD were significantly lower than those in control group （p〈0.01）, whereas CD8＋ was notbly increased （p〈0.01） ; IL-2 was obviously lower （p〈0.01） ; IgA, IgG and IgM were significantly lower （p〈0.05）, TNF-α was remarkably higher （p〈0.05）. All the indexes after treatment were improwed obviously （p〈0.05, p〈0.01）. Conclusion There are abnormalities in humoral immunity, cellular imunity and cytokines in patients with COPD at stable phase, the therapy of replenishing qi and nourishing yin and activating blood circulation to removing phlegm can improve he immunologic function in the patients with COPD.