中药配合CPAP对阻塞性睡眠呼吸暂停低通气综合征呼气冷凝液中炎症因子的影响

Treatment of CPAP Combined with Traditional Chinese Medicine for Inflammatory Factors in Exhaled Breath Condensate of Patients with Obstructives Sleep Apnea-hypopnea Syndrome

目的:探讨中药配合持续气道正压通气(CPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)呼气冷凝液中炎症因子的影响及意义。方法:60例OSAHS患者随机分成观察组(CPAP+中药组)和对照组(CPAP组)各30例,另设10名健康人员作为健康对照组。OSAHS组患者采用CPAP治疗,疗程12周;观察组在此基础上采用鲜竹沥口服液(20 mL/次,2次/d)、清咽滴丸(4～6粒,3次/d)及冰蛹通脉含片(舌下含服,l片/次,3次/d),疗程4～6周。分别于治疗前和治疗后3个月收集呼出气冷凝液(EBC),检测EBC中的炎症指标白介素-6(IL-6),白介素-8(IL-8),肿瘤坏死因子-α(TNF-α)的变化情况。结果:对照组和观察组治疗前呼气冷凝液中IL-6,TNF-α的含量均明显高于健康对照组(P<0.01);治疗后两组呼吸暂停低通气指数(AHI)均明显下降(P<0.01),夜间最低氧饱和度均明显上升(P<0.01),呼出气冷凝液中IL-6,TNF-α的含量均较治疗前明显降低(P<0.05);观察组上述指标的改善优于对照组(P<0.01);观察组总有效率90.0%,优于对照组的56.66%(P<0.01)。结论:中药配合CPAP治疗OSAHS能达到减轻气道炎性反应,提高临床疗效。

Objective： To examine the effect of treatment of continuous positive airway pressure （CPAP） combined with traditional Chinese medicine on inflammation factors in exhaled breath condensate （EBC） of patients with obstructives sleep apnea-hypopnea syndrome （OSAHS）. Method： Sixty OSAHS patients were divided into two groups： control group （CPAP group）, observe group （CPAP with traditional Chinese medicine group）, each 30 cases, and another 10 cases of health people as normal group.Control group was received CPAP and observation group received CPAP with traditional Chinese medicine.Traditional Chinese medicine were Xianzhuli oral liquid（20 mL, bid）, Qingyandi pill（4-6 pills tid） and Bingyong Tongmai lozenge （l piece under tongue, tid）.We collected the patient＇s EBC before treatment and 3 months after treatment and analized the inflammation factors of interleukin-6（IL-6）, interleukin-8（IL-8）, tumor necrosis factor （TNF-α） in EBC. Result： The concentration of IL-6 and TNF-α in control group and observation group were significant higher than those in normal group （P〈0.01）.After treatment, apnea-hypopnea index （AHI） of control group and observation group was decreased significantly than those before treatment （P〈0.01）.Night minimum oxygen saturation of control group and observation group were increased significantly than those before treatment （P〈0.01）.The concentration of IL-6 and TNF-α in control group and observation group were significant lower than those before treatment （P〈0.01）.The improving of indexes in observation group was better than those in control group（P〈0.01）.The effective rate in observation group （90.0%） was better than that in control group（56.66%） （P〈0.01）. Conclusion： Treatment of CPAP combined with traditional Chinese medicine can decrease the inflammatory reaction in patients of OSAHS to improve the effect.