辨证治疗方案对慢性阻塞性肺疾病患者全身炎症反应和T淋巴细胞亚群的影响

Influence of systemic inflammatory response and human T-cell subset numbers in stable chronic obstructive pulmonary disease by differentiation treatment with traditional Chinese medicine

目的评价中医综合治疗方案对慢性阻塞性肺疾病(COPD)稳定期患者的全身炎症反应因子和T淋巴细胞亚群的影响。方法 70例COPD稳定期患者随机分为试验组和对照组,两组均给予健康教育指导,对照组治疗参照相关诊疗指南制定稳定期治疗方案,试验组在对照组治疗基础上给予中医辨证分型治疗,治疗26 w,分别对C反应蛋白(CRP)、白介素-8(IL-8)和肿瘤坏死因子(TNF-α)和T淋巴细胞亚群进行分析。结果血清CRP、IL-8、TNF-α水平与健康组比较,试验组和对照组治疗前后均显著高于健康组(P<0.01);试验组与对照组治疗后均低于治疗前(IL-8除外,P<0.01)且试验组与对照组治疗后差异显著(P<0.05,P<0.01);血清CD3+T水平组间治疗前、治疗后比较均无统计学差异(P>0.05)。血清CD4+T水平与健康组比较,试验组治疗前有统计学差异(P<0.05);试验组治疗后高于治疗前(P<0.01);试验组高于对照组(P<0.05)。血清CD8+T水平试验组治疗后低于治疗前及对照组(P<0.05)。血清CD4+/CD8+水平与健康组比较,试验组治疗前较低(P<0.01);试验组疗后高于治疗前及对照组(P<0.01,P<0.05)。结论 COPD稳定期综合治疗方案具有显著临床疗效,可能与其降低血清IL-8、TNF-α和CRP水平,改善炎症损伤;改善外周血T淋巴细胞亚群相关指标,调节细胞免疫功能有关。

Objective To evaluate the influence of systemic inflammatory response factor and T lymphocyte subsets in stable chronic obstructive pulmonary disease （COPD） treated with associated method of traditional Chinese medicine （TCM）.Methods 35 patients were randomly selected from the test group and the control group,respectively,and to compare with 35 health examinees.Patients in test group were used fixed prescription of TCM therapy combined with Western standard treatment and the patients in control group received standard Western treatment.Patients of both groups were observed for 26 weeks,and levels of serum CRP,IL-8,TNF-oα were measured.T lymphocyte subsets were measured.Results There were no significant differences in all of the patients who were selected for sex,age,and so on.Before and after treatment,the serum CRP,IL-8 and TNF-α levels of the test group and the control group were higher than those of healthy group （P ＜0.01）.After treatment,the CRP and TNF-α levels of the two groups were lower than before （P ＜0.05）,and the levels in the test group were significantly lower than those of control group （P ＜ 0.01）.Before and after treatment,there were no significant statistical differences of the two groups in the level of CD3 ＋ （P ＞0.05）.Before treatment,the serum CD4 ＋ levels of the test group was lower than that of healthy group （P ＜ 0.05）.After treatment,the CD4 ＋ levels of test group was higher than before,and that of control group （P ＜ 0.01）.After treatment,the serum CD8 ＋ levels of the test group was lower than before and that of control group （P ＜ 0.05）.Before treatment,the serum CD4 ＋ / CD8 ＋ levels of the test group was lower than that of healthy group （P ＜ 0.05）.After treatment,the CD4 ＋ / CD8 ＋ levels of the test group were lower than before （P ＜ 0.01）,and the test group was higher than that of control group （P ＜ 0.05）.Conclusions The comprehensive therapeutic plan on patients with stable COPD has better efficacy,its mechanism may be related to reduce levels of the serum IL-8,TNF-α and CRP,improve inflammatory injury,improve T lymphocyte subsets in the peripheral blood,and regulate the cellular immune functional.