加味涤痰汤对老年阻塞性睡眠呼吸暂停低通气综合征患者氧化应激和炎性反应的干预作用

Intervention effects of Jiawei Ditan Decoction on oxidative stress and inflammatory response in elderly patients with obstructive sleep apnea hypopnea syndrome

目的探讨加味涤痰汤治疗老年阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的临床疗效及对氧化应激、炎性反应的干预作用。方法入选气虚痰淤互结型老年阻塞性睡眠呼吸暂停低通气综合征患者60例，随机分为治疗组30例，予以加味涤痰汤联合一般性治疗，对照组30例仅以一般性治疗，疗程为12周。观察两组患者治疗前后临床症状积分、Epworth嗜睡量表（ESS）评分、睡眠呼吸暂停低通气指数（AHI）值、最低血氧饱和度（SaO2）、血清超氧化物歧化酶（SOD）、丙二醛（MDA）、肿瘤坏死因子（TNFa）、白细胞介素6（IL-6）、C-反应蛋白（CRP）情况。结果治疗后治疗组患者临床症状积分、AHI值、最低SaO2、ESS评分、SOD、MDA、TNF-α、IL-6、CRP分别为（11．65±3．82）分、（21．18±12．37）次／h、（83．24±7．42）％、（7．12±4．84）分、（99．24±13．15）×10^3U／L、（8．56±3．23）μmol／L、（50．63±10．57）ng／L、（78．12±15．92）ng／L、（9．93±5．25）mg／L，均较治疗前（14．32±4．25）分、（29．16±13．58）次／h、（76．92±11．91）％、（10．0l士4．16）分、（87．51±14．82）×10^3U／L、（11．25±3．41）μmol／L、（58．92±11．65）ng／L、（89．13±16．54）ng／L、（13．59±4．92）mg／L改善（t=2．559、2．379、2．467、2．480、3．243、3．137、2．887、2．651、2．786，均P〈0．05），与对照组（13．89±4．45）分、（28．03±13．12）次／h、（78．26±10．15）％、（9．56±4．56）分、（90．13±13．56）×10^3U／L、（10．86±3．65）μmol／L、（56．52±11．04）ng／L、（87．81±15．61）ng／L、（12．97±5．03）mg／L比较差异有统计学意义（t=2．092、2．018、2．169、2．009、2．642、2．585、2．111、2．380、2．290，均P〈0．05）。结论加味涤痰汤可改善老年0sAHS患者的临床症状，对氧化应激及炎性反应具有保护作用，为中药治疗老年人OSAHS奠定了基础。

[Abstract] Objective To investigate the intervention effects of Jiawei Ditan Decoction on oxidative stress and inflammatory reaction in elderly patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods A total of 60 OSAHS patients with deficiency of phlegm and blood stasis mutual junction were enrolled, and randomly divided into treatment group （n= 30, receiving JiaweiDitan Decoction＋ conventional treatment for 12 weeks） and control group （n= 30, receiving conventional treatment for 12 weeks）. The clinical symptoms integral, Epworth Sleepiness Scale （ESS）, apnea hypopnea index （AHI）, minimum oxygen saturation （SaO2）, superoxide dismutase （SOD）, malondialdehyde （MDA）, tumor necrosis factor （TNF）-α interleukin （IL）-6, and C-reactive protein （CRP） were observed before and after treatment. Results The clinical symptoms integral, AHI value, minimum SaO2, ESS score, levels of SOD, MDA, TNF-α, IL-6 and CRP were significantly improved in treatment group after treatment as compared with pretreatment （（11.65±3.82）point、（21.18±12.37）points、（83.24±7.42）%、（7.12±4.84）points、（99.24±13.15）×10^3U/L、（8.56±3.23）μmol/L、（50.63±10.57）ng/L、（78.12±15.92）ng/L、（9.93±5.25）mg/L,vs（14.32±4.25）分、（29.16±13.58）/h、（76.92±11.91）%、（10.0l士4.16）points、（87.51±14.82）×10^3U/L、（11.25±3.41）μmol/L、（58.92±11.65）ng/L、（89.13±16.54）ng/L、（13.59±4.92）mg/L （t=2.559、2.379、2.467、2.480、3.243、3.137、2.887、2.651、2.786,P〈0.05）,（13.89±4.45）points、（28.03±13.12）次/h、（78.26±10.15）%、（9.56±4.56）分、（90.13±13.56）×10^3U/L、（10.86±3.65）μmol/L、（56.52±11.04）ng/L、（87.81±15.61）ng/L、（12.97±5.03）mg/L, t=2.092, 2.018, 2.169, 2.009, 2.642, 2.585, 2. 111, 2. 380, 2.290, respectively, all P〈0.05. Conclusions Jiawei Ditan Decoction could improve the clinical symptoms and has the intervention effect on oxidative stress and inflammatory reaction in elderly patients with OSAHS, which provides the experimental basis for the treatment of senile OSASH with Chinese herbal medicine.