中医药治疗稳定期慢性阻塞性肺疾病作用机制研究述评

Research Review on the Mechanism of Traditional Chinese Medicine in Treating for Chronic Obstructive Pulmonary Disease

中医药治疗稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)主要为缓解患者的临床症状、减少急性加重的情况、增强免疫力、改善患者的生活质量。研究多采用肺功能的指标作为评判的金标准并对疾病进行分级,在辨证中标准较为统一,但是研究中还存在一定的不足:1临床研究与基础研究结合得还不够紧密,一些临床研究只是给出临床疗效,其机制并没有阐述;一些长期的临床研究的经典方剂并没有被开发为上市的成药。2分组上单盲、随机、对照设计为主,少有研究采用更有判断意义的双盲、对照、随机的方法进行设计。中医药对于稳定期的COPD具有其治疗优势,表现为不仅仅对于某一个指标的升高降低,而是在治疗过程中对多靶点、多个环节途径的平衡调节作用,达到各个相关指标的平衡点。今后在稳定期COPD的中医药治疗上应该从调节抗氧化与氧化体系平衡、细胞因子的平衡、收缩与舒张血管物质的平衡上进行多中心大样本的细化研究,将中医药对该病的治疗优势阐述得更加清楚,提高中医药治疗该病的水平。

Treating for chronic obstructive pulmonary disease （ chronic obstructive pulmonary diseases with TCM, COPD） , can alleviate patient＇s clinical symptoms, reduce the number of exacerbations, enhance immunity and improve the patient＇s quality of life. Current re- search generauy uses the index of pulmonary function as the gold standard to carry on the classification of disease with, a unified stand- ard in the syndrome differentiation. However,there are certain deficiencies in the study field：（~）Clinical and basic theoretical research are not united closely enough. Some clinical research gives the clinical curative effect but its mechanism has not explained. Besides, some of the classic formula with long-term clinical study has not been developed as standard medicine. （~）Priority is given to single blind, random, controlled design in grouping. There is few research using double-blind, controlled, and random method in the design. Chinese medicine treatment has its advantages on stabilization of COPD, not just for the rising or reducing of a single index, but the bal- ancing adjustment of multiple targets and multiple link was in the process to achieve the balance of all relevant indicators. The future Chinese medicine treatment on COPD stabilization should be oxidation and oxidation system balance, the balaning of cytokineing, systol- ic and diastolic blood vessels, with detailed study with multicenter and large sample.