中药喘可治注射液联合糖皮质激素与支气管舒张剂雾化吸入对AECOPD患者炎症因子及免疫功能的影响

Effects of Atomization Inhalation of Chuan Ke Zhi Combined with Corticosteroid and Bronchodilators on Serum Inflammatory Cytokines and Immune Function in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:评价中药喘可治注射液联合糖皮质激素与支气管舒张剂雾化吸入治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效及对患者血清炎症因子与免疫功能的影响。方法:将符合评价标准的患者随机分为治疗组与对照组,治疗组在常规处理的基础上给予喘可治联合布地奈德(普米克令舒)与复方异丙托溴铵(可必特)雾化吸入,对照组单纯雾化吸入普米克令舒与可必特,疗程为14 d。观察两组临床疗效及安全性,检测治疗前后患者肺功能及血清超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)和肿瘤坏死因子(TNF-α)和T淋巴细胞亚群CD3^+、CD4^+、CD4^+/CD8^+的变化情况。结果:治疗组临床疗效优于对照组(P<0.05),且无明显不良反应;在改善患者FEV1%预计值、FEV1/FVC值,降低血清hs-CRP、IL-6和TNF-α水平,升高CD3^+、CD4^+、CD4^+/CD8^+方面,治疗组均明显优于对照组(P<0.05或P<0.01)。结论:喘可治联合普米克令舒、可必特雾化吸入对AECOPD安全有效,且能有效降低血清炎症因子水平、改善临床症状和免疫功能。

Objective： To evaluate the clinical efficacy of atomization inhalation of Chuan Ke Zhi with corticosteroid and bronchodilators in treating patients with acute exacerbation of chronic obstructive pulmonary disease（ AECOPD）,and its effects on serum level of inflammatory cytokines and immune function. Methods： Patients meeting the evaluation criteria were randomly divided into treatment group and control group. The treatment group was given atomization inhalation of the Chuan Ke Zhi with Budesonide（ Pulmicort） and Compound Ipratropium Bromide（ Combivent） based on western medicine,while the control group was given atomization inhalation of Pulmicort and Combivent. The therapeutic course was 14 days. The clinical effects,safety,pulmonary function and the serum levels of hs-CRP,IL-6,TNF-α and CD3^＋,CD4^＋,CD4^＋/ CD8^＋were observed before and after treatment. Results： Compared with control group,the effective rates were higher in treatment group,without obvious side effects（ P〈0. 05）. There were significant differences between treatment group and control group in improving FEV1% pred and FEV1/ FVC% level,decreasing the serum levels of hs-CRP,IL-6 and TNF-α,and increasing the levels of CD3^＋,CD4^＋and CD4^＋/ CD8（ P〈0. 05,P〈0. 01）. Conclusion： Aomization inhalation of Chuan Ke Zhi with Pulmicort and Combivent therapy shows excellent clinical effectiveness in treating AECOPD patients without obvious side effects,and can decrease serum inflammation level,improve clinical symptoms and immune function.