加味小青龙汤治疗慢性阻塞性肺病急性发作机理探讨

Mechanism of Modified Xiao Qing long Decoction in the Treatment of Acute Aggravation of Chronic Obstructive Pulmonary Disease

目的:探讨加味小青龙汤治疗慢性阻塞性肺病急性发作的作用机制。方法:选取寒痰内伏、气虚血瘀型慢性阻塞性肺病急性发作患者100例,采用密闭信封法随机分为中西医结合治疗组和西医对照组各50例。对照组患者采用常规西医治疗,治疗组患者在对照组治疗的基础上加服加味小青龙汤治疗,疗程结束后比较两组患者的治疗效果及血管内皮素-1、白细胞介素-8水平。结果 :治疗后两组患者症状均有所改善,治疗组患者总有效率显著高于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者血管内皮素-1(ET-1)和白介素-8(IL-8)水平均下降,与治疗前比较差异具有统计学意义(P均<0.01),且治疗组患者血管内皮素-1(ET-1)和白介素-8(IL-8)水平均明显低于对照组,差异具有统计学意义(P<0.01)。结论:加味小青龙汤可能是通过降低IL-8、ET-1含量,舒张收缩的肺血管,降低肺循环阻力,抑制炎症反应和组织损伤,增强机体免疫力等途径治疗慢性阻塞性肺气肿急性发作。

Objective： To explore the mechanism of modified Xiao Qing long decoction combined with western medicine on acute epi- sode of COPD. Methods ： Selection of TCM standard is cold sputum, deficiency of Qi and blood stasis type acute episode of COPD in 97 cases, closed envelope method was used in the therapeutic group（50 case） and control group（47case）. The treatment group was treated with modified Xiao Qing long decoction on the foundation treatment. On the fourteenth day, compared the therapeutic effect, endothelin-i, interleukin-8. Results： Therapeutic group＇s curative effect were better than others, （P〈0.05, P〈0.01）. After treat- ment, endothelin-1, interleukin-8 value declined （P〈0.01）, the therapeutic group changed even more （P〈0.01）. Conclusion： The remedy was no adverse reaction, and the effect was very well to COPD patients of acute aggravation with TCM standard of cold sputum, Qi deficiency and blood stasis. The mechanism of action may be with the relevant to the decrease of pulmonary circulation resistance, inhibition of inflammatory reaction and tissue damage.