山腊梅叶健脾汤对急性加重期慢性阻塞性肺疾病T淋巴细胞亚群的影响

Efficacy of Shanla Meiye Jianpi Decoction for Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Its Effects on Serum Levels of Peripheral T-Lymphocyte Subpopulations

目的:观察山腊梅叶健脾汤治疗慢性阻塞性肺疾病急性加重期的临床疗效及对外周血T淋巴细胞亚群的影响。方法:将93例慢性阻塞性肺疾病急性发作期患者随机分为观察组48例和对照组45例,对照组给予西医常规治疗,观察组在上述基础上加服山腊梅叶健脾汤,每日1剂,疗程2~3周。比较两组临床疗效及治疗前后中医证候积分、动脉血气分析、肺功能指标及外周血T淋巴细胞亚群变化。结果:观察组临床总有效率为93.75%,对照组为75.55%,两组比较差异有统计学意义(P<0.05)。与治疗前相比,两组患者中医证候积分均改善(P<0.05),且观察组改善明显优于对照组(P<0.05)。与治疗前相比,两组患者治疗后动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)均改善(P<0.05),且观察组改善明显优于对照组(P<0.05)。与治疗前相比,两组患者治疗后第一秒用力呼气量(FEV1)、第一秒用力呼气量占预计值的百分比(FEV1%pred)、最大呼气流速(PEFR)、第一秒用力呼气量占用力肺活量的百分比(FEV1/FVC)均改善(P<0.05),且观察组改善明显优于对照组(P<0.05)。治疗后观察组CD_3^+、CD_4^+、CD_4^+/CD_8^+上升(P<0.05),对照组CD_3^+上升(P<0.05),治疗后观察组CD_3^+、CD_4^+、CD_4^+/CD_8^+均高于对照组(P<0.05)。结论:山腊梅叶健脾汤能有效改善慢性阻塞性肺疾病急性加重期患者中医证候积分、动脉血气、肺功能;提高免疫功能。

Objective ： To observe the therapeutic effect of Shanla Meiye Jianpi Decoction （SMJD） for AECOPD and its effects on serum levels of peripheral T - lymphocyte subpopulations. Methods ： Ninety - three patients with AECOPD were randomized into the observation group（48 cases） and control group （45 cases）. The control group was given routine west- eru medicine. The observation group added SMJD one dose a day. The treatment lasted 2 - 3 weeks. The efficacy and the changes of TCM symptoms scores, arterial blood gas analysis, lung function and serum peripheral T - lymphocyte subpopu- lations were observed and compared. Result： The total effective rate of the observation group and control group was 93.75% and 75.55% respectively,with a significant difference between groups （P 〈 0.05）. The scores of TCM symp- toms were significantly decreased in both groups after treatment （ P 〈 0.05 ）, especially in the observation group （ P 〈 0. 05 ）. The values of PaO2and PaCO2 were significantly improved in both groups after treatment （P 〈 0.05 ） , especially in the observation group （ P 〈 0.05 ）. The forced expiratory volume in first second （ FEV1 ）, FEV1% pred, peak expirato- ry flow rate（ PEFR） and the percentage of forced expiratory volume in first second/forced vital capacity （FEV1/FVC） were significantly improved in both groups after treatment （ P 〈 0.05 ）, especially in the observation group （ P 〈 0. 05 ）. The CD3＋ , CD4＋ and CD4＋/CD8＋ of observation group and the CD3＋ of control group were significantly improved after treat- ment （ P 〈 0.05 ）. The CD3＋ , CD4＋ and CD4＋/CD8＋ of observation group were higher than those of the control group after treatment （P 〈 0. 05 ）. Conclusion ： SMJD has significant effect on improving the scores of TCM symptoms, arterial blood gas and lung function of patients with AECOPD, improving the immune function.