清肺化痰逐瘀汤对慢性阻塞性肺疾病急性加重期患者T淋巴细胞的干预研究

Intervention study of Qingfei-huatan-zhuyu decoction on T-lymphocyte in patients with acute exacerbation of chronic obstructive pulmonary disease

目的观察清肺化痰逐瘀汤对慢性阻塞性肺疾病急性加重期(AECOPD)患者肺泡灌洗液(BALF)及血清中T淋巴细胞的干预作用。方法将60例AECOPD患者随机分为2组,另选取健康老年人28人作为健康组。对照组30例予西医常规治疗,治疗组30例在对照组治疗基础上应用清肺化痰逐瘀汤治疗。2组均治疗14 d。于治疗前及治疗结束后第2 d检测患者BALF液及血清CD4^+、CD8^+及CD4^+/CD8^+T淋巴细胞,比较2组疗效。结果总有效率治疗组93.33%,对照组76.67%,2组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。治疗组治疗后BALF液、血清CD4^+、CD4^+/CD8^+均较本组治疗前升高(P<0.05),CD8^+降低(P<0.05);治疗组治疗后BALF液、血清CD4^+、CD4^+/CD8^+均高于对照组(P<0.05),CD8^+低于对照组(P<0.05);治疗组治疗后BALF液、血清CD4^+、CD4^+/CD8^+均低于健康组(P<0.05),CD8^+高于健康组(P<0.05);治疗组、对照组治疗前BALF液、血清CD4^+、CD4^+/CD8^+均低于健康组(P<0.05),CD8^+高于健康组(P<0.05)。结论 AECOPD患者存在细胞免疫功能下降和T淋巴细胞介导的肺部炎性损伤,清肺化痰逐瘀汤联合西医常规治疗可有效改善症状及细胞免疫状态。

Objective To observe the effects of Qingfei - huatan - zhuyu decoction on T - lymphocyte of the serum and bronchoalveolarlavage fluid（BALF）in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods 60 patients with AECOPD were randomly divided into two groups,another 28 healthy elderly were selected as healthy group. The control group（n = 30）received western routine treatment,the treatment group（n = 30）received Qingfei - huatan - zhuyu decoction on the basis of control group treatment,continuously treatment for 14 d. The CD4 ^＋ ,CD8 ^＋ and CD4 ^＋ / CD8 ^＋ in serum and BALF before and 2 d after treatment were observed in two groups,and the curative effect was compared. Results The total effective rate in treatment and control group was 93. 33% and 76. 67% ,respectively. The total curative effect in treatment group was superior to that in control group（P 〈 0. 05）. The CD4 ^＋ and CD4 ^＋ / CD8 ^＋ in serum and BALF after treatment were increased in treatment group（P 〈 0. 05）,the CD8 ^＋ was decreased（P 〈 0. 05）. The CD4 ^＋ and CD4 ^＋ / CD8 ^＋ in serum and BALF after treatment in treatment group were higher than those in control group（P 〈 0. 05）,and the CD8 ^＋ was lower（P 〈 0. 05）. The CD4 ^＋ and CD4 ^＋ / CD8 ^＋ in serum and BALF after treatment in treatment group were lower than those in healthy group（P 〈 0. 05）,and the CD8 ^＋ was higher（P 〈 0. 05）. The CD4 ^＋ and CD4 ^＋ / CD8 ^＋ in serum and BALF before treatment in treatment and control group were lower than those in healthy group（P 〈 0. 05）,and the CD8 ^＋ was higher（P 〈 0. 05）. Conclusion The decrease of cellular immunity function and pulmonary inflammatory injury mediated by T - lymphocyte were existed in AECOPD. The Qingfei - huatan - zhuyu decoction combined with routing western medicine can effectively improve the symptoms and cellular immunity.