基于扶阳思想探讨益肺宣肺汤对慢性阻塞性肺疾病的影响

Effect of Yifei Xuanfei Decoction on Chronic Obstructive Pulmonary Disease Based on Thought of Strengthening Yang

目的:基于扶阳思想观察益肺宣肺汤对慢性阻塞性肺疾病急性发作期炎症因子的影响,并探讨其作用机制。方法:随机将2015年1月—2016年6月收治的慢性阻塞性肺疾病急性加重期患者分为对照组与治疗组,各60例,对照组采用常规抗感染、化痰平喘等对证治疗,治疗组在此基础上加用益肺宣肺汤,检测治疗前后两组患者肺活量(forced vital capacity,FVC),1 s用力呼气量占预计值%(forced expiratory volume in 1 second,FEV_1%),FEV_1/FVC,超敏C反应蛋白(hypersensitive C reactive protein,hs-CRP),血沉(equivalent series resistance,ESR),白细胞介素-6(interleukin-6,IL-6),白细胞介素-8(interleukin-8,IL-8),白细胞介素-17(interleukin-17,IL-17),肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)水平,中医证候评分,复发率。结果:两组患者有效率比较差异无统计学意义。与治疗前比较,治疗后两组患者FEV_1,FEV_1/FVC均明显降低(P<0.05),两组患者比较差异无统计学意义。与治疗前比较,治疗后两组患者hs-CRP,ESR,IL-6,IL-8,IL-17,TNF-α,中医证候积分均明显降低(P<0.05),治疗后治疗组上述指标均明显低于对照组(P<0.05)。结论:益肺宣肺汤通过下调炎症因子,提高疾病证候评分,降低复发率,临床疗效以及远期疗效可观。

Objective： To explore the effect of Yifei Xuanfei decoction on inflammatory cytokines of chronic obstructive pulmonary disease at acute exacerbation stage based on the thought of strengthening Yang.Method： Patients with chronic obstructive pulmonary disease at acute exacerbation stage who were hospitalized from January 2015 to June 2016 were randomly divided into control group and treatment group,with 60 patients in each group. Control group received routine therapy for anti-infection,eliminating phlegm and relieving asthma. In addition to the therapy,treatment group was also given Yifei Xuanfei decoction. Before and after the treatment,forced vital capacity（FVC）,forced expiratory volume in 1 second（FEV1%）,FEV1/FVC,hypersensitive C reactive protein（hs-CRP）,equivalent Series Resistance（ESR）,interleukin-6（IL-6）,interleukin-8（IL-8）,interleukin-17（IL-17）,tumor necrosis factor-alpha（TNF-α）,syndrome score of traditional Chinese medicine（TCM） and the recurrence rate were detected. Result： The efficiency of two groups had no significant difference.Before and after the treatment,two groups showed significant reductions in FEV1 and FEV1/FVC（P〈0. 05）,with no statistically significant difference. Before and after the treatment,two groups showed significant reductions in hs-CRP,ESR,IL-6,IL-8,IL-17,TNF-alpha and comparison of TCM syndrome score（P〈0. 05）. The difference between groups was statistically significant（P〈0. 05）. Conclusion： Yifei Xuanfei decoction could down-regulate inflammatory factors,improve disease symptom and reduce the recurrence rate,with a considerable clinical efficacy and long-term efficacy.