中西医结合治疗慢性阻塞性肺疾病急性加重期痰瘀阻肺证临床疗效及对炎性细胞因子、NF-κB的影响

Clinical Effects Investigation of Integrated Traditional Chinese and Western Medicine in Treatment of Patients with AECOPD and Influence on Levels of Inflammatory Cytokines and NF-kB

目的:探讨清肺活血中药辅助舒利迭治疗慢性阻塞性肺疾病急性加重期(AECOPD)痰瘀阻肺证临床疗效及对炎性细胞因子、NF-κB的影响。方法:研究对象选取医院2015年2月—2017年2月收治AECOPD痰瘀阻肺证患者共100例,随机分为对照组(50例)和观察组(50例),分别给予舒利迭单用治疗和在此基础上加用清肺活血中药辅助治疗,比较两组患者临床疗效,治疗前后主要证候积分、肺功能指标、血气分析指标、炎性细胞因子及NF-κB水平等。结果:观察组患者治疗总有效率显著高于对照组(P<0.05);观察组患者治疗后主要证候积分显著低于对照组、治疗前(P<0.05);观察组患者治疗后FEV1预计值、FEV1/FVC、PaO_2、PaCO_2及SaO_2水平均显著优于对照组、治疗前(P<0.05);观察组患儿治疗后hs-CRP、IL-10、TNF-α及NF-κB水平均显著优于对照组、治疗前(P<0.05)。结论:清肺活血中药辅助舒利迭治疗AECOPD痰瘀阻肺证可有效减轻相关症状体征,提高肺部通气功能,改善动脉血气指标,抑制机体炎症反应,并有助于调节NF-κB水平。

Objective： To investigate the clinical effects of Qingfei Huoxue Decoction combined with seretide in the treatment of patients with AECOPD and influence on the levels of inflammatory cytokines and NF - κB. Methods ： A total of 100 patients with AECOPD were chosen in the period from February 2015 to February 2016 in our hospital and randomly divided into control group （50 patients） with seretide used alone and observation group （50 patients） with Qingfei Huoxue Decoction on the basis of control group ; and the clinical effects, the main symptom score, the levels of lung function index, blood gas analysis index, inflammatory cytokines and NF - κB before and after treatment of both groups were compared. Results： The clinical effects of observation group were significantly better than those of the control group（ P 〈 0. 05 ）. The main symptom score after treatment of observation group was significantly lower than that of the control group and before treatment（P 〈0. 05）. The levels of FEV1 predicted value, FEV1/FVC, PaO2, PaCO2 and SaO2 after treat- ment of observation group were significantly better than those of the control group and before treatment（ P 〈 0. 05 ）. The levels of hs - CRP, IL - 10, TNF - α and NF - κB after treatment of observation group were significantly better than those of the control group and before treatment （ P 〈 0. 05 ）. Conclusion： Qingfei Huoxue Decoction combined with seretide in the treatment of patients with AECOPD can efficiently relieve the symptoms and signs, higher pulmonary ventilation function, improve arterial blood gas index, inhibit the body＇s inflammatory response and be helpful to regulate the level of NF - κB.