苓桂咳喘宁胶囊辅助治疗慢性阻塞性肺疾病急性加重期痰湿阻肺证疗效及对血清炎症因子和免疫功能的影响

Effects of Linggui Kechuanning Capsule on Inflammatory Cytokines and Immunity in Patients with Acute Exacerbation of COPD with Syndrome of Phlegm-Damp Obstructing Lung

目的：观察苓桂咳喘宁胶囊辅助治疗慢性阻塞性肺疾病（COPD）急性加重期痰湿阻肺证患者的疗效,并分析其对血清炎症因子和免疫功能的影响。方法：选取2014年7月—2016年6月期间住院治疗的COPD急性加重期痰湿阻肺证患者115例,随机分为两组。对照组57例,给予常规西药治疗,观察组58例,在对照组基础上加用苓桂咳喘宁胶囊口服,两组共治疗14 d。比较两组患者的临床疗效,以及血清炎症因子和T细胞亚群的变化情况。结果：观察组56例完成研究,对照组54例完成研究,两组疗效的差异具有统计学意义（Z=2.439,P=0.015）。治疗前,两组患者C反应蛋白（CRP）、白介素（IL）-6和肿瘤坏死因子（TNF）-α的差异均无统计学意义（P〉0.05）;治疗后,两组CRP、IL-6、TNF-α均较同组治疗前明显下降（观察组t=16.274、11.646、15.634,P〈0.001;对照组t=11.215、4.323、9.859,P〈0.001）,且两组治疗后的差异具有统计学意义（t=4.349、6.563、5.004,P〈0.001）。治疗前,两组患者CD3＋细胞、CD4＋细胞、CD8＋细胞及CD4＋/CD8＋的差异均无统计学意义（P〉0.05）;治疗后,观察组CD3＋细胞、CD4＋细胞及CD4＋/CD8＋升高（t=3.824、7.618、5.343,P〈0.001）,CD8＋细胞下降（t=4.425,P〈0.001）,而对照组仅CD4＋/CD8＋出现下降（t=2.270,P=0.025）,两组治疗后CD3＋、CD4＋、CD8＋及CD4＋/CD8＋的差异均具有统计学意义（t=2.608、5.013、2.639、3.076,P〈0.05）。结论：苓桂咳喘宁胶囊辅助治疗COPD急性加重期痰湿阻肺证患者疗效确切,有助于降低血清炎症因子及改善免疫功能。

Objective： To investigate therapeutic effects of Linggui Kechuanning Capsule in patients with acute exacerbation and syndrome of phlegm-damp obstructing lung of chronic obstructive pulmonary disease（ COPD）,and its effect on serum inflammatory cytokines and immunity. Methods： A total of 115 patients with acute exacerbation of COPD（ AECOPD） and syndrome of phlegm-damp obstructing lung from July 2014 to June 2016 were randomly divided into two groups. The control group（57 cases） was given conventional Western medicine,while the observation group（58 cases）was additionally treated with Linggui Kechuanning Capsule orally. Both groups were treated for 14 days. We compared the clinical efficacy,inflammatory cytokines and T cell subsets between two groups. Results： The difference in clinical efficacy was statistically significant（ Z = 2. 439,P = 0. 015）,with 56 and 54 patients completed the study,respectively.There was no significant difference in C-reactive protein（ CRP）,interleukin-6（ IL-6） or tumor necrosis factor（TNF）-α between two groups before treatment（P 〉0. 05）. After treatment,they all significantly decreased in two groups（ t = 16. 274,11. 646,15. 634,P 〈0. 001; t = 11. 215,4. 323,9. 859,P 0. 001）,and the difference between two groups was also significant（ t = 4. 349,6. 563. 5. 004,P 〈0. 001）. There was no significant difference in CD3＋ cells,CD4＋ cells,CD8＋ cells or CD4＋/CD8＋ between two groups before treatment（ P 〉0. 05）. After treatment,the levels of CD3＋,CD4＋ and CD4＋/CD8＋ were increased,and CD8＋ was decreased in observation group（ t = 3. 824,7. 618,5. 343,4. 425,P 0. 001）,while only CD_4~＋/CD_8~＋ was increased in control group（ t = 2. 270,P = 0. 025）. After treatment,the difference in CD3＋,CD4＋,CD8＋ and CD4＋/CD8＋ was statistically significant between two groups（ t = 2. 608,5. 013,2. 639,3. 076,P 〉0. 05）. Conclusions： Linggui Kechuanning Capsule is effective in the treatment of acute exacerbation of COPD with syndrome of phlegm-damp obstructing lung,which can help to reduce the inflammatory cytokines and improve the immune function.