岩盐气溶胶疗法对尘肺患者痰液炎性因子水平的影响

Effect of halotherapy on levels of sputum inflammatory factors in patients with pneumoconiosis

目的通过分析尘肺患者采用岩盐气溶胶治疗前后痰液中白介素6(IL-6)、白介素8(IL-8)和肿瘤坏死因子α(TNF-α)的水平,了解该疗法对尘肺患者的临床作用。方法选取6家医院于2016年11月—2017年4月收治的389例尘肺患者为研究对象,按照尘肺期别分层,随机分为治疗组和对照组,治疗组在常规治疗的基础上加做岩盐气溶胶治疗,分别在治疗前、治疗后2周和治疗后4周收集患者晨痰,经处理后检测标本中IL-6、IL-8和TNF-α的水平,并对结果进行分析。结果治疗组和对照组的痰液炎性因子水平治疗前分别为[(243.97±27.98)pg/ml比(239.86±34.80)pg/ml,(1 480.01±226.39)pg/ml比(1 463.34±234.96)pg/ml,(720.73±132.76)pg/ml比(711.59±152.85)pg/ml],治疗2周后,IL-6、IL-8、TNF-α水平治疗组低于对照组[(213.72±31.93)pg/ml比(208.42±33.38)pg/ml,(1 392.23±231.46)pg/ml比(1 416.73±224.81)pg/ml,(683.23±143.56)pg/ml比(721.33±145.85)pg/ml],治疗后4周后IL-6、IL-8和TNF-α水平治疗组均低于对照组[(169.49±19.43)pg/ml比(195.38±21.95)pg/ml,(1 233.21±141.90)pg/ml比(1 309.94±189.59)pg/ml,(578.82±96.72)pg/ml比(651.62±131.32)pg/ml],治疗组和对照组随着治疗时间的延长均有所下降,且各观察时点之间的差异有统计学意义(P<0.05);治疗后各观察时点IL-6、IL-8和TNF-α的变化水平,治疗组均大于对照组,治疗后4周差异有统计学意义(P<0.05)。结论岩盐气溶胶疗法可以降低尘肺患者痰液中炎性因子IL-6、IL-8和TNF-α的水平,在常规治疗基础上加用岩盐气溶胶疗法可以更好的降低患者气道炎性反应,治疗效果更优,可为尘肺病临床治疗提供一种有效的辅助方法。

[Objective] To analyze the levels of inflammatory factors IL-6, IL-8 and TNF-α in sputum of patients with pneumoconiosis before and after halotherapy, explore the clinical effect of the therapy on patients with pneumoconiosis. [Methods] A total of 389 patients with pneumoconiosis were selected from six hospitals during November 2016 to April 2017, the patients were stratified according to pneumoconiosis stage and were randomly divided into the treatment group and the control group. The treatment group was given halotherapy on the basis of conventional treatment. The morning sputum samples were collected before treatment, two weeks and four weeks after treatment, and the levels of IL-6, IL-8 and TNF-α in the samples were detected. The results were analyzed. [Results] Before treatment, the levels of IL-6, IL-8 and TNF-α in the treatment group and the control group were [（243.97±27.98） pg/ml vs （239.86±34.80） pg/ml, （1 480.01±226.39） pg/ml vs （1 463.34±234.96） pg/ml, （720.73±132.76） pg/ml vs （711.59±152.85） pg/ml] respectively .treatment After two weeks of treatment, the levels of IL-6, IL-8 and TNF-α in the group were lower than those in the control group [（213.72±31.93） pg/ml vs （208.42±33.38） pg/ml, （1 392.23± 231.46） pg/ml vs （1 416.73±224.81 ） pg/ml, （683.23±143.56） pg/ml vs （721.33±145.85） pg/ml]. After four weeks of treatment, the levels of IL-6, IL-8 and TNF-α in the treatment group were lower than those in the control group [（169.49±19.43） pg/ml vs （195.38±21.95） pg/ml, （1 233.21±141.90） pg/ml vs （1 309.94±189.59） pg/ml, （578.82±96.72） pg/ml vs （651.62±131.32） pg/ml].The levels of IL-6, IL-8 and TNF-α in both treatment group and the control group decreased with treatment duration, and there were statistically significant differences among different observation time points （P〈0.05）. After treatment, the change levels of IL-6, IL-8 and TNF-α in the treatment group were higher than those in the control group at observation time point, and the difference after four weeks of treatment was statistically significant （P〈0.05）. [Conclusion] Halotherapy can reduce sputum inflammatory factor IL-6, IL-8 and TNF-α concentrations in patients with pneumoconiosis. Adding halotherapy based on routine treatment can better reduce airway inflammation sexual response, get better treatment effect and provide an effective adjunct for the clinical treatment of pneumoconiosis.