连花清瘟胶囊联合维生素D治疗慢性阻塞性肺疾病对CAT、mMRC评分和Th17/Treg细胞因子平衡的影响

Effect of Lianhua Qingwen Capsule combined with vitamin D on CAT,mMRC score and Th17/Treg cytokine balance in the treatment of chronic obstructive pulmonary disease

目的观察连花清瘟胶囊联合维生素D治疗慢性阻塞性肺疾病(COPD)对患者自我评估测试(CAT)评分、呼吸困难评分(m MRC)和Th17/Treg细胞因子平衡的影响。方法将100例COPD患者随机分为2组,对照组50例给予骨化三醇胶丸(0. 25μg/次,3次/d)口服,观察组50例在对照组治疗基础上给予连花清瘟胶囊(4粒/次,3次/d)口服,疗程8周。观察2组治疗前后肺功能、CAT评分、m MRC评分和Th17/Treg细胞因子的变化情况。结果 2组治疗后慢性阻塞性肺疾病全球倡议(GOLD)肺功能分级均显著改善(P均<0. 05),观察组肺功能分级改善明显优于对照组(P <0. 05); 2组治疗后CAT评分中各项(咳嗽、咳痰、胸闷、爬坡、家务活动、户外运动信心、睡眠、精神)评分和总分均显著降低(P均<0. 05),观察组前5项评分和总分均明显低于对照组(P均<0. 05); 2组治疗后m MRC评分分级均显著改善(P均<0. 05),观察组改善情况明显优于对照组(P <0. 05); 2组治疗后血清Th17细胞因子(IL-17、IL-6)水平显著降低(P均<0. 05),而Treg细胞因子(IL-10、TGF-β1)水平显著升高(P均<0. 05),观察组上述细胞因子改善情况显著优于对照组(P均<0. 05)。结论连花清瘟胶囊联合维生素D能够显著改善COPD患者肺功能,减轻呼吸困难,有利于疾病的控制和预后康复,其机制可能与有效调节机体Th17/Treg细胞因子平衡有关。

Objective It is to observe the effects of Lianhua Qingwen Capsule combined with vitamin D on the self-assessment test(CAT)score,dyspnea score(mMRC)and Th17/Treg cytokine balance in patients with chronic obstructive pulmonary disease(COPD).Methods One hundred patients with COPD were randomly divided into two groups.50 patients in the control group were given calcitriol capsules(0.25μg/time,3 times/d)by oral administration,and 50 patients in the observation group were given Lianhua Qingwen Capsule(4 capsules/time,3 times/d)on the basis of the control group.Both groups were treated for 8 weeks.The changes of lung function,CAT score,mMRC score and Th17/Treg cytokine were observed before and after treatment in the two groups.Results The lung function grading of the Global Initiative for Chronic Obstructive Pulmonary Disease(GOLD)was significantly improved in both groups after treatment(P<0.05),and the improvements in the observation group were better than that in the control group(P<0.05).Each item of CAT scores(cough,cough,chest tightness,climbing,housework,outdoor sports confidence,sleep,spirit)and total scores were significantly decreased after treatment in the two groups(P<0.05),the first five scores and total scores of the observation group were lower than that of the control group(P<0.05);the mMRC scores of the two groups were significantly improved after treatment,and the improvement of the observation group was better than that of the control group(P<0.05).The levels of serum Th17 cytokines(IL-17,IL-6)were significantly decreased while the levels of Treg cytokines(IL-10,TGF-β1)were increased after treatment,and the improvement of cytokines in the observation group was better than that of the control group(P<0.05).Conclusion Lianhua Qingwen Capsule combined with vitamin D can significantly improve lung function and reduce dyspnea in patients with COPD,which is conducive to control the development and recovery of this disease.The mechanism may be related to the effective regulation of Th17/Treg cytokine balance.