宣肺行气活血方联合2HRZE/4HR方案治疗结核性胸膜炎对患者血清Th1/Th2动态平衡的影响

Effect of Xuanfei Xingqi Huoxue Recipe Combined with 2HRZE/4HR Regimen on Serum Th1/Th2Homeostasis for Patients with Tuberculous Pleurisy

目的:观察宣肺行气活血方联合西医标准化疗(2HRZE/4HR)方案治疗结核性胸膜炎对患者血清辅助性T细胞1/辅助性T细胞2(Th1/Th2)动态平衡的影响。方法:选取我院于2017年5月~2020年5月收治的结核性胸膜炎患者124例,根据治疗方法分为两组,每组62例。两组均给予胸腔穿刺抽液治疗,对照组给予2HRZE/4HR方案治疗,观察组在对照组基础上给予宣肺行气活血方治疗。记录两组肺功能指标、血清Th1/Th2因子的变化,比较两组总有效率、胸腔积液排出量、吸收时间及胸膜厚度。结果:观察组的总有效率为91.94%,高于对照组的79.03%,组间比较发现,差异有统计学意义(P<0.05)。观察组胸腔积液排出量少于对照组,胸腔积液吸收时间短于对照组,胸膜厚度薄于对照组,组间比较发现,差异均有统计学意义(P<0.05)。治疗后进行组内比较发现,两组白细胞介素-10(IL-10)逐渐上升(P<0.05),干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)逐渐下降(P<0.05),进一步组间比较发现,观察组IL-10高于对照组(P<0.05),IFN-γ、IL-2、IL-6低于对照组(P<0.05)。治疗后进行组内比较发现,两组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)逐渐上升(P<0.05),进一步组间比较发现,观察组上述肺功能指标高于对照组(P<0.05)。结论:宣肺行气活血方联合2HRZE/4HR方案治疗结核性胸膜炎可调节患者血清Th1/Th2动态平衡,促进胸腔积液的吸收,改善肺功能。

Objective:To observe the effect of Xuanfei Qi Huoxue Recipe combined with western medicine standard chemotherapy(2 HRZE/4 HR)on the dynamic balance of serum helper T cell 1/helper T cell 2(Th1/Th2)for patients with tuberculous pleurisy.Methods:From May 2017 to May 2020,124 patients with tuberculous pleurisy were divided into two groups,62 cases in each group.Both groups were treated with pleural puncture and drainage,the controlled group was treated with 2 HRZE/4 HR regimen,and the observation group was treated with Xuanfei Xingqi Huoxue Recipe on the basis of the controlled group.Changes of pulmonary function index,serum Th1/Th2 factor were recorded,and the total effective rate,pleural effusion excretion,absorption time and pleural thickness were compared between the two groups.Results:Compared with the controlled group,the total effective rate of the observation group was 91.94,which was higher than that of the controlled group(P<0.05).Compared with the controlled group,the pleural effusion excretion in the observation group was less than that in the controlled group,the pleural effusion absorption time was shorter than that in the controlled group,and the pleural thickness was thinner than that in the controlled group(P<0.05).The intra-group comparison after treatment found that interleukin-10(IL-10)gradually increased(P<0.05),interferon-γ(IFN-γ),interleukin-2(IL-2),interleukin-6(IL-6)gradually decreased(P<0.05)in the two groups.Further inter-group comparison found that the IL-10 in the observation group was higher than that in the controlled group(P<0.05)the IFN-γ,IL-2,IL-6 was lower than that in the controlled group(P<0.05).The intra-group comparison after treatment found that the forced vital capacity(FVC)and forced expiratory volume(FEV1)in the first second of the two groups gradually increased(P<0.05).Further inter-group comparison found that the above pulmonary function indexes in the observation group were higher than those in the controlled group(P<0.05).Conclusion:The treatment of tuberculous pleurisy with 2 HRZE/4 HR regimen can regulate the dynamic balance Th1/Th2 serum,promote the absorption of pleural effusion and improve pulmonary function.