旋复代赭汤对慢性阻塞性肺疾病急性加重期患者生活质量及免疫功能的影响

Effect of Xuanfu Daizhe decoction on quality of life and immune function in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨旋复代赭汤(Xuanfu Daizhe Decoction)对慢性阻塞性肺疾病急性加重期(AECOPD)患者生活质量及免疫功能的影响。方法将90例AECOPD患者采用随机数字表随机分为观察组(n=45)与对照组(n=45),对照组采用常规综合治疗+安慰剂治疗,观察组采用常规综合治疗+旋复代赭汤治疗,疗程14天。比较两组中医证候积分、临床疗效、肺功能指标[第1秒用力呼气量(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC、最大呼气中期流量(MMEF)、深吸气量(IC)]、血清炎症细胞因子[人肺表面活性蛋白-D(SP-D)、趋化因子配体-18(CCL-18)、人可溶性细胞间黏附分子-1(sICAM-1)]水平、生活质量(CAT评分)、血清T淋巴细胞亚群(CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、CD4^(+)/CD8^(+))、血清免疫球蛋白[免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)]水平及安全性。结果治疗后,观察组中医证候积分明显低于对照组(P<0.001),观察组有效率[81.40%(35/43)]明显高于对照组[61.90%(26/42)],差异有统计学意义(P<0.05);治疗后,观察组FEV_(1)、FVC、FEV_(1)/FVC、MMEF、IC明显高于对照组(P<0.001),SP-D、CCL18、sICAM-1明显低于对照组(P<0.05),CAT评分明显低于对照组(P<0.001);观察组治疗后血清CD3^(+)T细胞、CD4^(+)T细胞、CD4^(+)/CD8^(+)、IgA、IgG明显高于对照组(P<0.01),CD8^(+)T细胞明显低于对照组(P<0.001);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论旋复代赭汤可减轻AECOPD患者临床症状,改善生活质量,并可增强机体免疫功能。

Objective To investigate the effect of Xuanfu Daizhe decoction on the quality of life and immune function in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 90 patients with AECOPD were randomly divided into observation group(n=45)and control group(n=45)by random number table.The patients in the control group were treated with routine comprehensive therapy+placebo,and the patients in the observation group were treated with routine comprehensive therapy+Xuanfu Daizhe decoction.The treatment courses for all were 14 days.Traditional Chinese medicine(TCM)syndrome scores,clinical efficacy,lung function indexes(forced expiratory volume in one second[FEV_(1)],forced vital capacity[FVC],FEV_(1)/FVC,maximum midexpiratory flow[MMEF],and inspiratory capacity[IC]),serum inflammatory cytokines(human lung surfactant protein-D[SP-D],chemokine CC-motif ligand-18[CCL-18],soluble intercellular adhesion molecule-1[sICAM-1]),quality of life(CAT scores),T lymphocyte subpopulations(CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,CD4^(+)/CD8^(+)),and levels and safety of immunoglobulin(immunoglobulin A[IgA],immunoglobulin M[IgM]and immunoglobulin protein G[IgG])were compared between the two groups.Results After treatment,the TCM syndrome scores in the observation group were significantly lower than those in the control group(P<0.001),the effective rate(81.40%[35/43])in the observation group was significantly higher than that in the control group(61.90%[26/42]),difference was statistically significant(P<0.05).The FEV_(1),FVC,FEV_(1)/FVC,MMEF,and IC in the observation group after treatment were significantly higher than those in the control group(P<0.05),the SP-D,CCL18,and sICAM-1 were significantly lower than those in the control group(P<0.05),and the CAT scores were significantly lower than those in the control group(P<0.001).The serum CD3^(+)T cells,CD4^(+)T cells,CD4^(+)/CD8^(+),IgA and IgG in the observation group after treatment were significantly higher than those in the control group(P<0.01),while CD8^(+)T cells were lower than those in the control group(P<0.001).There was no statistically significant difference in adverse reactions between the two groups(P>0.05).Conclusion For patients with AECOPD,Xuanfu Daizhe decoction can reduce clinical symptoms,improve the quality of life,and enhance immune function.