滋阴利肺汤治疗肺结核合并慢性阻塞性肺疾病疗效及对患者肺泡巨噬细胞分泌细胞因子水平的影响

Effect of Ziyin Lifei decoction in the auxiliary treatment of pulmonary tuberculosis patients with chronic obstructive pulmonary disease and its effect on the secretion of cytokines by alveolar macrophages

目的:研究滋阴利肺汤辅助治疗肺结核合并慢性阻塞性肺疾病患者效果观察及对肺泡巨噬细胞(AM)分泌细胞因子水平的影响。方法:选取肺结核合并慢性阻塞性肺疾病患者106例,随机分为对照组、观察组,对照组53例,采用常规西医治疗,观察组53例,采用常规西药联合滋阴利肺汤辅助治疗。比较两组治疗前后症状积分,临床疗效,两组治疗前后体液免疫、AM分泌细胞因子水平及不良反应。结果:两组治疗前咳嗽、咳痰、胸闷、气喘积分及总积分比较,差异无统计学意义(P>0.05);两组治疗后上述积分均降低,观察组低于对照组(P<0.05)。观察组临床总有效率高于对照组(P<0.05)。两组治疗后CD4^(+)T淋巴细胞占比、CD4^(+)/CD8^(+)均升高,观察组高于对照组,CD8^(+)T淋巴细胞占比均降低,观察组低于对照组(P<0.05)。两组治疗前AM分泌白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、白介素-6(IL-6)水平比较,差异无统计学意义(P>0.05);治疗后两组上述因子水平均降低,观察组低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:滋阴利肺汤辅助治疗肺结核合并慢性阻塞性肺疾病可改善患者临床症状及疗效,降低AM分泌炎性因子水平,增强体液免疫。

Objective:To study the effect of Ziyin Lifei decoction in adjuvant treatment of pulmonary tuberculosis patients with chronic obstructive pulmonary obstruction and its effect on the level of cytokine secreted by alveolar macrophages(AM).Methods:A total of 106 patients with pulmonary tuberculosis and chronic obstructive pulmonary disease were randomly divided into control group and observation group.The 53 cases in the control group were treated with conventional western medicine,and the 53 cases in the observation group were treated with conventional western medicine combined with Ziyin Lifei decoction adjuvant therapy.The symptom scores of the two groups before and after treatment were compared.The clinical efficacy of the two groups was compared.The humoral immunity and secretion of cytokines by AM of the two groups before and after treatment were compared.The adverse reactions of the two groups was compared.Results:There were no significant differences in the scores of cough,sputum,chest tightness,asthma,and total scores of the two groups before treatment(P>0.05).The scores of the two groups were reduced after treatment,which of and the observation group were lower than those of the control group(P<0.05).The total clinical effective rate of the observation group was higher than that of the control group(P<0.05).The ratio of CD4+T lymphocytes and CD4+/CD8+of the two groups were increased(P<0.05),which of and the observation group were higher than those of the control group(P<0.05).The ratio of CD8+T lymphocytes of the two groups were decreased(P<0.05),which of and the observation group was lower than that of the control group(P<0.05).There were no significant differences in the levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)and interleukin-6(IL-6)secreted by AM(P>0.05),which were reduced of the two groups after treatment,which of and the observation group were lower than those of the control group(P<0.05).There were no significant differences in the incidence of adverse reactions of the two groups(P>0.05).Conclusion:Ziyin Lifei decoction can improve the clinical symptoms and curative effect of patients with pulmonary tuberculosis combined with COPD,reduce the level of inflammatory factors secreted by AM,enhance humoral immunity.