皱肺定喘膏对慢性阻塞性肺疾病稳定期患者BODE指数、IL-8、TNF-α的作用研究

Effect of Zhoufei Dingchuan Ointment on BODE Index,IL-8 and TNF-αin Patients with Chronic Obstructive Pulmonary Disease

目的观察皱肺定喘膏对慢性阻塞性肺疾病(COPD)患者BODE指数、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)的影响,探讨皱肺定喘膏治疗该病的可能有效机制。方法107例COPD患者纳入研究,随机分为对照组58例、治疗组49例,对照组予噻托溴铵吸入剂18μg 1吸,日1次。治疗组在对照组治疗的基础上加用皱肺定喘膏,比较两组患者治疗前后体质量指数(BMI)、气流阻塞程度(FEV1%)、呼吸困难指数(mMRC)、运动耐力6 min步行距离(6MWT)、BODE指数积分、炎症指标IL-8、TNF-α的变化情况。结果(1)组内比较:两组患者FEV1%pred、6MWD、mMRC、BODE指数积分治疗后较治疗前改善(P<0.05),BMI无明显改善(P>0.05)。治疗组患者血清TNF-α、IL-8水平较治疗前明显降低(P<0.05),对照组患者血清IL-8水平较治疗前降低(P<0.05),TNF-α无明显改善(P>0.05)。(2)组间比较:除BMI外,治疗组治疗后FEV1%pred、6MWD、mMRC、BODE指数积分、血清TNF-α、IL-8水平均较对照组治疗后明显改善(P<0.05)。结论皱肺定喘膏联合噻托溴铵吸入既可显著降低COPD稳定期患者的BODE指数积分,又可抑制COPD稳定期患者体内的TNF-α、IL-8水平,从而发挥治疗作用。

Objective To observe the effect of Zhoufei Dingchuan ointment on BODE index,IL-8 and TNF-αin patients with chronic obstructive pulmonary disease(COPD),and to explore its possible effective mechanism in the treatment of the disease.Methods 107 patients with COPD were randomly divided into control group(n=58)and treatment group(n=49).The control group was given tiotropium bromide(18μg)once a day.On the basis of the treatment of the control group,the treatment group was added with Zhoufei Dingchuan ointment.The body mass index(BMI),degree of airflow obstruction(FEV1%),dyspnea index(mMRC),exercise endurance(6MWT),BODE index score,inflammatory index IL-8 and TNF-αwere compared between the two groups before and after treatment.Results(1)Intra group comparison:FEV1%PRED,6MWD,mMRC and BODE index score of the two groups were improved after treatment(P<0.05),but BMI had no significant improvement(P>0.05).Serum TNF-αand IL-8 levels in treatment group were significantly lower than those before treatment(P<0.05).The level of serum IL-8 in the control group was significantly lower than that before treatment(P<0.05).There was no significant improvement in TNF-αlevel(P>0.05).(2)Comparison between groups:After treatment,FEV1%PRED,6MWD,mMRC,BODE index score,TNF-αand IL-8 of treatment group were higher than those of control group except BMI(P<0.05).Conclusion The combination of Zhoufei Dingchuan ointment and tiotropium bromide inhalation can not only significantly reduce the BODE index score of patients with stable COPD,but also inhibit TNF-αand IL-8 level in patients with stable COPD,so as to play a therapeutic role.