滋阴祛风膏联合穴位埋线对缓解期哮喘患者气道重塑作用及哮喘控制、气道炎症反应和免疫平衡的影响

Effects of Ziyin Qufeng Ointment(滋阴祛风膏)and Acupoint Embedding on Airway Remodeling,Asthma Control,Airway Inflammatory Response and Immune Balance in Patients with Asthma in Remremission Stage

目的观察滋阴祛风膏联合穴位埋线治疗缓解期哮喘的临床疗效,并分析其对患者气道重塑、哮喘控制、气道炎症反应及免疫平衡的影响。方法将2019年1月—2020年12月就诊于秦皇岛市中医医院肺病科门诊及病房的110例缓解期哮喘患者纳入研究,采用随机数字表法将患者分为对照组与研究组,各55例。对照组采用沙美特罗替卡松粉吸入治疗,研究组在此基础上加用滋阴祛风膏联合穴位埋线治疗,两组患者均连续治疗3个月。记录治疗前后两组患者中医证候积分变化情况并评价临床疗效;对两组患者肺功能、哮喘控制测试(ACT)评分、血清基质金属蛋白酶-9(MMP-9)、转化生长因子-β_(1)(TGF-β_(1))及炎性因子、转录因子mRNA表达水平进行分析比较。结果治疗后,缓解期哮喘患者中医证候积分,血清MMP-9、TGF-β_(1),炎性因子超敏C反应蛋白(Hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及结合蛋白-3(GATA-3)mRNA表达水平均显著降低(P<0.05),且研究组降幅显著大于对照组(P<0.05)。肺功能指标最大呼气流速(PEF)、1秒用力呼气容量(FEV1)、FEV1/PEF、ACT评分、转移因子(T-bet)mRNA、T-bet/GATA-3比值均显著提高(P<0.05),且研究组增幅显著大于对照组(P<0.05)。研究组治疗总有效率显著高于对照组(92.73%vs 78.18%,P<0.05)。结论滋阴祛风膏联合穴位埋线治疗可以有效抑制气道重塑,减轻机体炎症反应并调整免疫平衡,从而改善患者肺功能,减轻哮喘症状。

Objective To observe the clinical efficacy of Ziyin Qufeng Ointment(滋阴祛风膏)combined with acupoint embedding thread in the treatment of asthma in remission period,and to analyze the effects on airway remodeling,asthma control,airway inflammatory response and immune balance.Methods A total of 110 patients with asthma in remission who were admitted to the pulmonary disease department and ward of Qinhuangdao hospital of traditional Chinese medicine from January 2010 to December 2020 were included in this study.The patients were divided into control group and study group by random number table method,with 55 patients in each group.The control group was treated with inhalation of Suledide,Salmeterofluticasone powder,and the research group was treated with add Ziyin Qufeng Ointment combined with acupoint embedding therapy on this basis.Patients in both groups were treated continuously for 3 months.The changes of TCM syndrome scores in two groups were recorded before and after treatment,and the clinical efficacy was evaluated.Lung function,asthma control test(ACT)score,serum matrix metalloproteinase-9(MMP-9),transforming growth factor-β_(1)(TGF-β_(1)),inflammatory factors and transcription factors mRNA expression levels in 2 groups were analyzed and compared.Results After treatment,TCM syndrome scores of patients with asthma in remission period,serum MMP-9,TGF-β_(1),inflammatory factors hypersensitive C-reactive protein(Hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),mRNA expression levels of binding protein-3(GATA-3)were significantly decreased(P<0.05),and the decrease in the study group was significantly greater than that in the control group(P<0.05).Pulmonary function indexes:maximum expiratory flow rate(PEF),forced expiratory volume in 1 second(FEV1),FEV1/PEF;ACT score,transfer factor(T-bet)mRNA and T-bet/GATA-3 ratio were significantly increased(P<0.05),and the increase rate in the study group was significantly higher than that in the control group(P<0.05).The total effective rate of the study group was significantly higher than that of the control group(92.73%vs 78.18%,P<0.05).Conclusion Ziyin Qufeng Ointment combined with acupoint embedding can effectively inhibit airway remodeling,reduce the inflammatory response of the body and adjust the immune balance,thus improving lung function and alleviating asthma symptoms.