针刺联合盐酸氨溴索治疗慢性支气管炎急性发作期的疗效观察及对血清CXCR3、NKT的影响

Efficacy Observation of Acupuncture Combined with Ambroxol Hydrochloride for Acute Exacerbation of Chronic Bronchitis and Its Effects on Serum CXCR3 and NKT

目的观察针刺联合盐酸氨溴索治疗慢性支气管炎急性发作期(AECB)的临床疗效及对血清趋化因子受体3(CXCR3)、自然杀伤T(NKT)细胞的影响。方法将152例慢性支气管炎患者随机分为对照组和观察组,每组76例。对照组采用盐酸氨溴索进行治疗,观察组在盐酸氨溴索的基础上联合俞募配穴针刺治疗。观察两组治疗前后炎性因子[白细胞介素(IL)-6、IL-8、肿瘤坏死因子(TNF)-α]水平、细胞[T淋巴细胞(CD4^(﹢)CXCR3^(﹢)、CD8^(﹢)CXCR3^(﹢))及NKT、干扰素(IFN)-γ]比率、1 s用力呼气容积(FEV1)、呼气峰流速(PEF)、用力肺活量(FVC)及中医证候积分的变化,并比较两组临床疗效。结果两组治疗后炎性因子水平明显降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组治疗后CD4^(﹢)CXCR3^(﹢)、CD8^(﹢)CXCR3^(﹢)细胞比率降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组治疗后NKT、IFN-γ细胞比率升高,且观察组高于对照组,差异有统计学意义(P<0.05)。两组治疗后PEF、FVC、FEV1升高,且观察组高于对照组,差异有统计学意义(P<0.05)。两组治疗后中医证候积分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组总有效率高于对照组(P<0.05)。结论俞募配穴针刺联合盐酸氨溴索可有效改善AECB患者肺功能,降低患者CXCR3水平,提高患者NKT水平。

Objective To observe the efficacy of acupuncture combined with Ambroxol hydrochloride in treating acute exacerbation of chronic bronchitis(AECB)and its effects on serum C-X-C chemokine receptor3(CXCR3)and natural killer T(NKT)cell.Method A total of 152 chronic bronchitis patients were randomly divided into a control group and an observation group,with 76 cases in each group.The control group was treated with Ambroxol hydrochloride,and the observation group was offered Ambroxol hydrochloride plus acupuncture at back-Shu and front-Mu acupoints group.Before and after the treatment,the levels of inflammatory factors[interleukin(IL)-6,IL-8,tumor necrosis factor(TNF)-α],the ratio of cell[T lymphocytes(CD4^(﹢)CXCR3^(﹢)and CD8^(﹢)CXCR3^(﹢)),NKT,and IFN-γcells],forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),forced vital capacity(FVC)and symptoms score of traditional Chinese medicine(TCM)were observed,and the clinical efficacy was compared between the two groups.Result The levels of inflammatory factors decreased notably after the treatment in both groups and were lower in the observation group than in the control group,and the differences were statistically significant(P<0.05).The ratio of CD4^(﹢)CXCR3^(﹢)and CD8^(﹢)CXCR3^(﹢)cells dropped after the treatment in the two groups and were lower in the observation group than in the control group,showing statistical significance(P<0.05).The ratio of NKT and IFN-γcells increased after the treatment in both groups and were higher in the observation group than in the control group,showing statistical significance(P<0.05).The PEF,FVC,and FEV1 rose after the treatment in both groups and were higher in the observation group than in the control group,and the differences were statistically significant(P<0.05).The symptoms score of TCM dropped after the treatment in both groups and was lower in the observation group than in the control group,showing statistical significance(P<0.05).The total effective rate in the observation group was higher than that in the control group(P<0.05).Conclusion Acupuncture at back-Shu and front-Mu acupoints group plus Ambroxol hydrochloride can effectively improve pulmonary function in patients with AECB,down-regulating the CXCR3 level and up-regulating the NKT level.