基于Th1/Th2细胞因子网络调控机制探索汉防己甲素片治疗Ⅱ期尘肺的临床研究

Study on the clinical effect of the treatment of stageⅡpneumoconiosis with hanfanghexin tablet based on the regulatory mechanism of Th1/Th2 cytokine network

目的探究汉防己甲素片通过调节Th1/Th2细胞因子网络机制治疗Ⅱ期尘肺的临床疗效。方法选取2016年4月至2019年4月本院收治的80例Ⅱ期尘肺病患者作为研究对象,按照随机数字表法分为对照组与研究组,各40例。对照组给予乙酰半胱氨酸泡腾片治疗,研究组予以汉防己甲素片治疗,比较两组治疗前后血清细胞因子[肿瘤坏死因子-α(TNF-α),白细胞介素(IL)-8,干扰素-γ(IFN-γ),IL-2,IL-4,和IL-10]水平、免疫功能指标[CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、免疫球蛋白M(IgM)和免疫球蛋白G(IgG)]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))和血氧饱和度(SaO_(2))]、呼吸功能指标[每分钟最大通气量(MVV)、第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)和FEV_(1)/FVC]及圣乔治呼吸问卷(SGRQ)评分。结果治疗后,研究组TNF-α、IL-8、IFN-β和IL-2水平均明显低于对照组(P<0.05),两组IL-4和IL-10水平比较差异无统计学意义;研究组CD4^(+)和CD4^(+)/CD8^(+)均明显高于对照组,CD8^(+)明显低于对照组(P<0.05),两组治疗前后血清IgM和IgG比较差异均无统计学意义;研究组PaO_(2)和SaO_(2)均明显高于对照组,PaCO_(2)明显低于对照组(P<0.05);研究组MVV、FEV_(1)、FVC和FEV_(1)/FVC明显高于对照组(P<0.05);研究组SGRQ评分为(54.07±6.11)分,明显低于对照组的(61.84±6.95)分(P<0.05)。结论汉防己甲素片可通过调节细胞免疫,纠正Ⅱ期尘肺病患者Th1/Th2细胞因子网络功能失衡状况,恢复免疫功能平衡,改善患者血气及呼吸功能状况,提高患者生存质量,值得临床推广应用。

Objective To investiate the clinical effect of hanfanghexin tablet on stageⅡpneumoconiosis by regulating Th1/Th2 cytokine network mechanism.Methods 80 patients with stageⅡpneumoconiosis treated in our hospital from April 2016 to April 2019 were selected as the research subjects,and they were divided into control group and study group according to the random number table methed,with 40 cases in each group.The control group was given acetylcysteine effervescent tablets treatment and the study group was given hangfanhexin tablets treatment,the levels of serum cytokines(tumor necrosis factor alpha-α[TNF-α],interleukin[IL]-8,interferon-γ[IFN-γ],IL-2,IL-4,and IL-10),immune function indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+),immunoglobulin M[IgM]and immunoglobulin G[IgG]),blood gas indexes(arterial partial pressure of oxygen[PaO_(2)],arterial partial pressure of carbon dioxide[PaCO_(2)],oxygen saturation[SaO_(2)])and respiratory function indexes(maximum minute ventilation[MVV],forced expiratory volume in 1 second[FEV_(1)],forced vital capacity[FVC]and FEV_(1)/FVC),and the scores of St George's respiratory questionnaire(SGRQ)were compared between the two groups before and after treatment.Results After treatment,the levels of TNF-α,IL-8,IFN-γand IL-2 in the study group were significantly lower than those in the control group(P<0.05),there was no significant difference in the levels of IL-4 and IL-10 between the two groups;the levels of CD4^(+)and CD4^(+)/CD8^(+) in the study group were significantly higher than those of the control group,while CD8^(+) was significantly lower than that of the control group(P<0.05).There was no significant difference in serum IgM and IgG levels between the two groups before and after treatment,after treatment,PaO_(2)and SaO_(2)in the study group were significantly higher than those in the control group,while PaCO_(2)in the study group was significantly lower than that in the control group(P<0.05);MVV,FEV_(1),FVC and FEV_(1)/FVC in the study group were significantly higher than those in the control group(P<0.05);SGRQ score in the study group was(54.07±6.11)scores,which was significantly lower than(61.84±6.95)scores in the control group(P<0.05).Conclusion Hanfanghexin tablet can correct the imbalance of Th1/Th2 cytokine network function in patients with stageⅡpneumoconiosis,restore the balance of immune function,improve the condition of blood gas and respiratory function,and improve the quality of life of patients,which is worthy of clinical application.