补中益气汤合小柴胡汤对肺小结节患者肺功能及免疫炎症指标的影响

Effects of Buzhong Yiqi Decoction combined with Xiaochaihu Decoction on pulmonary function and immune inflammatory indexes in patients with small pulmonary nodules

目的分析补中益气汤合小柴胡汤对肺小结节患者肺功能及免疫炎症指标的影响。方法选取2020年1月至2022年1月我院呼吸内科收治的106例实性孤立性肺小结节(small solitary pulmonary nodules,SSPN)患者作为研究对象,采用随机数字表法将患者分为研究组和对照组。研究组给予口服补中益气汤合小柴胡汤治疗,对照组给予安慰剂,连续服用3个月。对两组患者治疗前和治疗3个月末的肺结节直径、肺功能指标、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素(interleukin,IL)-1β、IL-6、IL-10、免疫球蛋白(immunoglobulin,Ig)G、IgA、IgM水平及外周血CD4^(+)T淋巴细胞比例、CD8^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)T淋巴细胞比值进行检测和比较。结果两组最终分别纳入52例和51例患者。在治疗3个月末,对照组患者肺结节直径、肺功能指标及免疫炎症指标与治疗前的差异无统计学意义(P>0.05);研究组患者肺结节直径、血清TNF-α、IL-1β、IL-6水平及外周血CD8^(+)T淋巴细胞比例均较治疗前降低,且均低于对照组,研究组患者的血清IL-10、IgG、IgA、IgM水平及外周血CD4^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)T淋巴细胞比值、肺功能指标均较治疗前升高,且均高于对照组,以上差异均有统计学意义(P<0.05)。结论对于实性SSPN患者采用补中益气汤合小柴胡汤的中药治疗方案,能够达到缩小结节、缓解炎症反应、纠正免疫失衡、改善肺功能的效果。

〕Objective To analyze the effects of Buzhong Yiqi Decoction combined with Xiaochaihu Decoction on pulmonary function and immune inflammatory indexes in patients with small pulmonary nodules.Methods A total of 106 patients with solid solitary small pulmonary nodules(SSPN)admitted to Department of Respiration in our hospital from January 2020 to January 2022 were selected as the research subjects.The patients were randomly divided into study group and control group.The study group was treated with Buzhong Yiqi Decoction combined with Xiaochaihu Decoction,and the control group was treated with placebo.The two groups were treated for 3 months.The lung nodule diameter,the pulmonary function indexes and the serum tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-6,IL-10,immunoglobulin(Ig)G,IgA,IgM levels as well as CD4^(+)T lymphocyte percentage,CD8^(+)T lymphocyte percentage and CD4^(+)/CD8^(+)T lymphocyte ratio in peripheral blood before and after 3 months of treatment between the patients in the two groups were measured and compared.Results Fifty two patients and 51 patients were included in the two groups respectively.After 3 months of treatment,there was no significant difference in pulmonary nodule diameter,pulmonary function indexes and immune inflammation indexes compared with those before the treatment in the control group(P>0.05).The pulmonary nodule diameter and the serum TNF-α,IL-1β,IL-6 levels as well as CD8^(+)T lymphocyte percentage in peripheral blood decreased compared with those before the treatment in the study group,which were lower than those in the control group.The pulmonary function indexes and the serum IL-10,IgG,IgA,IgM levels as well as CD4^(+)T lymphocyte percentage,CD4^(+)/CD8^(+)T lymphocyte ratio in peripheral blood increased compared with those before the treatment in the study group,which were higher than those in the control group.The above differences were statistically significant(P<0.05).Conclusion For the patients with solid SSPN,the Chinese medicine treatment scheme of Buzhong Yiqi Decoction combined with Xiaochaihu Decoction can reduce nodules,alleviate inflammatory reactions,regulate immune imbalance,and improve lung functions.