桑白皮汤加减治疗痰热郁肺证AECOPD疗效及对患者中医证候积分、血清CCL-18、MMP-9水平的影响

Efficacy of Modified Sangbaipi Decoction(桑白皮汤加减)in Treatment of AECOPD(Phlegm-Heat Obstructing Lung Syndrome)and Its Effects on TCM Syndromes Scores and Levels of Serum CCL-18 and MMP-9

目的观察桑白皮汤加减治疗痰热郁肺证慢性阻塞性肺疾病急性加重(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)的疗效及对患者中医证候积分、血清趋化因子配体(CCL-18)、金属基质蛋白酶(MMP-9)水平的影响。方法将2020年1月—2022年3月于医院治疗的65例痰热郁肺证AECOPD患者随机分为观察组33例与对照组32例。对照组给予常规治疗,观察组在对照组基础上给予桑白皮汤加减治疗。比较两组临床疗效,比较治疗前、治疗后两组中医证候积分、动脉血气分析[动脉氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))]、免疫指标[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]、血清相关指标[趋化因子配体(CCL-18)、金属基质蛋白酶(MMP-9)、可溶性细胞黏附因子-1(sICAM-1)、纤维蛋白原(Fib)]水平。结果治疗10 d后,观察组临床控制占比明显高于对照组(t=4.826,P=0.028)。两组中医证候评分(咳嗽、咯痰、气喘、哮鸣、胸闷)、PaCO_(2)、血清相关指标(CCL-18、MMP-9、sICAM-1、Fib)均低于治疗前,观察组低于对照组(P<0.05);两组PaO_(2)、免疫功能(IgA、IgG、IgM)均高于治疗前,且观察组高于对照组(P<0.05)。结论桑白皮汤治疗AECOPD痰热郁肺证患者效果显著,可改善患者临床症状,提高免疫功能,降低血清CCL-18、MMP-9、sICAM-1、Fib水平。

Objective To observe the efficacy of Modified Sangbaipi Decoction(桑白皮汤加减)in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)of phlegm-heat obstructing lung syndrome and its effects on scores of TCM syndromes and levels of serum chemokine ligand(CCL-18)and matrix metalloproteinase(MMP-9)in patients.Methods Sixty-five patients with AECOPD of phlegm-heat obstructing lung syndrome treated in the hospital between January 2020 and March 2022 were randomly divided into the observation group(33 cases)and the control group(32 cases).The control group was given conventional treatment,while the observation group was treated with Modified Sangbaipi Decoction on the basis of the control group.The clinical efficacy of the two groups was compared.The TCM syndromes scores,arterial blood gas analysis[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],immune indicators[immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM)]and serum-related indicators[chemokine ligand(CCL-18),matrix metalloproteinase(MMP-9),soluble intercellular adhesion molecule-1(sICAM-1),fibrinogen(Fib)]were compared between the two groups before and after treatment.Results After 10 days of treatment,the proportion of clinical control in the observation group was significantly higher than that in the control group(t=4.826,P=0.028).The scores of TCM syndromes(cough,expectoration,asthma,wheezing,chest tightness),PaCO_(2) and serum-related indicators(CCL-18,MMP-9,sICAM-1,Fib)in the two groups were all lower than those before treatment,and the above indicators in the observation group were lower than those in the control group(P<0.05).The PaO_(2) and immune function indicators(IgA,IgG,IgM)in both groups were higher than those before treatment,and the indicators were higher in the observation group than those in the control group(P<0.05).Conclusion Sangbaipi Decoction has a significant effect in the treatment of patients with AECOPD of phlegm-heat obstructing lung syndrome and can improve the clinical symptoms,enhance the immune function and reduce the levels of serum CCL-18,MMP-9,sICAM-1 and Fib.