参苓白术散对稳定期慢性阻塞性肺疾病患者免疫功能及生活质量的影响

Effects of Shenling Baizhu Powder(参苓白术散)on Immune Function and Quality of Life in Patients with Stable Chronic Obstructive Pulmonary Disease

目的分析参苓白术散治疗稳定期慢性阻塞性肺疾病(COPD)的效果,及对患者免疫功能及生活质量的影响。方法2021年7月—2021年11月张家口市第五医院内科收治的稳定期COPD患者210例,通过随机数字表法分为观察组105例及对照组105例。两组均接受常规治疗,包括营养支持、抗感染治疗、呼吸肌锻炼、加强免疫力,对照组接受布地奈德福莫特罗治疗;观察组接受布地奈德福莫特罗联合参苓白术散治疗,两组均治疗3个月。比较两组治疗前、治疗3个月后外周血T淋巴细胞亚群、肺功能指标、生活质量、炎症反应指标水平。结果治疗3个月后,两组全血CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平、用力肺活量(FVC)、一秒用力呼气容积(FEV1)、FEV1/FVC水平、简易健康调查量表(SF-36)得分均高于治疗前,且观察组在两组中更高(P<0.05)。与治疗前比较,治疗3个月后,两组全血CD_(8)^(+)、血清白细胞介素-17(IL-17)、白细胞介素-23(IL-23)、超敏-C反应蛋白(hs-CRP)水平、圣乔治呼吸问卷(SGRQ)、慢性阻塞性肺疾病评估测试(CAT)得分均降低,且观察组低于对照组(P<0.05)。结论参苓白术散可改善稳定期COPD患者肺功能,提高患者生活质量,分析与其提高患者免疫功能、抑制机体炎症反应有关。

Objective To analyze the effect of Shenling Baizhu Powder(参苓白术散)in stable chronic obstructive pulmonary disease(COPD)and the effect on immune function and quality of life of patients.Methods A total of 210 patients with stable COPD admitted to medical department of Zhangjiakou Fifth Hospital from July 2021 to November 2021 were divided into the observation group(105 cases)and the control group(105 cases)by random number table method.Both groups received routine treatment,including nutritional support,anti-infective therapy,respiratory muscle exercise and strengthening immunity.The control group received budesonide formoterol inhalation therapy.The observation group received Shenling Baizhu Powder on this basis.Both groups were treated for 3 months.The peripheral blood T lymphocyte subsets,pulmonary function indexes,quality of life and levels of inflammatory response indexes before treatment and after 3 months of treatment were compared between the two groups.Results After 3 months of treatment,the levels of CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) in the whole blood,the forced vital capacity(FVC),the score of Short Form-36(SF-36),forced expiratory volume in one second(FEV1)and FEV1/FVC of the two groups were higher than those before treatment,and those of the observation group were higher than those of the control group(P<0.05).After 3 months of treatment,the levels of CD_(8)^(+) in the whole blood,serum interleukin-17(IL-17),interleukin-23(IL-23),high-sensitivity-C-reactive protein(hs-CRP)and scores of St.george's respiratory questionnaire(SGRQ)and COPD assessment test(CAT)of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group(P<0.05).Conclusion Shenling Baizhu Powder could improve the pulmonary function and quality of life in patients with stable COPD,and it was related to the improvement of immune function and inhibition of inflammatory response in patients.