小柴胡汤合苓甘五味姜辛汤加减治疗慢性阻塞性肺疾病急性加重期外寒内饮证的临床疗效及对炎症因子和免疫功能的影响

Clinical efficacy of modified Xiaochaihu Decoction and Linggan Wuwei Jiangxin Decoction on acute exacerbation of chronic obstructive pulmonary disease of external cold and internal drinking and its influence on inflammatory factor and immune function

目的 观察小柴胡汤合苓甘五味姜辛汤加减治疗慢性阻塞性肺疾病急性加重期(AECOPD)外寒内饮证的临床疗效及对炎症因子和免疫功能的影响。方法 将72例AECOPD外寒内饮证患者按照随机数字表法分为2组,对照组36例予常规西医治疗,治疗组36例在对照组治疗基础上予小柴胡汤合苓甘五味姜辛汤加减治疗。比较2组治疗前后中医证候评分、血清炎症指标[白细胞介素6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)]、免疫功能指标[CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]水平,并统计2组临床疗效及治疗期间的不良反应情况。结果 治疗组总有效率94.44%(34/36),对照组总有效率77.78%(28/36),治疗组临床疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后血清IL-6、CRP、TNF-α均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后CD4^(+)、CD4^(+)/CD8^(+)均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05),2组治疗后CD8^(+)均降低(P<0.05),且治疗组治疗后低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 小柴胡汤合苓甘五味姜辛汤加减治疗AECOPD外寒内饮证的临床疗效确切,可缓解中医临床症状,降低炎症反应,免疫功能得到显著提高,安全性良好,值得推广。

Objective To observe the clinical efficacy of modified Xiaochaihu Decoction and Linggan Wuwei Jiangxin Decoction on acute exacerbation of chronic obstructive pulmonary disease(AECOPD)of external cold and internal drinking and its influence on inflammatory factor and immune function.Methods A total of 72 AECOPD patients(external cold and internal drinking)were randomly assigned into the treatment group(n=36)and the control group(n=36).All patients were managed by routine Western medicine,and those in the treatment group were additionally treated with modified Xiaochaihu Decoction and Linggan Wuwei Jiangxin Decoction.The aim was to compare traditional Chinese medicine(TCM)syndrome score,serum inflammatory markers(interleukin 6[IL-6],C-reactive protein[CRP],tumor necrosis factor alpha[TNF-α]),immune function indexes(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)).The curative effect and adverse reactions were assessed.Results The overall effective rate in the treatment group was better than that in the control group(94.44%[34/36]vs 77.78%[28/36],[P<0.05],respectively).After treatment,TCM symptom scores in the both groups were significantly decreased(P<0.05),which decreased notably in the treatment group compared with the control group(P<0.05).IL-6,CRP,TNF-αin the both groups were significantly decreased(P<0.05),the reduction in the treatment group was more prevalent compared with the control group(P<0.05).Increased CD4^(+)and CD4^(+)/CD8^(+),and decreased CD8^(+)were detected in the both groups(all P<0.05),and the treatment group was superior to the control group for CD4^(+),CD4^(+)/CD8^(+),CD8^(+)(all P<0.05).None of the incidence of adverse reactions differed significantly between groups(P>0.05).Conclusion For AECOPD patients(external cold and internal drinking),modified Xiaochaihu Decoction and Linggan Wuwei Jiangxin Decoction has definite clinical efficacy,which can relieve clinical symptoms of TCM,reduce inflammatory reactions,significantly improve immune function,and with good safety,worthy of promotion.