加味麻杏石甘汤治疗老年AECOPD对患者气道重塑及中医症候积分的影响

Effect of added Maxing Shigan decoction on airway remodeling and traditional Chinese medicine symptom score of elderly patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨老年慢性阻塞性肺疾病急性加重期(AECOPD)患者采用加味麻杏石甘汤治疗对其气道重塑、中医症候积分的改善情况。方法抽取2022年1月至2023年3月安阳市中医院收治的老年AECOPD患者138例,采用随机数字表法分为对照组和研究组,每组69例。对照组给予西医常规治疗,研究组在对照组用药基础上加用加味麻杏石甘汤,两组均治疗14 d。比较两组治疗前后的中医症候积分、气道重塑[气管壁平均管壁厚度(WT mean)、气道面积/总横截面积比值(WA)、气道壁厚度/外径比值(TDR)]及炎症反应[白细胞计数(WBC)、白细胞介素-8(IL-8)、白细胞介素-17(IL-17)],比较两组治疗期间的安全性。结果治疗14 d后,两组咳嗽、咳痰、喘息、胸闷、发热、哮鸣音或湿啰音各项中医症候积分均低于治疗前,且研究组低于对照组(P<0.05)。治疗14 d后,两组气管壁WT mean、WA、TDR均低于治疗前,且研究组低于对照组(P<0.05)。治疗14 d后,两组外周血WBC、IL-8、IL-17水平均低于治疗前,且研究组低于对照组(P<0.05)。治疗期间,研究组总不良反应发生率(11.59%,8/69)与对照组(8.70%,6/69)比较差异未见统计学意义(P>0.05)。结论老年AECOPD患者采用加味麻杏石甘汤进行治疗能够缓解中医症候,改善患者气道重塑情况,减轻炎症反应,且安全性良好。

Objective To investigate the improvement of airway remodeling and traditional Chinese medicine symptom score in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)treated with added Maxing Shigan decoction.Methods A total of 138 elderly patients with AECOPD admitted to Anyang Traditional Chinese Medicine Hospital from January 2022 to March 2023 were selected,and they were divided into the control group and the study group by random number table method,with 69 cases in each group.The control group was treated with conventional western medicine,and the study group was treated with added Maxing Shigan decoction on the basis of the above-mentioned control group,both groups were treated for 14 days.Airway remodeling,traditional Chinese medicine symptom score assessed by mean wall thickness(WT mean),wall area(WA)and ratio of airway wall thickness to outer diameter(TDR),inflammatory response,including white blood cell count(WBC),serum interleukin-8(IL-8)and interleukin-17(IL-17)before treatment and 14 days after treatment between the two groups were compared,and the safety during treatment were compared between the two groups.Results After 14 days of treatment,the scores of various traditional Chinese medicine symptoms,such as cough,sputum,wheezing,chest tightness,fever,wheezing or wet rales,in both groups were lower than before treatment,and the scores in the study group were lower than those in the control group(P<0.05).After 14 days of treatment,the WT mean,WA and TDR in two groups were lower than before treatment,and the above indexes in the study group were lower than those in the control group(P<0.05).After 14 days of treatment,the levels of WBC,IL-8 and IL-17 in both groups decreased compared with levels before treatment,and the levels of WBC,IL-8 and IL-17 in the study group were lower than those in the control group(P<0.05).There was no statistically significant difference in the overall incidence of adverse reactions between the study group(11.59%,8/69)and the control group(8.70%,6/69),P>0.05.Conclusions The use of added Maxing Shigan decoction in the treatment of elderly patients with AECOPD can alleviate the symptoms of traditional Chinese medicine,improve the remodeling of the airway,and reduce the inflammatory response,with good safety.