六君子汤治疗慢性阻塞性肺疾病稳定期肺脾气虚证临床研究

Clinical Study on Liujunzi Decoction for Chronic Obstructive Pulmonary Disease with Lung-Spleen Qi Deficiency Syndrome in Stable Stage

目的:观察六君子汤治疗慢性阻塞性肺疾病(COPD)稳定期肺脾气虚证患者的临床疗效。方法:选取60例COPD稳定期肺脾气虚证患者为研究对象,按照随机数字表法分为常规组与六君子汤组各30例。常规组参考COPD诊疗指南进行常规干预措施;六君子汤组在常规组基础上内服六君子汤。维持治疗12周后,比较2组临床疗效,并比较2组治疗前后肺功能、肺脾气虚证中医证候积分、外周血辅助性T细胞17(Th17)含量以及血清中白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平。结果:治疗后,2组第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC均升高(P<0.05),且六君子汤组高于常规组(P<0.05)。治疗后,2组气短、神疲乏力、恶风、易感冒、纳呆、胃脘胀满或便溏等中医证候积分均下降(P<0.05),且六君子汤组低于常规组(P<0.05)。治疗后六君子汤组总有效率93.33%,高于常规组67.67%(P<0.05)。治疗后,2组外周血Th17及血清IL-17、TNF-α、GM-CSF含量均下降(P<0.05),且六君子汤组低于常规组(P<0.05)。结论:在西医常规治疗基础上予六君子汤干预COPD稳定期肺脾气虚证患者的疗效更明显,同时可以有效下调外周血Th17含量及血清IL-17、TNF-α、GM-CSF水平。

Objective:To observe the clinical effect of Liujunzi Decoction on patients with chronic obstructive pulmonary disease(COPD)with lung-spleen qi deficiency syndrome in stable stage.Methods:A total of 60 patients with COPD with lung-spleen qi deficiency syndrome in stable stage were selected as the study subjects and divided into the conventional group and the Liujunzi Decoction group according to the random number table method,with 30 cases in each group.The conventional group was given routine intervention measures based on the guidelines for treatment and diagnosis of COPD,and the Liujunzi Decoction group was additionally treated with Liujunzi Decoction based on the treatment of the conventional group.After 12 weeks of treatment,the clinical effects were compared between the two groups.The lung function indexes,the traditional Chinese medicine syndrome scores of lung-spleen qi deficiency,contents of helper T cells(Th17)in peripheral blood,and the levels of serum interleukin-17(IL-17),tumor necrosis factor-α(TNF-α)and Hgranulocyte-macrophage colony-stimulating factor(GM-CSF)were compared before and after treatment between the two groups.Results:After treatment,the forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC)and FEV_(1)/FVC in the two groups Were increased(P<0.05),and the FEV_(1),FVC and FEV_(1)/FVC in the Liujunzi Decoction group Were higher than those in the conventional group(P<0.05).After treatment,the traditional Chinese medicine syndrome scores of shortness of breath,mental fatigue and lack of strength,aversion to cold,susceptibility to cold,torpid intake,epigastric distension or loose stool in the two groups were decreased(P<0.05),and the above scores in the Liujunzi Decoction group were lower than those in the conventional group(P<0.05).After treatment,the total effective rate was 93.33%in the Liujunzi Decoction group,higher than that of 67.67%in the conventional group(P<0.05).After treatment,the Th17 contents in peripheral blood and levels of serum IL-17,TNF-αand GM-CSF in the two groups were decreased(P<0.05),and the Th17 content and levels of serum IL-17,TNF-αand GM-CSF in the Liujunzi Decoction group were lower than those in the conventional group(P<0.05).Conclusion:The intervention of Liujunzi Decoction has a more significant curative effect on patients with COPD with lung-spleen qi deficiency syndrome in stable stage based on routine treatment with western medicines,which meanwhile can effectively down-regulate the Th17 content in peripheral blood and levels of serum IL-17,TNF-α and GM-CSF.