益气宣肺汤治疗老年哮喘疗效及对患者炎症因子和免疫功能的影响

The therapeutic effect of Yiqi Xuanfei decoction on elderly asthmatic patients and its role in regulating inflammatory factors and immune function

目的:观察益气宣肺汤对老年哮喘患者的治疗效果及在调节炎症和免疫功能中的作用。方法:纳入120例慢性持续期老年哮喘患者,随机分为对照组和益气宣肺组。对照组采用常规西医治疗,益气宣肺组在对照组基础上加服益气宣肺汤。观察两组治疗前后临床症状评分及临床疗效;比较患者治疗前后哮喘控制测试评分及实验室检查指标[白介素(IL)-4、IL-10、超敏C反应蛋白(hs-CRP)和干扰素γ(IFN-γ)]水平变化以及患者免疫指标(CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+))变化。记录两组治疗后不良反应及具体不良事件。结果:对照组临床总有效率为70.00%,益气宣肺组为88.33%,益气宣肺组高于对照组(P<0.05)。治疗后,两组中医症候积分明显低于治疗前,哮喘控制测试评分则高于治疗前;益气宣肺组改善优于对照组(均P<0.05)。治疗后3个月两组IL-4、IL-10、CD4^(+)水平和CD4^(+)/CD8^(+)比值明显高于治疗前,hs-CRP、IFN-γ和CD8^(+)水平明显降低;并且益气宣肺组的IL-4、IL-10、CD4^(+)水平和CD4^(+)/CD8^(+)比值明显高于对照组,而hs-CRP、IFN-γ和CD8^(+)水平明显低于对照组(均P<0.05)。结论:慢性持续期老年哮喘患者采用常规西药联用益气宣肺汤可改善哮喘症状并控制其复发,可能与该组方具有宣肺、抗炎、益气、调节免疫系统功能的作用有关。

Objective:To observe the therapeutic effect of Yiqi Xuanfei decoction on elderly asthmatic patients and its role in regulating inflammation and immune function.Methods:The research subjects were 120 elderly patients with chronic persistent asthma.Eligible patients were randomly divided into a control group and a Yiqi Xuanfei group.Patients in the control group received conventional western medicine treatment;while those in Yiqi Xuanfei group were given Yiqi Xuanfei decoction on the basis of treatment in the control group.This study further observed clinical symptom scores and clinical efficacy before and after treatment in the two groups;compared the asthma control test scores of patients before and after treatment,and changes in levels of laboratory indicators including interleukin(IL)-4,IL-10,hs-CRP,IFN-γin patients before and after treatment;as well as patient immune indicators of CD4^(+),CD8^(+)and CD4^(+)/CD8^(+).Adverse reactions and specific adverse events were recorded after treatment in the two groups.Results:The clinical effective rate of the control group was 70.00%,that of the Yiqi Xuanfei group was 88.33%,which was higher than that in the control group(P<0.05).The post-treatment syndrome scores of TCM in both groups were significantly lower than the pre-treatment scores,while the asthma control test scores were higher than before treatment;with obvious improvement in the Yiqi Xuanfei group in particular(all P<0.05).Compared with before treatment,the levels of IL-4,IL-10,CD4^(+)and CD4^(+)/CD8^(+)were significantly increased,while those of hs-CRP,IFN-γand CD8^(+)were obviously decreased in both groups after 3 months of treatment.Moreover,Yiqi Xuanfei group had highly increased levels of IL-4,IL-10,CD4^(+)and CD4^(+)/CD8^(+),but decreased levels of hs-CRP,IFN-γand CD8^(+)(all P<0.05).Conclusion:For elderly patients with chronic persistent asthma,conventional western medicine combined with Yiqi Xuanfei decoction can improve asthma symptoms and control its recurrence,which may be related to the effects of this formula in promoting lung function,preventing inflammation,nourishing Qi,and regulating immune system.