加味消风散治疗支气管哮喘风哮证的疗效观察及对炎症因子的影响

Clinical Efficacy of Modified Xiaofengsan and Its Effect on Cytokines in Persistent Asthma Patients with Wind-asthma Pattern

目的:观测加味消风散治疗慢性持续期支气管哮喘风哮证的临床疗效及对炎症因子的影响。方法:将120例符合纳入标准的慢性持续期哮喘患者随机分为对照组和治疗组,各60例。对照组60例,单用布地奈德福莫特罗粉吸入剂(160μg/4.5μg),2吸/次,bid。治疗组予加味消风散,日1剂,并联合布地奈德福莫特罗粉吸入剂(160μg/4.5μg)治疗。两组疗程均为1个月。观察两组患者临床疗效,治疗前后及治疗结束3个月后哮喘控制测试(asthma control test,ACT)评分表的得分情况以及治疗前后半年内哮喘平均急性发作次数,测定两组患者治疗前后第1秒用力呼气量占预计值百分比(percentage of forced expiratory volume in first second and its predicted value,FEV1%),PEF变异率(variety ratio of peak expiratory flow,PEF),外周血嗜酸性粒细胞(eosinophilic granulocyte,EOS)计数和血清白细胞介素-4(interleukin-4,IL-4),白细胞介素-6(interleukin-6,IL-6),白细胞介素-13 (interleukin-13,IL-13)水平。并对两组患者进行安全性评价。结果:治疗组总有效率高于对照组(P<0.05);治疗后及治疗结束3个月后ACT评分比较,治疗组高于对照组(P<0.05);治疗后治疗组FEV1%高于对照组(P<0.05);治疗后治疗组急性发作次数,PEF变异率,外周血EOS计数和血清IL-4,IL-6,IL-13水平低于对照组(P<0.05)。结论:加味消风散联合布地奈德福莫特罗粉吸入剂治疗支气管哮喘风哮证可有效缓解症状,提高临床疗效,改善肺功能,降低血清炎症因子水平,改善气道慢性炎症状态。

Objective: To observe the clinical efficacy of modified Xiaofengsan and its effect on cytokines in persistent asthma patients with wind-asthma pattern. Method: The 120 eligible patients with chronic and persistent asthma were randomly divided into control group ( 60 cases) and treatment group ( 60 cases) . Patients in control group received the budesonide /formoterol ( 160 μg /4. 5 μg,2 inhales /time,bid) . Patients in treatment group additionally received the modified Xiaofengsan combined with budesonide /formoterol ( 160 μg /4. 5 μg) . The treatment course was 1 month in both groups. The clinical efficacy of the two groups was observed. Before and 3 months after treatment,asthma control test ( ACT) and the average times of acute exacerbation in 6 months before and after treatment between two groups were observed;percentage of forced expiratory volume in first second and its predicted value ( FEV1%) ,variety ratio of Peak expiratory flow ( PEF) ,eosinophilic granulocyte ( EOS) count in peripheral blood and the levels of interleukin-4 ( IL-4) ,interleukin-6 ( IL-6) and interleukin-13 ( IL-13) in serum were measured before and after treatment respectively. In addition,the safety of the two groups was evaluated. Result: The total effective rate of the treatment group was higher than that of the control group ( P < 0. 05) . The levels of ACT value and FEV1% in treatment group were higher ( P < 0. 05) ,while the average times of acute exacerbation,PEF variety ratio,EOS count in peripheral blood,L-4,IL-6 and IL-13 in serum were lower ( P < 0. 05) than those in control group after treatment. There was no significant difference in incidence of the adverse reactions. Conclusion: Modified Xiaofengsan combined with budesonide /formoterol could relieve symptoms of asthma,improve pulmonary function and lower the levels of IL-4,IL-6 and IL-13 in serum.