目的 分析消积豁痰汤加减联合玉屏风散对肺脾气虚型支气管哮喘患者的疗效及对免疫功能的影响。方法 62例支气管哮喘患者以随机数字表法分研究组(31例)、对照组(31例)，对照组给予玉屏风散，研究组在对照组基础上给予消积豁痰汤加减方剂治疗，两组均持续治疗3个月后评价效果。比较两组中医症状评分、肺功能及临床疗效，对比两组外周血因子、体液免疫因子、细胞免疫因子变化情况，记录两组治疗期间不良事件发生情况。结果 两组治疗后的主症、次症中医证候评分均低于治疗前(P＜0。05)，研究组治疗后的主症、次症中医证候评分均低于对照组(P＜0。05)。两组治疗后第 1 秒用力肺活量(forced expiratory volume in the first second，FEV1)/用力肺活量(forced vital capacity，FVC)均高于治疗前，最大呼气流量(peak expiratory flow，PEF)变化率与FEV1变化率均低于治疗前(P＜0。05)，研究组治疗后的FEV1/FVC高于对照组，PEF变化率与FEV1变化率低于对照组(P＜0。05)。研究组总有效率(96。77％，30/31)高于对照组(77。42％，24/31)(P＜0。05)。两组治疗后血清干扰素γ(interferon-γ，IFN-γ)、白细胞介素-4(interleukin-4，IL-4)、转化生长因子-β(transforming growth factor-β，TGF-β)、白细胞介素-17(interleukin-17，IL-17)均低于治疗前(P＜0。05)，研究组治疗后的IFN-γ、IL-4、TGF-β、IL-17均低于对照组(P＜0。05)。两组治疗后外周血中免疫球蛋白E(immunoGlobin E，IgE)、IgG、IgM均低于治疗前，补体C3、C4均高于治疗前(P＜0。05)，研究组治疗后的IgE、IgG、IgM均低于对照组，C3、C4均高于对照组(P＜0。05)。两组治疗后辅助性T细胞1(Helper T cell 1，Th1)/Th2、Th17/调节性T细胞(Regulatory T cells，Treg)均低于治疗前，CD4+/CD8+均高于治疗前(P＜0。05)，研究组治疗后的Th1/Th2、Th17/Treg均低于对照组，CD4+/CD8+高于对照组(P＜0。05)。两组总不良事件发生率对比差异无统计学意义(P＞0。05)。结论 消积豁痰汤加减联合玉屏风散治疗肺脾气虚证支气管哮喘可改善临床症状及肺功能，增强治疗效果，改善患者外周血因子分泌及免疫功能，且安全性良好。
Effect of Modified Xiaoji Huotan Decoction(消积豁痰汤加减)Combined with Yupingfeng Powder(玉屏风散)on Bronchial Asthma Patients with Lung Qi Deficiency Syndrome and Its Influence on Immunity Function
Objective To analyze the effect of Modified Xiaoji Huotan Decoction(消积豁痰汤加减)combined with Yuping-feng Powder(玉屏 风散)on bronchial asthma patients with lung Qi deficiency syndrome and its influence on immunity function.Methods A total of 62 patients with bronchial asthma were randomly divided into study group(31 cases)and control group(31 ca-ses).The control group was treated with Yupingfeng Powder(玉 屏 风散)while the study group was treated with Xiaoji Huotan Decoction on the basis of the control group.The effect was evaluated after continuous treatment for 3 months.The TCM symptom scores,pulmonary function and clinical efficacy were compared between the two groups.The changes of peripheral blood factors,humoral immune factors and cellular immune factors were compared between the two groups,and the incidence of adverse events during treatment was recorded.Results The TCM syndrome scores of the two groups after treatment were lower than those before treatment(P＜0.05),and the TCM syndrome scores of the study group after treatment were lower than those of the control group(P＜0.05).The forced expiratory volume in the first second(FEV1)/forced vital capacity(FVC)of the two groups after treat-ment were higher than those before treatment,the change rate of peak expiratory flow(PEF)and FEV 1 were lower than those be-fore treatment(P＜0.05).FEV1/FVC of the study group was higher than that of the control group,and the change rates of PEF and FEV1 were lower than those of the control group after treatment(P＜0.05).The total effective rate of the study group(96.77％,30/31)was higher than that(77.42％,24/31)of the control group(P＜0.05).The serum levels of interferon-γ(IFN-γ),interleukin-4(IL-4),transforming growth factor-β(transforming growth factor-β)and interleukin-17(IL-17)in the two groups after treatment were lower than those before treatment(P＜0.05),the levels of IFN-γ,IL-4,TGF-βand IL-17 in the study group were lower than those of the control group after treatment(P＜0.05).The levels of immunoglobin E(IgE),immunoglobin G(IgG)and immunoglobin M(IgM)in peripheral blood of the two groups after treatment were lower than those before treatment,and the levels of complement C3 and C4 were higher than those before treatment(P＜0.05).The levels of IgE,IgG and IgM in the study group were lower than those in the control group,the levels of C3 and C4 were higher than those of the control group after treatment(P＜0.05).Th1/Th2 and Th17/Treg in the two groups after treatment were lower than those be-fore treatment,and CD4+/CD8+was higher than that before treatment(P＜0.05).Th1/Th2 and Th17/Treg in the study group were lower than those in the control group,and CD4+/CD8+was higher than that of the control group after treatment(P＜0.05).There was no significant difference in the total incidence of adverse events between the two groups(P＞0.05).Conclusion Xiaoji Huotan Decoction combined with Yupingfeng Powder in the treatment of bronchial asthma with lung Qi deficiency syndrome can improve the clinical symptoms and lung function,enhance the treatment effect,improve the peripheral blood factor secretion and immunity function and has good safety.
bronchial asthmaQi deficiency of lung and spleenXiaoji Huotan Decoction(消积豁痰汤)Yupingfeng Powder(玉屏风散)curative effectimmune function
万方数据
维普
