摘要
目的探究穴位贴敷辅助布地奈德治疗慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)急性加重期疗效及对其免疫功能和细胞因子的影响。方法按照随机数字表法将120例COPD急性加重期患者分为对照组与治疗组,每组60例。常规对症支持治疗基础上,对照组给予布地奈德,治疗组给予穴位贴敷辅助布地奈德治疗,两组均治疗10 d后评价相关指标。对比两组治疗前后中医证候积分、肺功能[第1秒用力呼气量占用力肺活量百分比(FEV1/FVC)、第1秒用力呼气量占预计值百分比(FEV1%)]、免疫功能[T淋巴细胞亚群水平(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))]、血清细胞因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]水平改善情况,以及两组治疗安全性。结果治疗后两组咳嗽、痰色、痰量、痰质、喘急积分均较治疗前降低,且治疗组低于对照组(P<0.05),差异有统计学意义;治疗后两组FEV1/FVC、FEV1%均较治疗前提高,且治疗组高于对照组高(P<0.05),差异有统计学意义;治疗后两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较治疗前提高,且治疗组较对照组(P<0.05),差异有统计学意义;治疗后两组血清TNF-α、IL-6、IL-8水平均较治疗前降低,且治疗组低于对照组(P<0.05),差异有统计学意义;治疗期间,两组肝肾功能、心电图、血尿常规未见明显异常,治疗组用药不良反应发生率与对照组比较差异无统计学意义(P>0.05)。结论COPD急性加重期患者给予穴位贴敷辅助布地奈德治疗,可取得显著临床疗效,改善患者肺功能,可能与调节机体免疫功能、下调血清炎症细胞因子表达有关,且该方案安全性具有保障。
Objective To explore the clinical value of acupoint application prescription combined with budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD).Method According to the random number table method,120 patients with acute exacerbation of COPD in our hospital were divided into control group and treatment group,with 60 patients in each group.On the basis of routine symptomatic supportive treatment,budesonide was given to the control group,and acupoint application was given to the treatment group to assist budesonide treatment.Relevant indicators were evaluated after 10 days of treatment in both groups.The TCM syndrome scores and pulmonary function before and after treatment were compared between the two groups[FEV1/FVC,FEV1 S Forced expiratory volume as a percentage of predicted(FEV1%)],immune function[T lymphocyte subset levels(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))],serum cytokines[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)]levels improved,and treatment safety in both groups.Result After treatment,the scores of cough,sputum color,sputum volume,sputum quality,and urgency of the two groups were lower than before treatment,and the treatment group was lower than the control group(P<0.05),the difference was statistically significant;after treatment,the FEV1/FVC and FEV1%were both higher than before treatment,and the treatment group was higher than the control group(P<0.05),the difference was statistically significant;after treatment,the two groups of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were all higher than before treatment,and the treatment group was higher than that before treatment.The control group was high(P<0.05),and the difference was statistically significant;after treatment,the serum TNF-α,IL-6,and IL-8 levels in the two groups were lower than before treatment,and the treatment group was lower than the control group(P<0.05),The difference was statistically significant;during the treatment period,the liver and kidney function,electrocardiogram,blood and urine routine of the two groups were not significantly abnormal,and the incidence of adverse drug reactions between the treatment group and the control group was not statistically significant(P>0.05).Conclusion Patients with acute exacerbation of COPD can be given acupoint application group to assist budesonide treatment,which can achieve significant curative effect and improve the lung function of patients,which may be related to the regulation of immune function and down-regulation of serum inflammatory cytokine expression,and the safety of this program is guaranteed.
作者
卢军仪
赵丹
孙义田
李亚
LU Jun-yi;ZHAO Dan;SUN Yi-tian;LI Ya(Department of Geriatrics,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou Hebei 061000)
出处
《世界中西医结合杂志》
2021年第4期700-704,709,共6页
World Journal of Integrated Traditional and Western Medicine
基金
河北省中医药管理局科研计划项目(3601014)。
