摘要
目的探讨黄芩咳喘散三伏贴辅助疗法治疗肺脾气虚证哮喘患者的临床疗效及对其免疫功能相关指标的影响。方法选取2021年5月—2022年8月期间在上海中医药大学附属市中医医院肺病科门诊就诊的肺脾气虚证哮喘患者140例,按随机数字表法分为治疗组和对照组,每组各70例。治疗组采用黄芩咳喘散三伏贴方案治疗,对照组采用黄芩咳喘散三伏贴模拟剂方案治疗。治疗2个月后,观察比较两组患者临床疗效,治疗前后中医证候积分评分、血清免疫球蛋白(Immunoglobulin E,IgE)、T淋巴细胞亚群(CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+))指标、肺功能相关指标[第1秒用力呼气容积(Forced expiratory volume in the first second,FEV1)、呼气流量峰值(Peak expiratory flow,PEF)]变化情况,并采用Pearson相关系数分析血清IgE与肺功能指标的相关性。结果治疗后治疗组临床总有效率89.70%(61/68)明显高于对照组75.00%(51/68),差异有统计学意义(P<0.05)。治疗后两组患者咳嗽气促、喘息咯痰、食少便溏、神疲乏力均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组各项评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者IgE、CD8^(+)水平均较治疗前明显降低,CD4^(+)、CD4^(+)/CD8^(+)水平较治疗前明显升高,差异有统计学意义(P<0.05),且治疗组IgE、CD8^(+)水平低于对照组,治疗组CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者肺功能相关指标FEV1、PEF均较治疗前升高,差异有统计学意义(P<0.05);且治疗组PEF值高于对照组,差异有统计学意义(P<0.05),治疗组FEV1值与对照组比较,差异无统计学意义(P>0.05)。采用Pearson相关系数分析显示,血清IgE与肺功能指标PEF呈显著负相关(r=-0.327,P<0.05)。结论黄芩咳喘散三伏贴辅助疗法应用于肺脾气虚证哮喘患者具有较为明显的临床疗效,对改善患者临床不良症状等具有积极效用,亦可有效减轻患者机体炎症、改善患者肺功能,值得临床推广应用。
Objective To explore the clinical efficacy of Huangqin Kechuansan Sanfu Paste adjuvant therapy on asthma patients with lung-spleen qi deficiency syndrome and its effect on immune function-related indicators.Methods A total of 140 asthma patients with lung-spleen qi deficiency syndrome who visited the Department of Pulmonary Diseases at the Shanghai Municipal Hospital of Traditional Chinese Medicine of Shanghai University of Traditional Chinese Medicine between May 2021 and August 2022 were enrolled and randomly divided into a treatment group and a control group,with 70 cases in each group.The treatment group received Huangqin Kechuansan Sanfu Paste therapy,while the control group received a simulated agent of Huangqin Kechuansan Sanfu Paste therapy.After two months of treatment,the clinical effica⁃cy of the two groups was observed and compared.Changes in traditional Chinese medicine(TCM)syndrome scores,serum immunoglobulin E(IgE),T lymphocyte subsets(CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)),and lung function-related indicators[forced expiratory volume in the first second(FEV1)and peak expiratory flow(PEF)]of the two groups were assessed be⁃fore and after treatment.The Pearson correlation coefficient was used to analyze the relationship between serum IgE and lung function indicators.Results After treatment,the overall clinical effective rate in the treatment group was 89.70%(61/68),significantly higher than 75.00%(51/68)in the control group(P<0.05).After treatment,symptoms including cough,shortness of breath,wheezing,expectoration,reduced appetite,loose stools,and fatigue were significantly improved in both groups compared with those before treatment(P<0.05),and the scores of various symptoms in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,the levels of IgE,CD8^(+)in both groups were significantly decreased,while the level of CD4^(+)、CD4^(+)/CD8^(+)increased significantly compared with those before treatment(P<0.05).Moreover,the levels of IgE,CD8^(+)in the treatment group were lower than those in the control group,while theCD4^(+)、CD4^(+)/CD8^(+)level in the treatment group was higher than that in the control group(P<0.05).After treatment,lung function indicators FEV1 and PEF in both groups increased significantly compared with those before treat⁃ment(P<0.05).The PEF value in the treatment group was higher than that in the control group(P<0.05),while there was no statistically significant difference in FEV1 values between the treatment and control groups(P>0.05).Pearson correlation coefficient analysis showed a significant negative correlation between serum IgE and lung function indicator PEF(r=-0.327,P<0.05).Conclusion Adjuvant therapy of Huangqin Kechuansan Sanfu Paste has evident clinical effica⁃cy in treating asthma patients with lung-spleen qi deficiency syndrome,which exerts a positive effect on improving adverse clinical symptoms,effectively reduces patient inflammation,improves lung function,and thus merits clinical promotion and application.
作者
丁楚
折哲
石克华
DING Chu;ZHE Zhe;SHI Ke-hua(Department of Pulmonary Diseases,Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071)
出处
《世界中西医结合杂志》
2023年第10期2060-2064,共5页
World Journal of Integrated Traditional and Western Medicine
基金
上海市卫生健康委员会科研课题(202040261)。
关键词
黄芩咳喘散三伏贴
哮喘
肺脾气虚证
免疫功能
肺功能
Huangqin Kechuansan Sanfu Paste
Asthma
Lung-Spleen Qi Deficiency Syndrome
Immune Func⁃tion
Lung Function
