摘要
目的：探讨培土生金方治疗慢性阻塞性肺疾病（COPD）稳定期肺脾气虚证兼血瘀证的临床疗效及对气道重塑机制的研究。方法：选择160例符合要求的患者,根据就诊先后,采用随机按数字表法分为对照组和观察组各80例。对照组给予噻托溴铵粉吸入剂治疗。观察组噻托溴铵粉吸入剂使用同对照组,并给予培土生金方。两组疗程均为4个月。进行治疗前后肺功能检查,记录用力肺活量（FVC）,第1秒用力呼气容积（FEV1）,FEV1占预计值百分比（FEV1%）;进行治疗后中医证候量表和呼吸困难指数（MMRC）评分;检测治疗前后白细胞介素-6（IL-6）,IL-8,肿瘤坏死因子-α（TNF-α）,转化生长因子-β1（TGF-β1）,血管内皮生长因子（VEGF）,基质金属蛋白酶（MMP-2）,MMP-9和基质金属蛋白酶组织抑制剂（TIMP-1）水平。结果：观察组患者临床疗效总有效率为89.33%,对照组为73.61%,观察组高于对照组（χ^2=6.056,P〈0.05）;治疗后观察组中医证候主要症状评分、总积分,MMRC评分均低于对照组（P〈0.01）;治疗后观察组FEV1%较治疗前增加,并高于治疗后对照组水平（P〈0.05）;治疗后观察组患者血清IL-6,IL-8,TNF-α水平均低于对照组（P〈0.01）;治疗后观察组患者血清TGF-β1,VEGF,MMP-2,MMP-9,TIMP-1水平均低于对照组（P〈0.01）。结论：培土生金方治疗COPD肺脾气虚证兼血瘀证患者,能缓解临床症状、提高肺功能的作用,并能抑制炎症因子反应,调节生长因子、蛋白酶-抗蛋白酶的失衡,减轻患者气道重塑作用。
Objective： To discuss the clinical effect of Peitu Shengjin decoction for chronic obstructive pulmonary disease（ COPD,Qi deficiency of lung and spleen） at stationary phase and investigate the mechanism of airway remodeling. Method： One hundred and sixty patients were randomly divided into control group 80 cases and observation group 80 cases by random number table. Patients in control group received tiotropium bromide powder for inhalation. Based on the treatment in control group,patients in observation group added Peitu Shengjin decoction. The treatment course was 4 months in both groups. Before and after treatment,pulmonary function was detected,and forced vital capacity（ FVC）,forced expiratory volume at the first second（ FEV1）,and percentage of FEV1 in estimated value（ FEV1%） were recorded. Scores of traditional Chinese medicine（ TCM） syndrome,and index of dyspnea（ MMRC） were graded. In addition,the levels of interleukin-6（ IL-6）,IL-8,tumor necrosis factor-α（ TNF-α）,transforming growth factor-β1（ TGF-β1）,vascular endothelial growth factor（ VEGF）,matrix metalloproteinase（ MMP-2, MMP-9）, and tissue inhibitor of metalloproteinase-1（ TIMP-1） were detected.Result： The total effective rate was 89. 33% in observation group,higher than 73. 61% in control group（ χ^2=6. 056,P〈0. 05）. The scores of cardinal symptom,total score of TCM syndrome and score of MMRC in observation group were lower than those in control group（ P〈0. 01）. Levels of IL-6,IL-8,TNF-α,TGF-β1,VEGF,MMP-2,MMP-9 and TIMP-1 were all lower than those in control group（ P〈0. 01）. Conclusion： Peitu Shengjin decoction can inhibit inflammatory response,regulate growth factor and balance of protease-antiprotease,relieve airway remodeling,alleviate clinical symptoms and improve pulmonary function.
作者
黄少君
傅汝梅
HUANG Shao-jun;FU Ru-mei(Haikou Hospital of Traditional Chinese Medicine, Haikou 570203, Chin)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2018年第1期174-179,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家中医药管理局2013年度全国名老中医专家传承工作室建设项目(2013-47):傅汝梅全国名老中医药专家传承工作室
海南省自然科学基金项目(817388)
关键词
慢性阻塞性肺疾病
气道重塑
肺脾气虚证
培土生金方
chronic obstructive pulmonary disease
airway remodeling
Qi deficiency of lung and spleen
Peitu Shengjin decoction
