摘要
目的观察自拟小青龙汤联合神阙穴拔罐对寒哮型支气管哮喘Th1/Th2型细胞因子失衡及气道重塑的影响。方法将150例寒哮型支气管哮喘患者随机分为观察组75例和对照组75例,2组均常规给予布地奈德福莫特罗粉吸入剂治疗,观察组在常规治疗基础上给予神阙穴拔罐联合自拟小青龙汤治疗,2组均连续治疗8周。观察2组治疗前后中医证候积分、哮喘控制测试(ACT)评分的变化情况,并检测2组治疗前后Th1/Th2型细胞因子及气道重塑相关指标。结果治疗后2组咳嗽、咳痰、喘息、肺部体征积分均显著降低(P均<0.05),且观察组上述积分均显著低于对照组(P均<0.05);观察组治疗后ACT评分、哮喘控制测试情况分布均显著优于对照组(P均<0.05);治疗后2组Th1/CD4^+比例、Th1/Th2比值及IL-17、IFN-γ水平均显著降低(P均<0.05),Th2/CD4^+比例及IL-4、IL-10水平均显著升高(P均<0.05),且观察组上述指标改善情况均显著优于对照组(P均<0.05);治疗后2组呼气峰值流速(PEF)、FEV_1占用力肺活量百分比(FEV_1/FVC)均明显升高(P均<0.05),气道壁厚度(T)、气道腔面积(AI)、气道壁面积(WA)、气道壁面积占气道总横截面积的百分比(WA%)均显著降低(P均<0.05),观察组上述指标改善情况均显著优于对照组(P均<0.05)。结论在常规西药治疗基础上联合小青龙汤和神阙穴拔罐治疗寒哮型支气管哮喘患者可明显改善临床症状及肺功能,提高哮喘控制疗效,其机制可能与调节机体Th1/Th2型细胞因子平衡、逆转气道重塑有关。
Objective It is to observe the effect of Xiaoqinglong decoction combined with Shenque acupuncture point cupping therapy on the imbalance of Th1/Th2 cytokines and airway remodeling in cold wheezing bronchial asthma. Methods 150 cases of cold wheezing bronchial asthma patients were randomly divided into observation group （75 cases） and control group （75 cases）, both groups were routinely given inhaler treatment of budesonide mott powder, additionally the observation group was treated with Xiaoqinglong decoction＋ Shenque acupuncture point cupping therapy. Both groups were treated for 8 weeks. The changes of TCM syndromes and ACT scores were observed, the levels of Th1/Th2 cytokines and airway remodeling related indexes before and after treatment were detected in both groups. Results After treatment, the scores of cough, phlegm, wheezing, lung signs, the proportion of Th1/CD4, Th1/Th2 ratio, and the levels of IL-4 and IL-10 were significantly reduced, while Th2/CD4^＋and the levels of IL-4 and IL-10 were significantly increased in both groups （ P 〈0.05）, the improvements of above indexes were better in the observation group than the control group （ P 〈0.05）. The ACT score and the distribution of asthma control test of the observation group were all better than the control group （ P 〈 0.05）;PEF, FEV 1/FVC were increased, airway wall thickness （T）, airway lumen area （AI）, airway wall area （WA）, airway wall area accounted for the total cross-sectional area of the airway （WA%） were significantly decreased in both groups, the improvements of above indexes were better than the control group （ P 〈0.05）. Conclusion The combination with Xiaoqinglong decoction and Shenque acupuncture point cupping therapy based on normal western medical therapy can significantly improve clinical symptoms and lung signs, improve asthma control effect in the treatment of cold wheezing bronchial asthma, its mechanism may be related to regulate Th1/Th2 cytokines balance and reverse airway remodeli
作者
郭洁
田振峰
景璇
魏树慧
吴丽梅
刘明
张林
武蕾
孟召湖
GUO Jie;TIAN Zhenfeng;JING Xuan;WEI Shuhui;WU Limei;LIU Ming;ZHANG Lin;WU Lei;MENG Zhaohu(Hebei Provincial Hospital of TCM,Shijiazhuang 050011,Hebei,China;The First Hospital of Shijiazhuang,Shijiazhuang 050011,Hebei,China;Hospital of Luanping County,Luanping 067002,Hebei,China)
出处
《现代中西医结合杂志》
CAS
2018年第20期2167-2170,2174,共5页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
河北省中医药管理局科研立项课题(2016021
2016029
2012037
2013045
zyzd2013001)
政府资助临床医学优秀人才培养项目(2015054965)
