补肺健脾益肾方治疗稳定期慢性阻塞性肺疾病营养状况和对免疫功能的影响

王靓雅; 刘冰; 祖权; 张延

doi:10.13422/j.cnki.syfjx.2017220182

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补肺健脾益肾方治疗稳定期慢性阻塞性肺疾病营养状况和对免疫功能的影响

临床 | 更新时间：2024-01-04

- 补肺健脾益肾方治疗稳定期慢性阻塞性肺疾病营养状况和对免疫功能的影响
- Effect of Bufei Jianpi Yishen Decoction on Nutritional Status Immune Function of Chronic Obstructive Pulmonary Disease at Stable Period
- 中国实验方剂学杂志 2017年23卷第22期页码：182-187
- 作者机构：
- 作者简介：
- 基金信息：
  
  吉林省卫生厅科技计划项目（201310156）。
- DOI：10.13422/j.cnki.syfjx.2017220182
  中图分类号： R259
- 纸质出版日期：2017
- 稿件说明：
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王靓雅, 刘冰, 祖权, 等. 补肺健脾益肾方治疗稳定期慢性阻塞性肺疾病营养状况和对免疫功能的影响[J]. 中国实验方剂学杂志, 2017,23(22):182-187.

WANG Liang-ya, LIU Bing, ZU Quan, et al. Effect of Bufei Jianpi Yishen Decoction on Nutritional Status Immune Function of Chronic Obstructive Pulmonary Disease at Stable Period[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(22): 182-187.
王靓雅, 刘冰, 祖权, 等. 补肺健脾益肾方治疗稳定期慢性阻塞性肺疾病营养状况和对免疫功能的影响[J]. 中国实验方剂学杂志, 2017,23(22):182-187. DOI： 10.13422/j.cnki.syfjx.2017220182.

WANG Liang-ya, LIU Bing, ZU Quan, et al. Effect of Bufei Jianpi Yishen Decoction on Nutritional Status Immune Function of Chronic Obstructive Pulmonary Disease at Stable Period[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(22): 182-187. DOI： 10.13422/j.cnki.syfjx.2017220182.

摘要

目的：探讨补肺健脾益肾方治疗稳定期慢性阻塞性肺疾病（慢阻肺，COPD）的临床疗效及对营养状况、免疫功能、炎症因子的影响。方法：将136 COPD 例患者采用SAS软件生成的，随机按数字表法分为对照组和观察组各68例。对照组采用异丙托溴铵气雾剂，40～80 μg/次，2～4次/d；沙美特罗替卡松粉吸入剂，每次1吸，2次/d。观察组在对照组治疗的基础上加服补肺健脾益肾方，1剂/d。两组疗程均治疗12周。症状评价采用改良版英国医学研究委员会呼吸问卷（mMRC），慢阻肺患者自我评估测试（CAT）和中医证候量表，于治疗前后各评价1次；评价治疗前后第1秒用力呼气容积（FEV1），用力肺活量（FVC）和FEV1占预计值百分比（FEV1%）；进行治疗前后圣乔治呼吸问卷（SGRQ），6 min 步行距离（6 mWD），微型营养评定法（MNA）评价；检测治疗前后T淋巴细胞亚群（CD4+，CD8+，CD4+/CD8+），免疫球蛋白（IgG，IgM，IgA），炎症因子[白细胞介素-8（IL-8），IL-4，肿瘤坏死因子-α（TNF-α）]，血清总蛋白（TB），白蛋白（ALB），前白蛋白（PAB），血红蛋白（HB）水平，于治疗前后各检测1次。结果：观察组中医证候疗效总有效率为93.85%，优于对照组的80.65%（χ2 ＝5.022，P<0.05）；治疗后观察组mMRC，CAT和中医证候评分均低于对照组（P<0.01）；治疗后观察组FEV1%，FEV1和FVC均高于对照组（P<0.05）；治疗后观察组呼吸症状、活动能力和疾病影响和SGRQ总分均低于对照组，6 mWD大于对照组（P<0.01）；治疗后观察组患者MNA评分高于对照组，TB，ALB，PAB水平均高于对照组（P<0.01）；治疗后观察组CD3+，CD4+，CD4+/CD8+水平均高于对照组，CD8+水平低于对照组（P<0.01）；观察组治疗后IgG，IgM，IgA水平均有升高，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-8，IL-4和TNF-α水平均低于对照组（P<0.01）。结论：补肺健脾益肾方治疗慢阻肺可以改善患者的营养状况，提高免疫功能，减轻炎症因子反应，起到缓解临床症状，改善肺功能，提高患者的生活质量和运动能力的作用，有较好的临床疗效。

Abstract

Objective: To discuss the clinical effect of Bufei Jianpi Yishen decoction ointment on chronic obstructive pulmonary disease at stable period

and its effect on nutritional status

immune function and inflammatory factors. Method: One hundred and thirty-six patients with COPD were randomly divided into control group and observation group by random number table. Patients in control group got ipratropium bromide aerosol

40-80 μg/time

2-4 times/day. And Salmeterol inhalation

1 suck/time

2 times/day. In addition to the therapy of control group

patients in observation group was also given Bufei Jianpi Yishen decoction

15 g/time

3 times/day. And 24 weeks were a course of treatment. The symptoms were evaluated by Modified British Medical Research Council (mMRC)

chronic obstructive pulmonary disease self-assessment test (CAT) and traditional Chinese medicine (TCM) syndrome scale before treatment

and at the 12th and 24th. And before and after treatment

forced expiratory volume in the first second (FEV1)

forced vital capacity (FVC) and proportion of FEV1 to expected value (FEV1%) were detected. And scores of St. George's Respiratory Questionnaire (SGRQ)

6 minute walk test (6 mWD) and mini nutritional assessment (MNA) were evaluated. Besides

T lymphocyte subsets (CD4+

CD8+ and CD4+/CD8+)

immunoglobulins (IgG

IgM and IgA)

inflammatory factors [interleukin-8 (IL-8)

IL-4

tumor necrosis factor-α (TNF-α)]

serum total protein (TB)

albumin (ALB)

prealbumin (PAB) and Hemoglobin (HB) were detected

1 times were detected before and after treatment. Result: The total effect rate of TCM symptoms in observation group was 93.85%

which was higher than 80.65% in control group (χ2=5.022

P<0.05). At the 12th and 24th week

scores of mMRC

CAT and TCM symptoms in observation group were lower than those in control group (P<0.01). After treatment

FEV1%

FEV1 and FVC were all higher than those in control group (P<0.05). Breathing symptoms

scores of activity ability

disease effects and total score of SGRQ were all lower than those in control group

and 6 mWD was longer than that in control group (P<0.01). After treatment

score of MNA was higher than that in control group

and levels of TB

ALB and PAB and CD3+

CD4+

CD4+/CD8+ were higher than those in control group

and levels of CD8+ and IL-8

IL-4 and TNF-α were lower than that in control group (P<0.01). After treatment

levels of IgG

IgM and IgA in observation group increased

which were higher than those in control group (P<0.05). Conclusion: Bufei Jianpi Yishen decoction can ameliorate nutritional status

improve lung function and immune function

relieve inflammation and clinical symptoms

increase the quality of life of the patients and exercise capability

with a better clinical effect than western medicine therapy.

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