| 刘中友,郑晓娜.千金清肺汤联合西药治疗痰热型支气管扩张的临床疗效及对外周血 Th17/Treg失衡及相关因子表达的影响[J].安徽医药,2023,27(4):835-839. |
| 千金清肺汤联合西药治疗痰热型支气管扩张的临床疗效及对外周血 Th17/Treg失衡及相关因子表达的影响 |
| Clinical efficacy of Qianjin Qingfei decoction combined with western medicine in the treatment of phlegm-heat bronchiectasis and its influences on the imbalance of Th17/Treg in peripheral blood and the expression of related factors in patients |
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| DOI：10.3969/j.issn.1009-6469.2023.04.047 |
| 中文关键词: 支气管扩张症 T淋巴细胞，辅助诱导 T淋巴细胞，调节性 白细胞介素类 痰热型 千金清肺汤 头孢哌酮 |
| 英文关键词: Bronchiectasis T-lymphocytes, helper-induction T-lymphocytes, regulatory Interleukins Phlegm-heat type Qianjin Qingfei decoction Cefoperazone |
| 基金项目:河南省中医药科学研究专项课题( 20-21ZY3041) |
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| 中文摘要: |
| 目的探究千金清肺汤联合西药头孢哌酮钠舒巴坦钠与硫酸阿米卡星注射液静脉滴注治疗痰热型支气管扩张的临床疗效及对病人外周血 Th17/Treg失衡及相关因子表达的影响。方法选取 2019年 5月至 2021年 3月在驻马店市中医院治疗的属痰热型支气管扩张病人 85例，采用随机数字表法将病人分为两组，对照组( 43例)采用西医治疗(头孢哌酮钠舒巴坦钠联合硫酸阿米卡星注射液静脉滴注 10 d治疗)研究组( 42例)采用中西医结合治疗，其中中医采用千金清肺汤口服，西药应用头孢哌酮钠舒巴坦钠联合硫酸阿米卡星注射液静，脉滴注 10 d治疗。比较两组病人的临床疗效、肺功能指标、 Th17/Treg水平及血清炎症指标白细胞介素 -6(IL-6)白细胞介素 -10(IL-10)白细胞介素 -17(IL-17)及转化生长因子 -β(TGF-β)水平。结果研究组治疗效果显著高于对照组( P<0.0、5)。治疗后，两组病人肺、功能第一秒用力呼气容积( FEV1)、用力肺活量( FVC)和 FEV1/FVC指标均上升，且研究组显著高于对照组［( 2.73±0.55)L比( 2.47±0.49)L、(3.41±0.68)L比( 3.05±0.61)L、(82.46±9.16)L比( 76.12±8.46)L］(P<0.05)；两组外周血辅助 T细胞 17(Th17)、 Th17/Treg表达水平下降，调节 T细胞( Treg)表达水平上升，且研究组 Th17、Th17/Treg水平显著低于对照组［(1.15±0.23)%比( 1.64±0.33)%、(0.22±0.04)%比( 0.35±0.07)%］Treg水平显著高于对照组［(5.35±1.07)%比( 4.82±0.96)%］(P<0.05)；两组炎性因子 IL-6、IL-17水平均下降， TGF-β、IL-10水上升，且研究组 IL-17、 IL-6水平显著低于对照组， IL-10T、GF-β水平显著高于对照组( P<0.05)。结论千金清肺汤联合抗生素治疗对痰热型支气管扩张症病人有较好疗效，可以改善病人肺功能及炎症反应，调节病人外周血 Th17/Treg平衡。 |
| 英文摘要: |
| Objective To explore the clinical efficacy of Qianjin Qingfei decoction combined with Western medicine (cefoperazonesodium sulbactam sodium combined with amikacin sulfate injection intravenous drip) in the treatment of phlegm-heat bronchiectasis and its influence on the imbalance of Th17/Treg in peripheral blood and the expression of related factors.Methods From May 2019 to March 2021, 85 patients with phlegm-heat bronchiectasis treated at Zhumadian Hospital of Traditional Chinese Medicine were selected,and the patients were divided into two groups using the random number table method. The control group (43 cases) was treated withWestern medicine, and the study group (42 cases) was treated with integrated traditional Chinese medicine and Western medicine.Among them, traditional Chinese medicine adopts Qianjin Qingfei decoction orally, and Western medicine applies cefoperazone sodiumsulbactam sodium combined with amikacin sulfate injection intravenously for 10 d. The clinical efficacy, lung function indexes, Th17/Treg levels and serum inflammatory indexes interleukin-6 (IL)-6, IL-10, IL-17 and transforming growth factor-β (TGF-β) levels in the two groups were compared.Results The treatment effect in the study group was significantly higher than that in the control group (P < 0.05). After treatment, the first second forced expiratory volume (FEV1), forced vital capacity (FVC) and FEV1/FVC indexes increased in both groups, and the study group were significantly higher than the control group [(2.73±0.55) L vs. (2.47±0.49) L, (3.41±0.68) L vs. (3.05±0.61) L, (82.46±9.16) L vs. (76.12±8.46) L] (P < 0.05); the expression levels of peripheral blood T helper 17 (Th17) and Th17/Treg decreased, and the expression levels of regulatory T cells (Treg) increased in both groups, and the levels of Th17 and Th17/Treg inthe study group were significantly lower than those in the control group [(1.15±0.23) % vs. (1.64±0.33) % , (0.22±0.04) % vs. (0.35± 0.07) %], and Treg levels were significantly higher than those in the control group [(5.35±1.07) % vs. (4.82±0.96) %] (P < 0.05); the levels of IL-6 and IL-17 decreased and the levels of TGF-β and IL-10 increased in both groups, and the levels of IL-17 and IL-6 in the study group were significantly lower than those in the control group, and the levels of IL-10 and TGF-β were significantly higher than those in the control group (P < 0.05).Conclusion Qianjin Qingfei decoction combined with antibiotic has a good effect on patients with phlegm-heat bronchiectasis, which can improve lung function and the inflammatory response, and regulate the Th17/Treg balance |
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