Clinical study of Xiaoyong Qufu Shengji Decoction combined with thymosin α1 in the treatment of bronchodilation in stable stage of lung Qi deficiency type
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摘要:
目的 基于“治肺不远温”的中医理论,探讨消痈祛腐生肌汤联合胸腺肽α1治疗支气管扩张稳定期的效果,为增益临床疗效提供依据。 方法 选取2021年1月—2023年1月浙江中医药大学附属丽水中医院收治的88例肺脾气虚型支气管扩张稳定期患者,采用随机数表法分为对照组和研究组,各44例。在常规对症治疗基础上,对照组给予胸腺肽α1治疗,研究组给予消痈祛腐生肌汤联合胸腺肽α1治疗,均持续治疗和观察8周。观察2组中医证候积分、肺功能[第1秒用力呼气容积占预计值百分比(FEV1%pred)、第1秒用力呼气量占用力肺活量的比值(FEV1/FVC)]、T淋巴细胞亚群指标[CD4+、CD8+、CD4+/CD8+],比较中医证候疗效和不良反应发生情况。 结果 研究组治疗后“咳嗽”“咳痰”积分和中医证候总积分均低于对照组(P<0.05),中医证候总有效率[90.91%(40/44)]高于对照组[72.73%(32/44), P<0.05]。研究组治疗后FEV1%pred、FEV1/FVC、CD4+、CD4+/CD8+均高于对照组(P<0.05),CD8+低于对照组(P<0.05)。2组间不良反应发生率比较差异无统计学意义(χ2=0.451,P=0.502)。 结论 消痈祛腐生肌汤联合胸腺肽α1能充分缓解肺脾气虚型支气管扩张稳定期的临床症状,改善肺功能和免疫功能,增益临床疗效且安全性较好。 Abstract:Objective Based on the traditional Chinese medicine (TCM) theory of "treating the lung close to the temperature", the effect of Xiaoyong Qufu Shengji Decoction combined with thymosin α1 on the stable stage of bronchiectasis was discussed to provide evidence of clinical curative effect. Methods From January 2021 to January 2023, 88 patients with lung Qi deficiency type bronchodilation admitted to Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Chinese Medicine were selected and divided into control and study groups of 44 cases each by random number table method. On the basis of conventional symptomatic treatment, the control group was treated with thymosin α1, and the study group was treated with Xiaoyong Qufu Shengji Decoction combined with thymosin α1, all of which were continuously treated and observed for 8 weeks. The TCM syndrome score, lung function [percentage of forced expiratory volume in one second to expected value (FEV1 % pred), ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC)], T lymphocyte subsets [CD4+, CD8+, CD4+/CD8+] of the two groups were observed, and the efficacy and adverse reactions of the TCM syndrome were compared. Results After treatment, the scores for "cough" and "expectoration" and the total score for TCM syndrome were lower in the study group than in the control group (P < 0.05), and the total efficacy rate for TCM syndrome [90.91% (40/44)] was higher than that in the control group [72.73% (32/44), P < 0.05]. After treatment, FEV1 % pred, FEV1/FVC, CD4+, CD4+/CD8+ in the study group were higher than those in the control group (P < 0.05) and CD8+ were lower than those in the control group (P < 0.05). There was no significant difference in the rate of side effects between groups (P>0.05). Conclusion Xiaoyong Qufu Shengji Decoction combined with thymosin α1 can completely relieve the clinical symptoms of bronchodilation of lung Qi deficiency type, improve lung function and immune function, and enhance clinical efficacy and safety. -
表 1 2组支气管扩张患者中医证候积分比较(x±s,分)
Table 1. Comparison of TCM syndrome scores between the two groups of patients with bronchiectasis (x±s, points)
组别 例数 咳嗽 咳痰 总积分 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 对照组 44 2.23±0.34 1.61±0.32a 2.21±0.37 1.68±0.34a 13.53±2.83 8.12±2.37a 研究组 44 2.20±0.37 1.32±0.29a 2.23±0.36 1.29±0.31a 13.49±2.86 6.05±1.96a t值 0.396 4.454 0.257 5.623 0.066 4.464 P值 0.693 <0.001 0.798 <0.001 0.948 <0.001 注:与同组治疗前比较,aP<0.05。 表 2 2组支气管扩张患者中医证候总有效率比较[例(%)]
Table 2. Comparison of total effective rate to TCM syndromes between the two groups of patients with bronchiectasis[cases (%)]
组别 例数 显效 有效 无效 总有效 对照组 44 8(18.18) 24(54.55) 12(27.27) 32(72.73) 研究组 44 13(29.55) 27(61.36) 4(9.09) 40(90.91) 注:2组总有效率比较,χ2=4.889,P=0.027。 表 3 2组支气管扩张患者肺功能比较(x±s,%)
Table 3. Comparison of lung function between the two groups of patients with bronchiectasis(x±s, %)
组别 例数 FEV1%pred FEV1/FVC 治疗前 治疗后 治疗前 治疗后 对照组 44 63.07±9.26 68.29±10.35a 66.03±6.25 69.47±7.23a 研究组 44 62.73±9.41 73.26±11.07a 66.12±6.53 72.81±7.16a t值 0.171 2.175 0.066 2.243 P值 0.865 0.032 0.948 0.028 注:与同组治疗前比较,aP<0.05。 表 4 2组支气管扩张患者免疫功能比较(x±s)
Table 4. Comparison of immune function between the two groups of patients with bronchiectasis(x±s)
组别 例数 CD4+(%) CD8+(%) CD4+/CD8+ 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 对照组 44 36.17±4.26 39.20±4.61a 27.46±3.25 25.13±3.30a 1.32±0.35 1.56±0.47a 研究组 44 36.10±4.30 42.75±4.80a 27.18±3.47 21.87±3.21a 1.33±0.38 1.95±0.56a t值 0.077 3.538 0.391 4.697 0.128 3.538 P值 0.939 0.001 0.697 <0.001 0.898 0.001 注:与同组治疗前比较,aP<0.05。 -
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