加味小青龙汤治疗哮喘-慢性阻塞性肺疾病重叠综合征OA
Supplemented Minor Green Dragon Decoction in the Treatment of Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome
目的:基于辅助性 T 细胞17(T helper 17 cells,Th17)/调节性 T 细胞(regulatory T cells,Treg)探讨加味小青龙汤对哮喘-慢性阻塞性肺疾病重叠综合征(asthma-chronic obstructive pulmonary disease overlap syndrome,ACO)患者炎症反应的影响.方法:将80 例 ACO 急性期患者按照随机数字表法分为对照组和试验组,每组40 例.对照组给予布地奈德粉混悬液、噻托溴铵吸入剂雾化吸入治疗,试验组在对照组治疗的基础上加用加味小青龙汤治疗.观察两组治疗前后 Th17/Treg、CAT 评分、ACT评分、MRC 评分、生长因子-β(transforming growth factor-β,TGF-β)、白细胞介素(interleukin,IL)-10、IL-17、IL-21、第 1秒用力呼气容积(forced expiratory volume in the first second,FEV1)、用力肺活量(forced vital capacity,FVC)、FEV1/FVC 变化情况及临床疗效、不良反应发生情况.结果:治疗后,试验组 Treg 细胞水平高于对照组,Th17 细胞水平低于对照组,Th17/Treg 低于对照组,差异有统计学意义(P<0.05);试验组治疗后 TGF-β、IL-10 水平高于对照组,IL-17、IL-21 水平低于对照组,差异有统计学意义(P<0.05);试验组治疗后 FEV1、FVC、FEV1/FVC 水平高于对照组,差异有统计学意义(P<0.05);试验组治疗后 CAT、MRC 评分低于对照组,ACT 评分高于对照组,差异有统计学意义(P<0.05);试验组有效率为92.50%,对照组有效率为75.00%,试验组有效率高于对照组,差异有统计学意义(P<0.05);对照组不良反应发生率为12.50%,试验组不良反应发生率为5.00%,两组不良反应发生率比较,差异无统计学意义(P>0.05).结论:加味小青龙汤能够通过降低 Th17/Treg 及相关细胞因子水平,调节 ACO 患者机体免疫平衡、减轻气道炎症,改善肺功能.
Objective:To explore the effect of Supplemented Minor Green Dragon Decoction on the inflammatory response in patients with asthma-COPD overlap(ACO)based on T helper 17 cells(Th17)/regulatory T cells(Treg).Methods:A total of 80 patients with acute exacerbation of ACO were randomly divided into the control group and the experimental group,with 40 cases in each group.The control group received nebulized inhalation of budesonide powder suspension and tiotropium bromide inhalation.On the basis of the treatment given to the control group,the experimental group was additionally treated with Supplemented Minor Green Dragon Decoction.Changes in Th17/Treg ratio,CAT score,ACT score,MRC score,transforming growth factor-β(TGF-β),interleukin(IL)-10,IL-17,IL-21,forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),FEV1/FVC ratio before and after treatment,as well as clinical efficacy and adverse reactions were observed in the two groups.Results:After treatment,the level of Treg cells in the experi-mental group was higher,while the level of Th17 cells and Th17/Treg ratio were lower than those in the control group,with statistically significant differences(P<0.05).The levels of TGF-β and IL-10 in the experimental group were higher,and the levels of IL-17 and IL-21 were lower than those in the control group after treatment,with statistically significant differences(P<0.05).FEV1,FVCand FEV1/FVC in the experimental group were higher than those in the control group after treatment,with statistically significant differences(P<0.05).The CAT and MRC scores decreased,whereas the ACT score increased in the experimental group compared with the con-trol group,with statistically significant differences(P<0.05).The effective rate was92.50%in the experimental group which was higher than 75.00%in the control group,with a statistically significant difference(P<0.05).The incidence of adverse reactions was 12.50%in the control group and 5.00%in the experimental group,with no statistically significant difference between the two groups(P>0.05).Conclusion:Supplemented Minor Green Dragon Decoction can regulate immune homeostasis,alleviate airway inflammation and improve pulmonary function in ACO patients by reducing the Th17/Treg ratio and the levels of related cytokines.
张慧冰
许昌市第二人民医院,河南 许昌 461000
医药卫生
哮喘-慢性阻塞性肺疾病重叠综合征调节性T细胞辅助性T细胞17加味小青龙汤炎症反应《伤寒论》张仲景
asthma-COPD overlapregulatory T cellsT helper 17 cellsSupplemented Minor Green Dragon Decoctioninflammatory re-sponseTreatise on Cold Damage DiseasesZhang Zhongjing
《河南中医》 2026 (10)
1507-1512,6
河南省中医药科学研究专项课题项目(2019ZY3025)
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