目的:观察苏子降气汤对慢性阻塞性肺疾病急性发作期(痰浊壅肺证)患者肺功能和生命质量的影响,并探讨其部分机制.方法:选取2015年1月至2017年5月辽宁中医药大学附属医院呼吸内科住院的AECOPD(痰浊壅肺证)患者共108例,通过随机数字表法将108例患者按照随机编号分成对照组与观察组,每组54例;观察组:在对照组西药治疗的基础上根据中医辨证论治予苏子降气汤口服.根据量化的中医证候评分变化、肺功能和生命质量观察苏子降气汤对AECO-PD(痰浊壅肺证)的影响,并采用酶联免疫吸附试验(ELISA)法检测IL-21和CXCL13的水平.结果:与治疗前比较,2组中医证候评分明显降低(P<0.05),且观察组治疗后的中医证候评分明显低于对照组(P<0.05).治疗后2组肺功能均较治疗前有所提高,然而观察组肺功能的主要指标FVC(L)、FEV1(L)、FEV1/FVC(%)和PEF(L/s)明显优于对照组(P<0.05).治疗后观察组生命质量评定症状、活动、影响和平均分均显著低于对照组(P<0.05).治疗后IL-21和CXCL13的表达水平2组均明显下降(P<0.05),且观察组优于对照组(P<0.05).结论:苏子降气汤可明显改善AECOPD(痰浊壅肺证)患者的病情,提高患者的肺功能及生命质量,其作用机制可能与降低外周血IL-21及CXCL13水平有关.
Objective:To observe the effect of Suzi Jiangqi Decoction on pulmonary function and quality of life of acute exacerba -tion of chronic obstructive pulmonary disease (AECOPD), and to explore its mechanism.Methods:A total of 108 cases of patients with AECOPD with turbid phlegm obstructing lung syndrome in our hospital from January 2015 to May 2017 were selected and ran-domly divided into control group and observation group according to random number table method , with 54 cases in each group;The observation group :on the basis of Western medicine treatment in the control group , given oral administration of Suzi Jiangqi Decoction based on syndrome differentiation.According to the lung function and life quality of TCM syndrome score changes , the effect of Suzi Jiangqi Decoction on phlegm obstructing lung type AECOPD was observed , and enzyme linked immunosorbent assay (ELISA) method was used to detect IL-21 and CXCL13 levels.Results:Compared with those before treatment , the TCM syndrome scores of two groups were significantly lower than those before treatment (P<0.05), and the observation group was significantly lower than that in the control group after treatment (P<0.05).After treatment, the lung function of the two groups increased com-pared with that before treatment.However, the main indicators of lung function in the observation group FVC (L), FEV1(L), FEV1/FVC (%) and PEF (L/s) were significantly better than those in the control group (P<0.05).After treatment, the symp-tom, activity, influence and average score of quality of life in the observation group were significantly lower than that of the control group (P<0.05).After treatment, the expression level of IL-21 and CXCL13 in the 2 groups was significantly decreased (P<0.05), and the observation group was better than the control group (P<0.05).Conclusion:Suzi Jiangqi Decoction can obviously improve the phlegm obstructing lung type AECOPD disease , improve lung function and life quality of the patients , and the mecha-nism may be related to the decrease of peripheral blood IL-21 and CXCL13 concentration.