作者：张威1，2，王珺3

单位：

1.250014山东省济南市，山东中医药大学　2.274000山东省菏泽市立医院呼吸内科3.250001山东省济南市，山东中医药大学第二附属医院呼吸与危重症医学科

Units：

1.Shandong University of Traditional Chinese Medicine, Jinan 250014, China2.Department of Respiratory, Heze Municipal Hospital, Heze 274000, China3.Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Shandong University of TraditionalChinese Medicine, Jinan 250001, China

关键词：

肺疾病，慢性阻塞性；肺肾气虚；百令胶囊；证候；炎性指标；T淋巴细胞亚群；肺功能

Keywords：

　Pulmonary disease, chronic obstructive; Lung kidney Qi deficiency pattern; Bailing capsule; Symptomcomplex; Inflammatory indexes; T lymphocyte subsets; Pulmonary function

CLC：

R 563.9

DOI：

10.12114/j.issn.1008-5971.2022.00.224

Funds：

山东省中医药科技发展计划项目（2019-0217）；山东省中医药科技项目（2021Q101）；山东省医药卫生科技发展计划项目（202003020981）

摘要：

目的　探讨百令胶囊对肺肾气虚型稳定期慢性阻塞性肺疾病（COPD）患者中医证候、病情、气道炎症、免疫功能及肺功能的影响。方法　选取2019年10月至2021年10月于山东中医药大学第二附属医院住院的肺肾气虚型稳定期COPD患者80例为研究对象，采用随机数字表法分为对照组和治疗组，各40例。对照组患者给予常规西医治疗，治疗组在常规西医治疗基础上加用百令胶囊，两组治疗周期均为12周。比较两组治疗前后中医证候积分、慢性阻塞性肺疾病评估测试（CAT）评分、炎性指标〔白细胞计数（WBC）、嗜酸粒细胞计数（EOS）、C反应蛋白（CRP）、降钙素原（PCT）、白介素（IL）-6、IL-8、肿瘤坏死因子α（TNF-α）〕、T淋巴细胞亚群〔CD4+ T淋巴细胞分数、CD8+ T淋巴细胞分数、CD4+/CD8+ T淋巴细胞比值〕、肺功能指标〔第1秒用力呼气容积（FEV1）占预计值百分比（FEV1%）、FEV1/用力肺活量（FVC）〕。结果　治疗后，两组咳嗽、咳痰、气促、喘息气急积分及总积分、CAT评分分别低于同组治疗前，且治疗组咳嗽、咳痰积分及总积分、CAT评分低于对照组（P ＜0.05）；两组CRP、IL-6、IL-8分别低于同组治疗前，且治疗组低于对照组（P ＜0.05）；治疗后，治疗组CD4+ T淋巴细胞分数高于治疗前（P ＜0.05）；治疗后，两组CD8+ T淋巴细胞分数分别低于同组治疗前，CD4+/CD8+ T淋巴细胞比值分别高于同组治疗前，且治疗组CD8+ T淋巴细胞分数低于对照组，CD4+ T淋巴细胞分数、CD4+/CD8+ T淋巴细胞比值高于对照组（P ＜0.05）；治疗前及治疗后，两组FEV1%、FEV1/FVC比较，差异无统计学意义（P ＞0.05）。结论　百令胶囊能有效减轻肺肾气虚型稳定期COPD患者的中医证候、病情、气道炎症，增强免疫功能，但不能改善肺功能。

Abstract：

Objective　To investigate the effect of Bailing capsule on TCM syndrome, condition, airway inflammation,immune function and pulmonary function of patients with stable chronic obstructive pulmonary disease (COPD) with lung kidneyQi deficiency pattern. Methods　A total of 80 stable COPD with lung kidney Qi deficiency pattern hospitalized in the SecondAffiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2019 to October 2021 were selectedas the study objects, which were divided into the control group and the treatment group by random number table method, and 40cases in each group. Patients in the control group were treated with conventional western medicine, while patients in the treatmentgroup were treated with Bailing capsule on the basis of conventional western medicine. The treatment cycles of the two groups were 12 weeks. TCM syndrome score, COPD Assessment Test (CAT) score, inflammatory indexes [white blood cell (WBC) , eosinophils(EOS) , C-reactive protein (CRP) , procalcitonin (PCT) and interleukin (IL) -6, IL-8, tumor necrosis factor-α (TNF-α) ] , Tlymphocyte subsets (CD4+ T lymphocyte, CD8+ T lymphocyte, CD4+/CD8+ T lymphocyte ratio) , pulmonary function indexes [forcedexpiratory volume in one second (FEV1) as a percentage of predicted value (FEV1%) , FEV1/forced vital capacity (FVC) ] werecompared between the two groups before and after treatment. Results　After treatment, the scores of cough, expectoration,shortness of breath, wheezing and dyspnea, total score and CAT score in the two groups were lower than those before treatment,respectively, and the scores of cough and expectoration, total score and CAT score in the treatment group were lower than those inthe control group (P < 0.05) . After treatment, CRP, IL-6 and IL-8 in the two groups were lower than those before treatment, CRP,IL-6 and IL-8 in the treatment group were lower than those in the control group (P < 0.05) . After treatment, CD4+ T lymphocytein the treatment group was higher than that before treatment (P < 0.05) , after treatment, CD8+ T lymphocyte in the two groups waslower than that before treatment, respectively, CD4+/CD8+ T lymphocyte ratio was higher than that before treatment, respectively,and CD8+ T lymphocyte in the treatment group was lower than that in the control group, CD4+ T lymphocyte and CD4+/CD8+ Tlymphocyte ratio were higher than those in the control group (P < 0.05) . There was no significant difference in FEV1% and FEV1/FVC between the two groups before and after treatment (P > 0.05) . Conclusion　Bailing capsule can effectively reduce the TCMsyndrome, condition, airway inflammation of patients with stable COPD with lung kidney Qi deficiency pattern, enhance immunefunction, but it can't improve pulmonary function.

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