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目的:观察中西医结合治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床效果以及对炎症因子、免疫功能的影响。方法:将60例AECOPD患者按随机数字表法分为治疗组和对照组各30例。2组均予现代医学综合性常规治疗,治疗组则加服补肾益肺健脾膏方,并配合离子导入活血祛痰中药。2组疗程均为6周。比较2组治疗前后血清前降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、Ig A、Ig G、Ig M、CD3~+、CD4~+、CD4~+/CD8~+比值及自然杀伤(NK)细胞活性。结果:治疗后,2组血清PCT、hs-CRP、TNF-α、IL-6含量均较治疗前降低,IL-10含量均较治疗前增加,差异均有统计学意义(P<0.05)。2组各指标比较,差异均无统计学意义(P>0.05)。治疗组血清Ig A、Ig G、Ig M、CD3~+、CD4~+、CD4~+/CD8~+比值及NK细胞活性均较治疗前增加,差异均有统计学意义(P<0.05);对照组以上7项指标值与治疗前比较虽有升高趋势,但差异均无统计学意义(P>0.05);2组以上7项指标比较,差异均有统计学意义(P<0.05)。结论:在现代医学规范化治疗的基础上加用补肾益肺健脾膏方内服联合离子导入活血祛痰中药治疗AECOPD,能够有效抑制炎症反应,增强机体免疫功能。
Objective: To observe the clinical effect of combined traditional Chinese and western medicine in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and their effects on inflammatory factors and immune function. Methods: Sixty patients with AECOPD were divided into treatment group and control group according to random number table. The two groups were given conventional treatment of modern medicine, while the treatment group was given the supplementing kidney invigorating spleen and invigorating the spleen ointment and iontophoretic Chinese medicine. The two courses of treatment were 6 weeks. The levels of serum pre-procalcitonin, hs-CRP, TNF-α, IL-6, leukocyte IL-10, Ig A, Ig G, Ig M, CD3 ~ +, CD4 ~ +, CD4 ~ + / CD8 ~ + ratio and natural killer (NK) cell activity. Results: After treatment, the levels of serum PCT, hs-CRP, TNF-α and IL-6 in serum of the two groups were lower than those before treatment, and the levels of IL-10 in the two groups were significantly increased after treatment (P <0.05). There was no significant difference between the two groups (P> 0.05). The serum IgA, Ig G, Ig M, CD3 ~ +, CD4 ~ +, CD4 ~ + / CD8 ~ + ratio and NK cell activity in treatment group were significantly higher than those before treatment (P <0.05). There was no significant difference between the above 7 indexes in the control group and those before treatment (P> 0.05). There were significant differences between the above 7 indexes in the two groups (P <0.05). Conclusion: Acupuncture combined with Bushen Yifei Jianpi Ointment combined with iontophoresis and activating blood and removing expectorant Chinese traditional medicine can effectively suppress the inflammatory reaction and enhance the immune function of the body.