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目的:探讨六君子汤治疗慢性阻塞性肺疾病(COPD)患者的临床疗效及对内源性抗炎机制的影响。方法:采用单盲随机的方法,将60例Ⅱ级COPD稳定期患者(中医辨证属脾虚型)分成2组,治疗组30例常规西医治疗联合六君子汤治疗,对照组30例常规西医治疗,疗程均为3个月。疗程结束后进行综合疗效评价及痰液细胞HDACs活性、TNF-α、NF-κB、IL-1β、IL-8等细胞因子的测定,并进行比较。结果 (:1)临床总有效率,治疗组为96.67%,对照组为80%,两组比较,差异有统计学意义(P<0.01);(2)治疗后治疗组痰液HDACs活性、细胞因子(TNF-α、NF-κB、IL-1β、IL-8)水平与对照组比较,差异有统计学意义(P<0.05)。结论:六君子汤治疗COPD(脾虚型)患者具有较好的临床疗效,能够降低COPD患者痰液TNF-α、NF-κB、IL-1β、IL-8水平,提高HDACs活性,恢复HDACs功能,改善糖皮质激素作用的敏感性,从而恢复COPD气道抗炎系统功能。
Objective: To investigate the clinical efficacy of Liujunzi Decoction in treating patients with chronic obstructive pulmonary disease (COPD) and its effect on endogenous anti-inflammatory mechanism. Methods: Sixty patients with stage Ⅱ stable COPD were divided into two groups according to a single-blind randomized method. The treatment group was treated with routine western medicine combined with Liujunzi Decoction, while the control group with 30 conventional western medicine. Treatment are 3 months. After the course of treatment, the comprehensive efficacy evaluation and sputum cell HDACs activity, TNF-α, NF-κB, IL-1β, IL-8 and other cytokines were measured and compared. Results (1) The total clinical effective rate was 96.67% in the treatment group and 80% in the control group. There was significant difference between the two groups (P <0.01). (2) The activity of HDACs, The levels of TNF-α, NF-κB, IL-1β and IL-8 in the control group were significantly different (P <0.05). Conclusion: Liujunzi Decoction has good clinical curative effect in patients with COPD (spleen deficiency type), can reduce the levels of TNF-α, NF-κB, IL-1β and IL-8 in sputum of COPD patients, increase the activity of HDACs and restore the function of HDACs, Improve the sensitivity of glucocorticoid action, thereby restoring COPD airway anti-inflammatory system function.