CAJ | 학술논문

目的：探讨热毒宁注射液在慢性阻塞性肺疾病急性加重期（AECOPD）痰热阻肺证中的抗炎与免疫作用。方法：收集从2012年1月-2013年12月的住院患者110例，按照随机数字表方法分为治疗组（基础治疗方案+热毒宁注射液20 mL+5%葡萄糖注射液250 mL每日1次静注）和对照组（基础治疗方案+生理盐水20 mL+5%葡萄糖注射液250 mL每日1次静注），每组各55例，疗程为14天。观察两组治疗前后中医症状积分、临床疗效、血常规、血气分析及T淋巴细胞亚群的改善情况。结果：在中医证候评分和临床疗效方面，治疗组治疗后中医症状评分及总积分除喘促气短、口干欲饮、面赤均较对照组改善明显（P<0.05），总有效率较对照组明显好转；在抗感染方面，治疗组治疗前后患者白细胞总数及中性粒细胞分类百分比，均较治疗前明显下降（P<0.05），但与对照组治疗后白细胞总数及中性粒细胞分类百分比，无统计学差异；血气分析方面，治疗组治疗后血气分析PaCO2、PaO2较对照组明显好转（P<0.05）；在免疫调节方面，治疗组治疗后患者T淋巴细胞亚群CD3+、CD4+明显高于对照组，表达抑制/细胞毒细胞（CD8+）明显低于对照组（P<0.05），CD4+/CD8+比值恢复到正常参考值水平。结论：在AECOPD痰热阻肺证的治疗中，在西医对症治疗方案的基础上，辅以热毒宁注射液清热解毒化痰，能够明显改善患者临床症状，提高临床疗效,特别是针对感染诱发合并呼吸衰竭存在免疫功能低下的患者，可能疗效更为确切。
목적：탐토열독저주사액재만성조새성폐질병급성가중기（AECOPD）담열조폐증중적항염여면역작용。방법：수집종2012년1월-2013년12월적주원환자110례，안조수궤수자표방법분위치료조（기출치료방안+열독저주사액20 mL+5%포도당주사액250 mL매일1차정주）화대조조（기출치료방안+생리염수20 mL+5%포도당주사액250 mL매일1차정주），매조각55례，료정위14천。관찰량조치료전후중의증상적분、림상료효、혈상규、혈기분석급T림파세포아군적개선정황。결과：재중의증후평분화림상료효방면，치료조치료후중의증상평분급총적분제천촉기단、구간욕음、면적균교대조조개선명현（P<0.05），총유효솔교대조조명현호전；재항감염방면，치료조치료전후환자백세포총수급중성립세포분류백분비，균교치료전명현하강（P<0.05），단여대조조치료후백세포총수급중성립세포분류백분비，무통계학차이；혈기분석방면，치료조치료후혈기분석PaCO2、PaO2교대조조명현호전（P<0.05）；재면역조절방면，치료조치료후환자T림파세포아군CD3+、CD4+명현고우대조조，표체억제/세포독세포（CD8+）명현저우대조조（P<0.05），CD4+/CD8+비치회복도정상삼고치수평。결론：재AECOPD담열조폐증적치료중，재서의대증치료방안적기출상，보이열독저주사액청열해독화담，능구명현개선환자림상증상，제고림상료효,특별시침대감염유발합병호흡쇠갈존재면역공능저하적환자，가능료효경위학절。
This study was aimed to discuss the anti-inflammatory and immunization properties ofRe-Du-Ning (RDN) injection in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with phlegm-heat stagnated in the lung syndrome. A total of 110 in-patients were collected from January 2012 to December 2013. Cases were randomly divided into the treatment group (basic treatment plan + 20 ml RDN injection + 250 mL of 5% GS injection, once a day, intravenous injection) and the control group (basic treatment plan + 20 ml of 0.9% NS injection + 250 mL of 5% GS injection, once a day, intravenous injection), with 55 cases in each group. The treatment course was 14 days. Observations were made on traditional Chinese medicine (TCM) symptom score, clinical effect, blood routine examination, blood gas analysis and T lymphocyte subgroups before and after the treatment in both groups. The results showed that in the aspects of TCM symptom score and clinical effect, the posttreatment TCM symptom score and total integration in the treatment group were obviously improved compared to the control group except for shortness of breath, dry mouth and thirsty, flushing (P < 0.05). The total effective rate was obviously better than that of the control group. In the aspect of anti-inflammation, the total white blood cell (WBC) count and the normal neutrophil percentage of both pretreatment and posttreatment in the treatment group were obviously decreased compared to pretreatment (P < 0.05). However, there were no statistical differences on WBC count and normal neutrophil percentage compared to posttreatment in the control group. In the aspect of blood gas analysis, the posttreatment PaCO2 and PaO2 of the treatment group were obviously better than the control group (P < 0.05). In the aspect of immune regulation, the posttreatment T lymphocyte subgroups CD3+ and CD4+ of the treatment group were higher than the control group. The expression inhibition / cytotoxic lymphocyte (CD8+) was obviously lower than the control group (P < 0.05). The CD4+ / CD8+ was back to the normal reference level. It was concluded that in the treatment of AECOPD with phlegm-heat stagnated in the lung syndrome, on the basis of western medicine symptomatic treatment plan, RDN injection was assisted to clear heat, relieve toxin and remove phlegm. It can obviously improve patient’s clinical symptoms and increase the clinical therapeutic effects. The treatment was especially targeted to infection-induced respiratory failure patients combined low immunity with possible identified therapeutic effects.