CAJ | 학술논문

目的：探讨喘可治注射液联合沙美特罗替卡松治疗慢性阻塞性肺疾病急性加重期患者的疗效及对免疫功能的影响。方法2011年6月—2014年10月收治的85例慢性阻塞性肺疾病急性加重期患者，随机分为观察组（43例）和对照组（42例），观察组使用喘可治注射液联合沙美特罗替卡松治疗，对照组使用沙美特罗替卡松治疗，比较2组患者治疗效果、肺功能变化、炎性指标（ CRP、IL-8、TNF-α）和T淋巴细胞亚群变化。结果观察组总有效率97．67％，对照组总有效率88．10％，2组比较差异无统计学意义（χ2＝2．97， P ＞0．05）；治疗前2组患者第1秒用力呼气容积（ FEV1）、第1秒用力呼气容积占肺活量比重（ FEV1／FVC）、第1秒用力呼气容积占预计量比重（ FEV1％）比较差异无统计学意义（ P ＞0．05），治疗后观察组和对照组均有显著提高（ t 观＝9．99、6．46、8．40， t 对＝5．15、3．52、5．44， P ＜0．05），且观察组提高程度优于对照组（ t ＝3．79、2．34、2．46， P ＜0．05）；2组患者治疗前血清CRP、IL-8、TNF-α水平比较差异无统计学意义（ P ＞0．05），治疗后均有明显降低（ P ＜0．05， P ＜0．01），且观察组低于对照组（ P ＜0．01）；治疗前观察组与对照组CD3＋、CD4＋、CD8＋、CD4＋／CD8＋水平无差异（ P ＞0．05），治疗后均得到明显改善（ P ＜0．05， P ＜0．01）；治疗后观察组CD3＋、CD4＋、CD4＋／CD8＋水平高于对照组，CD8＋水平低于对照组，差异具有统计学意义（ P ＜0．01）。结论喘可治注射液联合沙美特罗替卡松治疗对慢性阻塞性肺疾病急性加重期患者治疗效果确切，明显改善患者肺功能，提高患者免疫功能。
목적：탐토천가치주사액연합사미특라체잡송치료만성조새성폐질병급성가중기환자적료효급대면역공능적영향。방법2011년6월—2014년10월수치적85례만성조새성폐질병급성가중기환자，수궤분위관찰조（43례）화대조조（42례），관찰조사용천가치주사액연합사미특라체잡송치료，대조조사용사미특라체잡송치료，비교2조환자치료효과、폐공능변화、염성지표（ CRP、IL-8、TNF-α）화T림파세포아군변화。결과관찰조총유효솔97．67％，대조조총유효솔88．10％，2조비교차이무통계학의의（χ2＝2．97， P ＞0．05）；치료전2조환자제1초용력호기용적（ FEV1）、제1초용력호기용적점폐활량비중（ FEV1／FVC）、제1초용력호기용적점예계량비중（ FEV1％）비교차이무통계학의의（ P ＞0．05），치료후관찰조화대조조균유현저제고（ t 관＝9．99、6．46、8．40， t 대＝5．15、3．52、5．44， P ＜0．05），차관찰조제고정도우우대조조（ t ＝3．79、2．34、2．46， P ＜0．05）；2조환자치료전혈청CRP、IL-8、TNF-α수평비교차이무통계학의의（ P ＞0．05），치료후균유명현강저（ P ＜0．05， P ＜0．01），차관찰조저우대조조（ P ＜0．01）；치료전관찰조여대조조CD3＋、CD4＋、CD8＋、CD4＋／CD8＋수평무차이（ P ＞0．05），치료후균득도명현개선（ P ＜0．05， P ＜0．01）；치료후관찰조CD3＋、CD4＋、CD4＋／CD8＋수평고우대조조，CD8＋수평저우대조조，차이구유통계학의의（ P ＜0．01）。결론천가치주사액연합사미특라체잡송치료대만성조새성폐질병급성가중기환자치료효과학절，명현개선환자폐공능，제고환자면역공능。
Objective To investigate the efficacy of Chuankezhi injection combined with salmeterol fluticasone on im-mune function in patients with chronic obstructive pulmonary disease ( COPD) .Methods From June 2011 to October 2014 , 85 cases of chronic obstructive pulmonary disease with exacerbation were randomly divided into two groups , observation group (43 patients) and control group (42 cases), the observation group received Chuankezhi injection combined with salmeterol fluticasone propionate therapy , the control group received salmeterol fluticasone propionate therapy , therapeutic effect , lung function changes , inflammatory markers ( CRP, IL-8, TNF-α) and T lymphocyte subsets were compared between the two groups of patients.Results The total efficiency was 97.67%in the observation group, the control group’s total efficiency was 88.10%, the two groups showed no significant difference (χ2 =2.97, P >0.05);before treatment, patients in the 2 groups had no statistically significant difference of following indexes:forced expiratory volume in one second ( FEV1 ) , forced expira-tory volume in 1 second proportion accounted for FVC ( FEV1/FVC) , forced expiratory volume in 1 second%predicted vol-ume proportion (FEV1%) ( P >0.05), after treatment, both of observation group and the control group revealed significant-ly increased of these indexes (observation group:t =9.99,6.46,8.40,control group:t =5.15, t =3.52, t =5.44, P <0.05),and the degree of increase in the observation group were better than the control group ( t =3.79, t =2.34, t =2.46, P <0.05);before treatment, serum CRP, IL-8, TNF-αlevel revealed no difference between the two groups ( P >0.05), after treatment, both of the two groups’ indexes were significantly decreased ( P <0.05), and the observation group were better than the control group ( P <0.05);before treatment, both groups’ CD3+, CD4+, CD8+, CD4+/CD8+revealed no differ-ences ( P >0.05);after treatment, these indexes’ levels were significantly improved ( P <0.05);after treatment, in the observation group , CD3+, CD4+, CD4+/CD8+level was higher and CD 8+level were lower than the control group , the difference was statistically significance ( P <0.05).Conclusion It proved that the Chuankezhi injection combined with salmeterol flu-ticasone propionate therapy revealed definite therapeutic effect for chronic obstructive pulmonary disease , it could significant improve the lung function and immune function .