陈淑娇 　林劲榕

【摘要】 目的：評价补虚平喘膏治疗慢性阻塞性肺疾病（COPD）稳定期的效果及对患者外周血T淋巴细胞亚群的影响。方法：将62例COPD稳定期患者随机分组，对照组（31例）仅采取常规西医治疗，治疗组（31例）在常规西医治疗的基础上加用补虚平喘膏，比较两组慢性阻塞性肺疾病急性加重（AECOPD）发作次数及外周血T淋巴细胞亚群的变化。结果：两组均有1例失访。52周内，治疗组AECOPD发作次数少于对照组，差异有统计学意义（P<0.05）。治疗24周后，治疗组CD3+、CD4+及CD4+/CD8+均较治疗前升高，CD8+较治疗前降低，差异均有统计学意义（P<0.05）。治疗24周后，治疗组CD3+、CD4+及CD4+/CD8+均高于对照组，CD8+低于对照组，差异均有统计学意义（P<0.05）。结论：补虚平喘膏可减少AECOPD发作次数，增强细胞免疫功能。

【关键词】 慢性阻塞性肺疾病 急性加重 补虚平喘膏 T淋巴细胞亚群

doi：10.14033/j.cnki.cfmr.2019.28.014 文献标识码 B 文章编号 1674-6805（2019）28-00-03

Effect of Buxu Pingchuan Cream Formulae on Cellular Immunity and Acute Attack Frequency of Stable COPD/CHEN Shujiao， LIN Jinrong. //Chinese and Foreign Medical Research， 2019， 17（28）： -36

[Abstract] Objectives： To evaluate the effect of Buxu Pingchuan Cream Formulae on the stable period of chronic obstructive pulmonary disease （COPD） and its effect on peripheral blood T lymphocyte subsets. Method： Sixty-two patients with stable period of COPD were randomly divided into two groups.The control group （31 cases） only received conventional western medicine treatment， while the treatment group （31 cases） received Buxu Pingchuan Cream Formulae on the basis of conventional western medicine treatment. And acute exacerbation of chronic obstructive pulmonary disease （AECOPD） frequency and the changes of peripheral blood T lymphocyte subsets were compared. Result： One case was lost in both groups. Within 52 weeks， AECOPD frequency in the treatment group was significantly less than that of the control group， and the difference was statistically significant（P<0.05）. After 24 weeks of treatment， CD3+， CD4+ and CD4+/CD8+ in the treatment group were significantly higher than before treatment， and CD8+ was significantly lower than before treatment， and the differences were statistically significant （P<0.05）. After 24 weeks of treatment， CD3+， CD4+ and CD4+/CD8+ in the treatment group were significantly higher than those of the control group， and CD8+ was significantly lower than those of the control group， and the differences were statistically significant （P<0.05）. Conclusion： Buxu Pingchuan Cream Formulae can reduce AECOPD frequency and enhance cellular immune function.

[Key words] Chronic obstructive pulmonary disease Acute aggravation Buxu Pingchuan Cream Formulae T lymphocyte subsets

First-authors address： The Affiliated Peoples Hospital of Fujian University of Traditional Chinese Medicine， Fuzhou 350004， China

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）的死亡率居世界所有死因的第4位[1]。同时，带来的经济负担也居我国疾病首位，有效减少慢性阻塞性肺疾病急性加重（AECOPD）是慢阻肺疾病管理过程中的重要工作[2]。COPD患者预后和机体免疫功能状态有关[3]。如何改善患者免疫功能，减少发病率和住院次数，改善临床症状是目前面临的重要问题。临床研究证实，补益肺气等中药能通过调节免疫系统以减少反复呼吸道感染次数的风险[4]。因此，为进一步评价慢阻肺稳定期患者长期使用补虚平喘膏对于预防AECOPD、改善临床预后等的效果和安全性，笔者进行本次临床研究。

1 资料与方法

1.1 一般资料

选取2017年1-11月于笔者所在医院门诊就诊的慢阻肺患者，共62例。纳入标准：（1）符合GOLD 2013版慢性阻塞性肺疾病稳定期诊断标准，且吸入支气管舒张剂后第1秒用力呼气容积占预计值百分比（FEV1% pred）为30%～79%;（2）处于稳定期，近4周无呼吸道感染及AECOPD;（3）过去1年内至少有2次急性加重史或因急性加重住院1次;（4）近1个月内未使用激素、免疫抑制剂等可能影响免疫状态的药物;（5）年龄40～80岁。……