舒莉莉 谢进

摘要 目的：探讨小青龙汤加减对慢性支气管炎急性发作期T淋巴细胞亚群影响。方法：回顾性分析2018年9月至2019年4月广西国际壮医医院收治的慢性支气管炎急性发作期患者118例作为研究对象，按照治疗方法不同分为对照组和观察组，每组59例，2组患者均行常规西医治疗，观察组再予以小青龙汤治疗。观察2组患者治疗前、完成治疗后肺功能、T淋巴细胞亚群、炎性反应因子、SF-36、相关症状改善时间变化并比较。结果：治疗2周后，观察组患者在FVC、FEV1、FEV1/FVC、CD3+、CD4+、CD25+、CD95+、CD3+/CD25+、CD8+/CD28+改善效果优于对照组患者，在下调IL-8、TNF-α、IL-6、IL-17、CD19+、生命质量评分各维度改善及热消退时间、咯痰改善时间、咳嗽改善时间、干湿啰音改善时间方面均较对照组患者有明显优势（P<0.05）。结论：小青龙汤加减可通过抑制炎性反应，改善肺功能和提高免疫功能，从而缓解慢性支气管炎急性发作期临床症状，改善生命质量。

关键词 小青龙汤;慢性支气管炎;急性发作期;T淋巴细胞亚群;炎性反应因子;肺功能;健康调查简表;症状改善时间

Abstract Objective：To investigate the effect of Xiaoqinglong Decoction on T lymphocyte subsets in acute exacerbation of chronic bronchitis.Methods：The clinical data of 118 patients with acute exacerbation of chronic bronchitis were retrospectively analyzed.The patients were divided into control group（n=59）and study group（n=59）according to treatment methods.Both groups were treated with conventional western medicine， and study group received Xiaoqinglong Decoction in addition.Lung function， T lymphocyte subsets， inflammatory factors， SF-36 and improvement time of related symptoms were observed and compared between the two groups before and after treatment.Results：After 2 weeks of treatment， the improvement effect of FVC、FEV1、FEV1/FVC、CD3+、CD4+、CD25+、CD95+、CD3+/CD25+、CD8+/CD28+in the study group were better than those in the control group.The down-regulation of IL-8，TNF-α，IL-6，IL-17，CD19+ and the improvement of various dimension of life quality score， heat regression time， expectoration improvement time，cough improvement time， dry and wet rales improvement time in the study group were much better than those in the control group（P<0.05）.Conclusion：Xiaoqinglong Decoction can alleviate the clinical symptoms of acute exacerbation of chronic bronchitis and improve the quality of life by inhibiting inflammatory reaction， improving lung function and immune function.

Keywords Xiaoqinglong Decoction; Chronic bronchitis; Acute attack stage; T Lymphocyte Subgroup; Inflammatory factor; Lung function; Health questionnaire; Symptom improvement time

中圖分类号：R256.1文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.13.024

慢性支气管炎是临床上常见病、多发病，是呼吸系统最常见疾病，是因气管、支气管黏膜和周围组织慢性特异性炎性反应，好发于冬春二季，常见于老年人。临床症状以咳嗽、咯痰、气急、喘息、周身疼痛、食欲欠佳、反复发作。目前对该疾病确切发病机制不明确，多因刺激性物质造成气道炎性反应，黏膜分泌增多和纤毛清除力受损[1]。目前在治疗上西医以抗感染、祛痰、镇咳、解痉、平喘为原则，药物多采用茶碱类或β2受体激动剂，虽然疗效佳，但病程长，复发率高，且不良反应较多[2]。而中医治疗可发挥多方向、多靶点治疗，且不良反应较低，综合治疗，避免西医侧重治标特点。……