基于“肺与大肠相表里”复方苍术方治疗慢性阻塞性肺疾病

窦增娥 姚惠青 赵永祥 谭烨 巴迎莹

摘要 目的：基于“肺与大肠相表里”复方苍术方调节肠道菌群对慢性阻塞性肺疾病（COPD）疗效的影响。方法：选取2016年2月至2019年2月青海省中医院收治的COPD患者110例作为研究对象，按照入院先后顺序分为对照组和观察组，每组55例，对照组行常规西医治疗，观察组加用复方苍术方治疗。观察2组患者治疗前、治疗后炎性反应递质、免疫功能、肺功能、临床症状和肠道菌群变化并比较。结果：观察组患者治疗后在CD3+、CD4+、CD4+/CD8+、CD8+、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、IL-8、第1秒用力呼气容积（FEV1）/用力肺活量（FVC），最大通气量（MVV），6 min步行距离（6MWD）、双岐杆菌、乳酸杆菌、拟杆菌、B/E值及临床症状积分改善较对照组患者更具优势，差异有统计学意义（P<0.05）。结论：复方苍术方能提高调节肠道菌群、抑制炎性反应、提高肺功能和免疫功能，从而改善COPD临床症状。

关键词 肺与大肠相表里;复方苍术方;肠道菌群;慢性阻塞性肺疾病;炎性反应递质;肺功能;T淋巴细胞亚群;症状积分

The Therapeutic Effects of Compound Cangzhu Formula on Chronic Obstructive Pulmonary Disease Based on“Lung and Large Intestine-Exterior and Interior”

DOU Zeng′e，YAO Huiqing，ZHAO Yongxiang，TAN Ye，BA Yingying

（Department of Pulmonary Disease，Qinghai Traditional Chinese Medicine Hospital，Xi′ning 810000，China）

Abstract Objective：Based on the“lung and large intestine”compound Cangshu Formula to regulate intestinal flora on the effects of chronic obstructive pulmonary disease（COPD）.Methods：A total of 110 patients with COPD admitted to Qinghai Traditional Chinese Medicine Hospital from Feb 2016 to Feb 2019 were divided into a control group and a study group，with 55 cases in each group.The control group was treated with routine Western medicine，and the study group was treated with compound Cangshu Formula.The changes of inflammatory factors，immune function，lung function，clinical symptoms and intestinal flora were observed and compared before and after treatment.Results：After treatment，the patients in the observation group in terms of CD3+，CD4+，CD4+/CD8+，CD8+，C-reactive protein（CRP），tumor necrosis factor-α（TNF-α），interleukin-6（IL-6），IL-8，forced expiratory volume（FEV1）/forced vital capacity（FVC），maximum ventilation（MVV），6-minute walking distance（6MWD），Bifidobacterium，Lactobacillus，Bacteroides，B/E and clinical symptom scores and the improvement effects，were better than that of the control group（P<0.05）.Conclusion：Compound Cangshu Formula can improve the clinical symptoms of COPD by regulating intestinal flora，inhibiting inflammation，improving lung function and immune function.

Keywords Lung and large intestine-exterior to interior; Compound Cangshu Formula; Chronic obstructive pulmonary disease; Inflammatory factors; Lung function; T lymphocyte subsets; Symptom score

中圖分类号：R256.12;R289.5文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.01.022

慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease，COPD）是以慢性气道炎性反应为特征的呼吸道疾病，临床表现为不完全可逆性气流受限，呈进行性进展。其发病关键是慢性气道炎性反应。该疾病患者免疫功能低下，机体内外各种致病菌能轻易通过各种途径促使慢性气道炎性反应。生理情况下机体器官、组织各菌群处于稳态，当内外环境改变时机体内菌群稳态打破，防御功能受到破坏，降低外界致病菌侵袭引起肺部或气道感染，促使COPD发生发展。西医在治疗上以支气管扩张剂、糖皮质激素、祛痰和镇咳、抗氧化剂为主，但复发率高，不良反应较多。……