中医益气养阴活血法对肺心病急性期发作患者T细胞亚群的影响及评价(1)
中图分类号：R541.5文献标识码： A文章编号： 1005-0019(2014)05-0006-03
【摘要】目的探讨益气养阴活血化瘀法对慢性肺心病患者免疫功能的影响。方法80例肺心病患者随机分为中药组42例，对照组38例，分别给于综合及加服黄芪、川芎等中药剂治疗；治疗前后4、8周时测定T细胞亚群值，动脉血气分析，进行治疗前后对比，临床疗效分析，并设正常对照组。结果80例患者CD3、CD4水平明显低于正常对照组，CD8高于正常对照组(P<0.01);治疗后血氧分压均明显升高；住院天数中药组明显低于对照组(P<0.01);8周时，T淋巴细胞亚群各项指标虽未达到正常水平，但治疗前后差异显著(P<0.05,P<0.01)，8周时CD3、CD4，中药组高于对照组。结论益气养阴活血化痰对肺心病患者的细胞免疫有增强调节作用，对防治肺心病急性发作有重要意义。
【关键词】慢性肺源性心脏病；T细胞亚群
, 百拇医药 Qi and Blood Circulation Method of Traditional Chinese Medicine in the Acute Phase of Corpulmonale Attack Patients T Cells and Group of Influence and Evaluation.SUN Ai-e1，WU Shao-jing2， CHEN Fang-tao2.(1.The Center Health Hospital of Laixi Xiagezhuang,Laixi 266606 ,China;2.The Chinese Medicinal Hospital of Laixi )【Abstract】ObjectiveTo investigate the effects of replenishing qi and nourishing yin and activating blood circulation on T-lymphocyte sub-population in patients with Cor-puhmonal.Methods80 patients with chronic corpulmoanl were dividend into two groups as follow. Control group was given common treatment,and in Tom group Astragalus and Ligusticum were given orally for a course of treatment. Before administration and ,4.8weeks after treatment T-lymphocyte tessubser were measured,and evaluating therapeutic effect by arterial blood gas analysis and clinical symptom.Results80 cases of corpulmonal significanting lower than normal group of CD3,CD4.but CD8 higher. After treatment blood PaO2 higher than before, the time in hospital TCM group patients are shcorter than control group, and the distance for 6 minutes walking. TCM group longer than later, At 4.8 week of treatment T-lymphocyte subset were significantly difference from pretreatment values. Although they did not return to normal range. The CD3,CD4 of TCM group significantly higher than control group at 8 week.ConclusionThe therapy of replenishing qi and nourishing yin and activating blood eirculation can improve the function of cell-mediated immunity in chronic cor-pulmonale patients. There for it may be of significance to use in the prophylaxis and treatment the exacerbation of chronic cotpulmonal.
, 百拇医药
【Key words】Cor-puhmonal;T-lymphocyte subset
感染与急性炎性反应在慢性肺源性心脏病的发病中起着重要作用[1]，长期反复的呼吸道感染导致了肺心病患者肺功能下降，并因由此引起的低氧血症，导致和加重肺动脉高压，促进了肺心病的进展，患者白细胞吞噬作用和细胞免疫功能明显低下，尤其是细胞免疫功能低下，造成机体对外源性感染物的易感性，从而使疾病进一步恶化或迁延[2]。抗生素治疗虽可缓解某些症状，但却不能有效控制复发。本试验通过对肺心病患者临床症状及T细胞亚群变化的观察，探讨中医益气养阴活血化瘀法对患者免疫功能的影响，现报告如下。
1资料与方法
1.1一般资料
80例肺心病患者均为急性发作期就诊。男38例，女42例。随机分为两组，中药组42例，对照组38例。年龄：中药组平均(62.3±9.7)岁，对照组平均(61.6±10.7)岁。病程中药组(16.4±9.6)年；对照组(15.0±9.8)年。均符合1977年全国肺心病专业会议修订的慢性肺心病诊断标准。所有患者均排除近期手术、自身免疫性疾病、严重器官功能障碍、活动性风湿性疾病；近3个月内未服用免疫调节剂，并排除支气管哮喘患者。两组在性别、年龄、病程、病情程度等方面均无显著差异，P>0.05，具有可比性。另设健康正常组40例，其中男24例，女16例，平均年龄(60.3±7.0)岁，均为健康查体时所得。
, http://www.100md.com
1.2治疗方法
①发病组治疗前及治疗后4.8周同时进行动脉血气分析，并对主要症状、体征观察记录，依照全国第二次会议修订的慢性肺心病疗效判定标准评价疗效，同时测定T淋巴细胞亚群(采用碱性磷酸酶-抗碱性磷酸酶法PAAP法)。②发病组急性发作期予抗感染、吸氧等常规治疗，中药组同时加服中药；缓解期对照组予以止咳平喘等处理。中药合剂基本方：黄芪30g，川芎12g，党参12g，当归15g，丹参18g，沙参10g，桑白皮10g，黄芩9g，杏仁6g。急性发作期加炙麻黄9g，双花18g；缓解期随症略有加减。水煎浓缩、去杂，含生药2g/mL，30mL每日2次。
1.3统计学处理
数据采用 (x±s)表示，t检验。, 百拇医药(孙爱娥 吴绍京 陈方焘)
【摘要】目的探讨益气养阴活血化瘀法对慢性肺心病患者免疫功能的影响。方法80例肺心病患者随机分为中药组42例，对照组38例，分别给于综合及加服黄芪、川芎等中药剂治疗；治疗前后4、8周时测定T细胞亚群值，动脉血气分析，进行治疗前后对比，临床疗效分析，并设正常对照组。结果80例患者CD3、CD4水平明显低于正常对照组，CD8高于正常对照组(P<0.01);治疗后血氧分压均明显升高；住院天数中药组明显低于对照组(P<0.01);8周时，T淋巴细胞亚群各项指标虽未达到正常水平，但治疗前后差异显著(P<0.05,P<0.01)，8周时CD3、CD4，中药组高于对照组。结论益气养阴活血化痰对肺心病患者的细胞免疫有增强调节作用，对防治肺心病急性发作有重要意义。
【关键词】慢性肺源性心脏病；T细胞亚群
, 百拇医药 Qi and Blood Circulation Method of Traditional Chinese Medicine in the Acute Phase of Corpulmonale Attack Patients T Cells and Group of Influence and Evaluation.SUN Ai-e1，WU Shao-jing2， CHEN Fang-tao2.(1.The Center Health Hospital of Laixi Xiagezhuang,Laixi 266606 ,China;2.The Chinese Medicinal Hospital of Laixi )【Abstract】ObjectiveTo investigate the effects of replenishing qi and nourishing yin and activating blood circulation on T-lymphocyte sub-population in patients with Cor-puhmonal.Methods80 patients with chronic corpulmoanl were dividend into two groups as follow. Control group was given common treatment,and in Tom group Astragalus and Ligusticum were given orally for a course of treatment. Before administration and ,4.8weeks after treatment T-lymphocyte tessubser were measured,and evaluating therapeutic effect by arterial blood gas analysis and clinical symptom.Results80 cases of corpulmonal significanting lower than normal group of CD3,CD4.but CD8 higher. After treatment blood PaO2 higher than before, the time in hospital TCM group patients are shcorter than control group, and the distance for 6 minutes walking. TCM group longer than later, At 4.8 week of treatment T-lymphocyte subset were significantly difference from pretreatment values. Although they did not return to normal range. The CD3,CD4 of TCM group significantly higher than control group at 8 week.ConclusionThe therapy of replenishing qi and nourishing yin and activating blood eirculation can improve the function of cell-mediated immunity in chronic cor-pulmonale patients. There for it may be of significance to use in the prophylaxis and treatment the exacerbation of chronic cotpulmonal.
, 百拇医药
【Key words】Cor-puhmonal;T-lymphocyte subset
感染与急性炎性反应在慢性肺源性心脏病的发病中起着重要作用[1]，长期反复的呼吸道感染导致了肺心病患者肺功能下降，并因由此引起的低氧血症，导致和加重肺动脉高压，促进了肺心病的进展，患者白细胞吞噬作用和细胞免疫功能明显低下，尤其是细胞免疫功能低下，造成机体对外源性感染物的易感性，从而使疾病进一步恶化或迁延[2]。抗生素治疗虽可缓解某些症状，但却不能有效控制复发。本试验通过对肺心病患者临床症状及T细胞亚群变化的观察，探讨中医益气养阴活血化瘀法对患者免疫功能的影响，现报告如下。
1资料与方法
1.1一般资料
80例肺心病患者均为急性发作期就诊。男38例，女42例。随机分为两组，中药组42例，对照组38例。年龄：中药组平均(62.3±9.7)岁，对照组平均(61.6±10.7)岁。病程中药组(16.4±9.6)年；对照组(15.0±9.8)年。均符合1977年全国肺心病专业会议修订的慢性肺心病诊断标准。所有患者均排除近期手术、自身免疫性疾病、严重器官功能障碍、活动性风湿性疾病；近3个月内未服用免疫调节剂，并排除支气管哮喘患者。两组在性别、年龄、病程、病情程度等方面均无显著差异，P>0.05，具有可比性。另设健康正常组40例，其中男24例，女16例，平均年龄(60.3±7.0)岁，均为健康查体时所得。
, http://www.100md.com
1.2治疗方法
①发病组治疗前及治疗后4.8周同时进行动脉血气分析，并对主要症状、体征观察记录，依照全国第二次会议修订的慢性肺心病疗效判定标准评价疗效，同时测定T淋巴细胞亚群(采用碱性磷酸酶-抗碱性磷酸酶法PAAP法)。②发病组急性发作期予抗感染、吸氧等常规治疗，中药组同时加服中药；缓解期对照组予以止咳平喘等处理。中药合剂基本方：黄芪30g，川芎12g，党参12g，当归15g，丹参18g，沙参10g，桑白皮10g，黄芩9g，杏仁6g。急性发作期加炙麻黄9g，双花18g；缓解期随症略有加减。水煎浓缩、去杂，含生药2g/mL，30mL每日2次。
1.3统计学处理
数据采用 (x±s)表示，t检验。, 百拇医药(孙爱娥 吴绍京 陈方焘)