参苓白术散联合沙美特罗氟替卡松治疗支气管哮喘慢性持续期疗效及对患者机体氧化-抗氧化平衡的影响

目的:观察探讨参苓白术散联合沙美特罗氟替卡松治疗肺脾气虚型支气管哮喘慢性持续期的临床效果,及对机体氧化-抗氧化平衡的影响。方法:选取120肺脾气虚型支气管哮喘慢性持续期患者,随机分为两组,各60例。对照组采用沙美特罗氟替卡松气雾剂吸入治疗,观察组在对照组基础上加用参苓白术散治疗,治疗12周,观察比较两组治疗前后中医症候积分、肺功能指标、呼出气一氧化氮(FeNO)水平、哮喘控制测试(ACT)评分、机体氧化-抗氧化平衡指标及血清转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)水平的变化,并在疗程结束后随访3个月,比较两组复发率。结果:观察组治疗12周后,各项中医症候积分及总分、FeNO测定值、血清MDA、8-iso-PG表达、血清VEGF、TGF-β1表达均与治疗前相比明显降低(P<0.05),各项肺功能指标、ACT评分、血清SOD、GSH-Px表达均与治疗前相比明显提高(P<0.05),改善程度均明显优于对照组(P<0.05); 随访3个月,观察组复发率为3.3%,显著低于对照组复发率16.7%(P<0.05)。结论:联用参苓白术散治疗肺脾气虚型支气管哮喘慢性持续期的疗效显著,优于单用沙美特罗氟替卡松治疗,可有助改善相关症候及肺功能,调节机体氧化-抗氧化平衡,减小气道反应,控制和减少哮喘发作,降低复发率。

Effect of Shenling Baizhu powder combined with salmeterol and fluticasone in the treatment of chronic bronchial asthma on the balance of body oxidation and antioxidation

Objective:To observe and explore the clinical effect of Shenling Baizhu powder combined with salmeterol and fluticasone in the treatment of chronic duration of bronchial asthma with deficiency of lung and spleen,and its effect on the balance of oxidation and antioxidation.Methods:120 patients with chronic persistent bronchial asthma of lung-spleen-qi deficiency type were randomly divided into two groups,each with 60 cases.The control group was treated with salmeterol fluticasone aerosol inhalation,and the observation group was treated with Shenling Baizhu powder on the basis of the control group,for 12 weeks.Observe and compare the TCM symptom score,lung function index exhaled nitric oxide(FeNO)level,asthma control test(ACT)score,body oxidation-oxidation balance index,serum TGF-β1 and the change of VEGF level was followed up for 3 months after the end of the treatment,and the recurrence rate of the two groups was compared.Results:After 12 weeks of treatment in the observation group,the scores and total scores of various TCM symptoms,the measured value of FeNO,the expression of serum MDA,8-iso-PG,serum VEGF,TGF-β1 expression was significantly lower than that before treatment(P<0.05).The lung function index,ACT score,serum SOD,GSH-Px expression were significantly higher than those before treatment(P<0.05).The improvement degree was significantly better than that of the control group(P<0.05).Following up for 3 months,the recurrence rate in the observation group was 3.3%,significantly lower than that in the control group was 16.7%(P<0.05).Conclusion:Combined with the method of Shenling Baizhu powder,the treatment of chronic duration of bronchial asthma with deficiency of lung and spleen is significantly effective,which is superior to the treatment of salmeterol and fluticasone alone.It can help improve the relevant symptoms and lung function,regulate the balance of oxidation and oxidation resistance of the body,reduce the airway reaction,control and reduce asthma attacks,and reduce the recurrence rate.