温肺健脾化痰汤配合热敏灸对支气管哮喘慢性持续期痰哮证患者中医证候积分及Th17/Treg平衡的影响

目的:探讨温肺健脾化痰汤配合热敏灸对支气管哮喘慢性持续期痰哮证(哮喘痰哮证)患者中医证候积分及辅助性T细胞/调节性T细胞(Th17/Treg)平衡的影响。方法:选取120例哮喘痰哮证患者,以随机数字表法分组,各60例。均予以布地奈德治疗,对照组加热敏灸治疗,观察组加温肺健脾化痰汤配合热敏灸治疗。观察指标:①临床疗效; ②哮喘控制率; ③中医证候积分; ④肺功能:1秒呼气容积(FEV₁)、最大呼气流量(PEF)、呼吸流速峰值(PEFR); ⑤Th17/Treg平衡。结果:观察组临床疗效、哮喘控制率优于对照组(P<0.05); 观察组治疗后痰涎壅盛、喘急胸满、坐不得卧、面色青暗积分低于对照组(P<0.05); 观察组治疗后FEV₁、PEF高于对照组,PEFR低于对照组(P<0.05); 观察组治疗后外周血Treg高于对照组,Th17、Th17/Treg低于对照组(P<0.05)。结论:温肺健脾化痰汤配合热敏灸能通过纠正Th17/Treg平衡,进一步缓解哮喘痰哮证临床症状,改善肺功能,提高治疗效果。

Effects of Wenfei Jianpi Huatan decoction combined with heat-sensitive moxibustion on TCM syndrome score and Th17/Treg balance in patients with syndrome of phlegm asthma in chronic persistent stage of bronchial asthma

Objective:To investigate the effect of Wenfei Jianpi Huatan decoction combined with heat-sensitive moxibustion on TCM syndrome scores and Th17/Treg balance in patients with syndrome of phlegm asthma in chronic persistent stage of bronchial asthma(asthma and phlegm asthma).Methods:A total of 120 asthma patients with phlegm-asthma syndrome were selected and divided into groups by random number table,60 cases in each group.All were treated with budesonide,the control group was treated with heat-sensitive moxibustion,and the observation group was treated with warming Wenfei Jianpi Huatan decoction combined with heat-sensitive moxibustion.Observation indicators:①Clinical efficac.②Asthma control rate.③TCM syndrome integral.④Lung function,1 second expiratory volume(FEV₁),maximum expiratory flow(PEF),peak respiratory flow rate(PEFR).⑤Th17/Treg balance.Results:The clinical efficacy and asthma control rate in the observation group were better than those in the control group(P<0.05).After treatment,the scores of phlegm and saliva congestion,dyspnea,chest fullness,sitting without lying down,and dull complexion in the observation group were lower than those in the control group(P<0.05).After treatment,FEV₁ and PEF in the observation group were higher than those in the control group,and PEFR was lower than that in the control group(P<0.05).The Treg of peripheral blood in the observation group after treatment was higher than that in the control group,and Th17 and Th17/Treg were lower than those in the control group(P<0.05).Conclusion:Wenfei Jianpi Huatan decoction combined with heat-sensitive moxibustion can further alleviate the clinical symptoms of asthma and phlegm asthma syndromes by correcting the Th17/Treg balance,which can improve lung function,and improve the treatment effect.