三步序贯法对激素依赖型哮喘患者T辅助细胞亚群的影响

作者	单位
崔红生	北京中医药大学东直门医院呼吸科北京100700
崔巍	北京中医药大学东直门医院呼吸科北京100700
温志浩	北京中医药大学东直门医院呼吸科北京100700
王硕仁	北京中医药大学东直门医院呼吸科北京100700

摘要点击次数: 1240

全文下载次数: 1

中文摘要:

目的揭示三步序贯法治疗激素依赖型哮喘(steroid-dependent asthma,SDA)的疗效机制。方法将40例患者随机分为两组,每组各20例,对照组予普米克都保(布地奈德粉吸入剂,Pul micort Turbuhaler,100μg/吸,AstraZeneca AB,瑞典),每次400μg,每日两次吸入;治疗组予中药三步序贯方煎剂,每次100ml,每日2次口服,同时给予普米克都保200μg,每日两次吸入。两组疗程均12～14周。观察治疗前后哮喘症状积分、口服激素用量以及肺功能变化;流式细胞仪技术检测治疗前后外周血CD4+胞内细胞因子IL-4和IFN-γ的阳性细胞表达率(即Th1%和Th2%)。结果两组患者治疗前后哮喘症状积分、口服激素用量以及肺功能比较,差异均有显著性(P<0.01);两组治疗后Th2表达率均显著降低(P<0.01,P<0.05),Th1/Th2比值均显著升高(P<0.01);上述两组之间比较差异均有显著性(P<0.01);Th1表达率在治疗前后及组间比较差异均无显著性(P>0.05)。结论三步序贯法能够有效调节Th细胞亚群失衡,抑制炎性细胞因子的产生,减轻气道高反应性,从而改善了肺通气功能,减轻了哮喘症状,减少了患者对激素的依赖。

英文摘要:

ObjectiveTo investigate the therapeutic mechanism of three-step sequential method(TSSM)on patients with corticosteroid-dependent asthma(SDA).Methods Forty patients with SDA were randomly assigned according to the randomizing number table to two groups equally,the treated group treated with three-step sequential recipes plus inhalation of Pulmicort Turbuhaler 200 μg,twice a day,and the control group treated with Pulmicort Turbuhaler alone.The therapeutic course for both groups was 12-14 weeks.Changes of the symptom score of asthma,the corticosteroid dosage used and the lung function were observed and the positive expression rate of IFN-γ and IL-4 in peripheral CD+4 T cells were determined by flow cytometry before and after treatment.Results There was significant difference in the asthma symptom score,the oral corticosteroid dosage and the lung function between the treated group and the control group after treatment(P<0.01).The expression rate of Th2 reduced,the ratio of Th1/Th2 increased significantly after treatment in both groups(P<0.01,P<0.05),but the changes were more remarkable in the treated group than those in the control group,showing significant difference between them(P<0.01),while the expression rate of Th1 had no obvious change after treatment with no significant difference shown between the two groups(P>0.05).Conclusion TSSM can regulate imbalance of Th1/Th2,inhibit generation of inflammatory cytokines,decrease airway hyper-response,and therefore improve the pulmonary function,alleviate the asthmatic symptoms and reduce the patients’ dependence on corticosteroid.

关闭