哮喘宁颗粒对哮喘慢性持续期患者的临床疗效分析

Clinical effect of xiaochuanning granule on chronic persistent bronchial asthma based on Th1/Th2 immuno-balance

摘要:

目的 基于Th1/Th2 免疫失衡机制观察哮喘宁颗粒对哮喘慢性持续期患者的临床疗效。 方法 选取2018 年1 月—2019 年2 月南通市中医院慢性持续期哮喘患者130 例，随机分为对照组（雾化吸 入沙美特罗替卡松）和观察组（雾化吸入沙美特罗替卡松+ 口服哮喘宁颗粒），每组65 例。比较两组临床 疗效；辅助性T 淋巴细胞1（Th1）/Th2 分化水平、白细胞介素-4（IL-4）、IL-12、IL-17、干扰素-γ （IFN-γ）等相关炎症因子；T 盒子转录因子（T-bet）、GATA 结合蛋白3（GATA-3）、维A 酸相关孤 独受体亚家族γt（RORγt）及叉头框转录因子P3（FoxP3）水平的变化。结果 观察组治愈率高于对照 组（32.31% VS 13.85%）（P <0.05）。观察组Th2/CD4+、IL-4、IL-17、GATA-3、RORγt 降低的差值， 以及Th1/CD4+、Th1/Th2 比值、IL-12、IFN-γ、T-bet、FoxP3 升高的差值均高于对照组（P <0.05）。 结论 哮喘宁颗粒通过诱导Th0 细胞向Th1 型细胞分化，抑制Th2 型细胞分化能力，提高Th1/Th2 比值，进 而提高慢性持续期哮喘患者的治愈率。

Abstract:

Objective To compare the clinical effect of xiaochuanning granule on chronic persistent bronchial asthma based on Th1/Th2 immuno-balance. Methods From January 2018 to February 2019, 130 patients with chronic persistent bronchial asthma in our hospital were collected and randomly divided into control group (salmeterol and fluticasone propionate inhalation) and observation group (salmeterol and fluticasone propionate inhalation + xiaochuanning granule). The clinical effect was observed. The changes of Th1/CD4+, Th2/CD4+, Th1/Th2, related cytokines, such as interleukin (IL)-4, IL-12, IL-17, interferon-γ (IFN-γ), and nuclear transcription factors, such as T-box expressed in T cells (T-bet), GATA-binding protein 3 (GATA-3), retinoid related orphan nuclear receptor subfamily γt (ROR γt), fork-head box P3 (FoxP3) mRNAs, were compared between the two groups. Results After 12 months of treatment, the recovery rate of observation group were 32.31% (21/65), higher than that of control group (P < 0.05). Patients in both groups had lower Th2/CD4+(%), serum values of IL-4, IL-17 and GATA-3 mRNA, ROR γt mRNA than before treatment, while they had higher Th1/CD4+(%), Th1/Th2 ratio, the serum values of IL- 10, IFN-γ and T-bet mRNA, FoxP3 mRNA. The declined differences of Th2/CD4+(%), serum values of IL-4, IL- 17 and GATA-3 mRNA, ROR γt mRNA and the increased differences of Th1/CD4+(%), Th1/Th2 ratio, the serum values of IL-10, IFN-γ and T-bet mRNA, FoxP3 mRNA in observation group were higher than those in control group (P < 0.05). Conclusion The application of xiaochuanning granule in the treatment of chronic persistent bronchial asthma could effectively improve the clinical recovery by regulating Th1/Th2 immuno-balance, which would be recommended for an effective treatment.