| Objective:By observing the clinical therapeutic effect of modified xiao qing long decoction joint titropium in patients with stable chronic obstructive pulmonary disease (Chronic obstructive pulmonary disease, COPD),and exploring the mechanism of the therapy plays the clinical curative,And to provide evidence for the exact effect of Chinese medicine treatment with COPD.Methods:Selected 80 patients consistent with stable chronic obstructive pulmonary disease and the Chinese medicine dialectical is within the cold drink and Qi deficiency of lung and spleen. According to the sequence of admission,using random digital table randomly divided into combined group and control group,two groups include 40 patients.Two groups during the process of observation were not removed and shedding. The control group in oxygen,maintain acid-base balance and electrolyte balance on the basis of tiotropium bromide inhalation powder18 μg/day,were nine o’clock in the morning daily inhalation,The combined group also take with modified xiao qing long decoction except the same basical treatment with the control group,100ml at a time,3 times a day,5 days taking traditional Chinese medicine after taking 2 days off,So the whole study course cycle in this way.Two groups of patients were observed for 3 months, Record before and after treatment in two groups’patients with clinical symptoms index (mMRC), the degree of airflow limitation (FEV1, FEV1 predicted value,FEV1/FVC%), Sport endurance (6 minute walk test,6MWT), body mass index (BMI), BODE score, tlymphocyte subsets (CD3+, and CD4+, and CD8+, and CD4+/CD8+) in percentage, inflammatory mediators (IL-6, TNF-a) in The concentration. Results:① The mMRC grade in Both the combination group and the control group patients after treatment decreased compared with before (P<0.05), but the combination group than the control group classification mMRC more significantly lower (P <0.05), the difference was statistically significant. ②Combined group and control group after treatment FEV1, FEV1 predicted value%, FEV1/ FVC% were higher than treatment before (P<0.05), but the combination group than the control group increased more significantly (P<0.05), the divergence was statistically extraordinary. ③ After therapy, Both groups’ 6MWT increased (P<0.05) more than before, the combined group raise more significant than the control group after therapy, (P<0.05), the difference was statistically outstanding.④ Both groups’BMI increased Compared treatment before (P<0.05),the combined group was Obviously higher than the control group (P<0.05), the difference was statistically significant.⑤ Both groups’BODE score decreased (P<0.05) after treatment,but the combined treatment group compared with the control group decreased significantly (P<0.05), the difference was statistically significant.⑥ The levels of CD3+, CD4+, CD4+/CD8+in the combined treatment group increased more than treatment before(P<0.05), The levels of CD8+was significantly lower than treatment before (P <0.05), the differences were statistically significant; The levels of CD3+, CD4+, CD4+/CD8+in the control group after treatment lower than before (P<0.05), CD8+levels increased more after the treatment (P<0.05), the difference was statistically significant. the level of CD3+, CD4+, CD4+/ CD8+ in combined treatment group was higher than the control group (P <0.05), The level of CD8+lower than the control group (P<0.05), the difference was statistically significant. ⑦ TNF-a in the combination group and control group reduced after therapy (P<0.05), but more significantly reduced in the combined group (P<0.05), the discrepancy was statistically outstanding; IL-6 in the combined group decreased compared with treatment before (P<0.05), IL-6 in the control group increased after the treatment (P<0.05), the difference was statistically significant.Conclusion:① Modified xiao qing long decoction combined with tiotropium bromide in terms of improving clinical symptoms and the order of se;verity has better curative effect Compared with using tiotropium only ② Modified xiao qing long decoction joint tiotropium significantly increased T-lymphocyte subsets CD3+, CD4+, CD4+/CD8+ levels, lower CD8+levels; ③ Modified xiao qing long decoction joint tiotropium reduces cell immunity in patients with stable COPD-related inflammatory cytokines TNF-a, IL-6 levels;④ The Mechanism of modified xiaoqinglong decoction combined with tiotropium bromide playing Significant effect may be modulating the t-lymphocyte subsets, enhance immune function with stable chronic obstructive pulmonary disease patients. |
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