【摘要】 目的 观察生脉散加减辅助无创机械通气对慢性阻塞性肺疾病急性加重期（AECOPD）患者免疫功能、氧化应激损伤的影响。方法 选取AECOPD患者104例，按照随机数字表法分为2组，每组52例。对照组患者使用无创机械通气治疗，治疗组在对照组治疗基础上加生脉散加减治疗，连续治疗2周。比较2组治疗前后肺功能指标用力肺活量（FVC）、第1 s用力呼气容积（FEV₁）、FEV₁/FVC,炎症因子白细胞介素6（IL-6）、IL-8、肿瘤坏死因子α（TNF-α）水平，免疫功能指标辅助性T淋巴细胞1（Th1）、Th2、Th1/Th2水平，氧化应激指标超氧化物歧化酶（SOD）、丙二醛（MDA）及总抗氧化能力（T-AOC）水平。统计比较2组不良反应及临床疗效。结果 治疗后，2组FVC、FEV₁、FEV₁/FVC均较本组治疗前升高（P<0.05）,且治疗组均高于对照组（P<0.05）。治疗后，2组IL-6、TNF-α、IL-8水平均较本组治疗前降低（P<0.05）,且治疗组均低于对照组（P<0.05）。治疗后，2组Th1、Th1/Th2水平均较本组治疗前升高（P<0.05）,Th2水平均较本组治疗前降低（P<0.05）,且治疗组Th1、Th1/Th2水平均高于对照组（P<0.05）,Th2水平低于对照组（P<0.05）。治疗后，2组SOD、T-AOC水平均较本组治疗前升高（P<0.05）,MDA水平均较本组治疗前降低（P<0.05）,且治疗组SOD、T-AOC水平均高于对照组（P<0.05）,MDA水平低于对照组（P<0.05）。治疗组不良反应发生率为5.77%（3/52）,对照组为21.15%（11/52）,治疗组不良反应发生率低于对照组（P<0.05）。治疗组总有效率92.31%（48/52）,对照组75.00%（39/52）,治疗组总有效率高于对照组（P<0.05）。结论 应用生脉散加减辅助无创机械通气对AECOPD患者进行治疗，能够改善患者肺功能和免疫功能，减轻炎性反应及氧化应激损伤，效果显著。更多还原

【Abstract】 Objective To observe the effect of modified Shengmai Powder combined with noninvasive ventilation（NIV） on immune function and oxidative stress injury in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods A total of 104 AECOPD patients were randomly divided into the treatment group（n=52） and the control group（n=52）. All patients were managed by NIV, and those in the treatment group were additionally treated with modified Shengmai Powder. A 2-week treatment was performed to compare the pulmonary function indexes（forced vital capacity [FVC], forced expiratory volume in one second [FEV₁], FEV₁/FVC）, the inflammatory factors（interleukin-6 [IL-6], IL-8, tumor necrosis factor-α [TNF-α]）, the immune function indexes（T-helper cell 1 [Th1], Th2, Th1/Th2）, the oxidative stress indexes（superoxide dismutase [SOD], malonaldehyde [MDA], total antioxidant capacity [T-AOC]）; the adverse reaction and the curative effect were compared and assessed. Results After treatment, FVC, FEV₁, FEV₁/FVC in groups were increased（P<0.05）, which were increased in the treatment group compared with the control group（P<0.05）; IL-6, TNF-α, IL-8 in groups were decreased（P<0.05）, which were lower in the treatment group than in the control group（P<0.05）; increased levels of Th1, Th1/Th2 and decreased levels of Th2 were detected in groups after treatment（all P<0.05）; higher Th1 and Th1/Th2 levels, and lower Th2 levels were detected in the treatment group than those in the control group（all P<0.05）; SOD and T-AOC in groups were increased（P<0.05）, the treatment group was more prevalent（P<0.05）; MDA in groups was decreased（P<0.05）, the treatment group was more common（P<0.05）. The incidence of adverse reactions was 5.77%（3/52） in the treatment group, lower than that of 21.15%（11/52） in the control group（P<0.05）. The overall effective rate was better in the treatment group than the control group（92.31 [48/52] vs 75.00% [39/52], [P<0.05], respectively）. Conclusion For AECOPD patients, modified Shengmai Powder combined with NIV can improve the pulmonary function and immune function, reduce inflammation and oxidative stress, and with remarkable effect.更多还原