The Clinical Study Of Shengeyifeisan Combined With Tiotropium Bromide In The Treatment Of Patients In COPD Stabilization Period

Objective:This study Provides theoretical and experimental evidence for drugs clinical application and further development, through observing the curative effect of Shengeyifeisan combining with tiotropium bromide to treat COPD Stability of the patient’s clinical efficacy, to explore the therapy in the regulation of T lymphocyte subsets and related cytokines (IL-6, TGF-p, IL-17) mechanism.Method:46cases of stable COPD patients were randomly divided into joint group23cases and control group23cases; The control group tiotropium18μg dry powder inhalation, once daily in the morning; In the joint group on the basis of the foregoing treatment, plus to take sengeyifeisan2g,3times a day for6months. Assess symptoms two groups of patients before and after treatment (CAT, mMRC), lung function (FEV1, FEV1%predicted, FEV1/FVC%), Acute exacerbation risk, exercise endurance (6MWT), body mass index changes (Body Mass Index, BMI), while observing the before and after treatment of T cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+), serum cytokine (IL-6, TGF-β, IL-17) levels.Results:①mMRC CAT scores were lower after the two groups of patients before treatment and mMRC CAT scores were lower (P<0.05); joint group after treatment and mMRC CAT score than the control group significantly decreased (P<0.05).②After treatment, the joint group FEV1, FEV1%predicted values%, FEV1/FVC%values were improved (P<0.05); no significant difference compared to the control group before and after treatment (P>0.05) Joint group was significantly improved after control group compared with FEV1(P<0.05).③The Frequency of acute episodes joint group was significantly less than the control group (P<0.05) after treatment.④Two groups of patients after treatment improved than before treatment6MWT (P<0.05); Joint group improved more significantly than the control group (P<0.05) after treatment.⑤The BMI of joint group improved significantly than before treatment (P<0.05) after treatment; the control group(P>0.05) did not change significantly after treatment Compared to before treatment;the BMI of joint group increased after treatment compared to before treatment group, but it is not statistically significant (P>0.05).⑥After treatment, the joint group ’s CD3+, CD4+, CD4+/CD8+was significantly higher than that before treatment, and the difference was significant (P<0.05); after treatment the joint group’s CD8+was significantly lower than before treatment (P<0.05); After treatment in the control group’s CD3+, CD4+, CD4+/CD8+increased than before treatment (P<0.05), and CD8+was higher than before treatment, but no statistical difference (P>0.05); After treatment, the joint group’s CD3+, CD4+, CD4+/CD8+was significantly higher (P<0.05), whereas CD8+joint group was significantly lower than the control group (P<0.05). Serum IL-6, TGF-β, IL-17levels compared with before treatment, the joint group was significantly decreased;⑦After treatment the IL-6, IL-17, the control group has increased (P<0.05); while joint group decreased (P<0.05),compared before treatment, the difference was significant (P<0.05), TGF-β than the control group, but the difference was not statistically significant (P>0.05).Conclusion:Shengeyifeisan joint tiotropium compared to tiotropium to stable COPD, has better clinical efficacy in improving the patients symptoms and signs, ventilation conditions, acute exacerbations, exercise endurance; the mechanism of action of Shengeyifeisan joint tiotropium treasting COPD may be associated with T cell subsets and related cytokines (IL-6, TGF-β, IL-17) of the regulation.