中医药治疗支气管扩张症及相关机制研究进展

摘要/Abstract

摘要： 支气管扩张症是肺系难治疾病之一,与肺癌、支气管哮喘、慢阻肺等重大疾病相比,其关注度远远不够。笔者通过检索中医药治疗支气管扩张症的相关文献,并翻阅古籍进行整理归纳后发现,传统中医药治疗支气管扩张症具有疗效确切、不良反应少及整体调理等优势和特色。然而,中医治疗本病无论是基础研究还是临床研究都需要进一步深入探索。文章旨在对支气管扩张症的中医病名、病因病机、临床研究及现代机制等现状进行综合述评,以期为各位同道提供参考。

关键词: 支气管扩张症, 中医药, 作用机制, 研究进展

Abstract: Bronchiectasis is one of the refractory diseases of the lung system. Compared with lung cancer, bronchial asthma, chronic obstructive pulmonary disease and other major diseases, its attention is far from enough. By searching the relevant literature on the treatment of Bronchiectasis with traditional Chinese medicine, and reviewing the ancient books, the author found that the treatment of Bronchiectasis with traditional Chinese medicine has the advantages and characteristics of definite efficacy, reducing the side effects of western medicine, and overall conditioning. However, the treatment of this disease with traditional Chinese medicine requires further exploration in both basic and clinical research. The purpose of this article is to make a comprehensive review of the status quo of Bronchiectasis in terms of its name, etiology, pathogenesis, clinical research and modern mechanism, so as to provide reference for colleagues.

Key words: bronchiectasis, traditional Chinese medicine, mechanism of action, research progress

中图分类号:

R256.1

陈晶晶, 张念志, 薛晓明, 韩明向. 中医药治疗支气管扩张症及相关机制研究进展[J]. 中华养生保健, 2023, 41(24): 70-73.

CHEN Jing-jing, ZHANG Nian-zhi, XUE Xiao-ming, HAN Ming-xiang. Research Progress of Traditional Chinese Medicine in the Treatment of Bronchiectasis and Related Mechanisms[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(24): 70-73.

参考文献

[1] FLUME P A, CHALMERS J D, OLIVIER K N.Advances in bronchiectasis: endotyping, genetics, microbiome, and disease heterogeneity[J].Lancet,2018,392(10150):880-890.
[2] 周玉民,王辰,姚婉贞,等.我国7省市城区40岁及以上居民支气管扩张症的患病情况及危险因素调查[J].中华内科杂志,2013,52(5):379-382.
[3] DICKER A J, LONERGAN M, KEIR H R, et al.The sputum microbiome and clinical outcomes in patients with bronchiectasis: a prospective observational study[J].Lancet Respir Med,2021,9(8):885-896.
[4] 支气管扩张症专家共识撰写协作组,中华医学会呼吸病学分会感染学组.中国成人支气管扩张症诊断与治疗专家共识[J].中华结核和呼吸杂志,2021,44(4):311-321.
[5] 郭方霞. 乙酰半胱氨酸雾化吸入治疗支气管扩张症的疗效分析[J].中华养生保健,2021,39(7):1-3.
[6] 李淑芬. 支气管镜肺泡灌洗对支气管扩张症患者肺功能指标的影响研究[J]. 中华养生保健,2021,39(15):44-45.
[7] 马志英,赵娜,李新.乙酰半胱氨酸溶液辅治老年支气管扩张症急性加重患者的价值[J].中华养生保健,2021,39(6):5-7.
[8] 陈晶晶,张念志,韩明向.中西医结合治疗支气管扩张症的思路探讨[J].中华中医药杂志,2020,35(7):3499-3502.
[9] 马丽鑫. 加减千金苇茎汤对支气管扩张症伴感染(痰热郁肺证)的临床观察及对IL-8的影响[D].哈尔滨:黑龙江中医药大学,2016.
[10] 刘子云,谢东,周刚.千金苇茎汤加减方辅助治疗支气管扩张症效果及对中医临床症状、肺功能和炎性因子改善情况[J].解放军医药杂志,2020,32(10):70-74.
[11] 许志远. 苍术二陈汤治疗支气管扩张缓解期(痰湿蕴肺证)随机、对照临床研究[D].成都:成都中医药大学,2012.
[12] 李彦玲,陈芳,徐文慧.苇茎二陈汤治疗支气管扩张症急性发作期(痰热郁肺证)患者的临床疗效[J].中国中医急症,2022,31(2):271-274.
[13] 田兆华. 加味清金化痰汤在痰热蕴肺型支气管扩张症患者中的应用效果[J].中国医药科学,2018,8(16):49-52.
[14] 王莉影,桂吟哲,仝润芍.清金化痰汤加减治疗支气管扩张合并肺部感染临床观察[J].中医药临床杂志,2023,35(1):147-151.
[15] 周建军,陈建建,吴吉锋,等.补中益气汤治疗支气管扩张稳定期25例[J].江西中医药,2013,44(8):34-35.
[16] 范海军. 补中益气汤联合针灸对支气管扩张稳定期患者肺通气功能及日常生活能力的影响[J].北方药学,2019,16(4):136-137.
[17] 于国强,乔世举,于雪峰,等.麻杏石甘汤加味联合针灸治疗急性期支气管扩张症53例[J].河南中医,2015,35(9):2022-2024.
[18] 莫伟强,邵剑骏,高景蓬,等.麻杏石甘汤加味联合西药治疗急性期支气管扩张症疗效观察[J].新中医,2015,47(3):58-59.
[19] 张元兵,王丽华,洪广祥.洪广祥从“治肺不远温”辨治支气管扩张[J].上海中医药杂志,2013,47(2):1-4,19.
[20] 熊同. 基于数据挖掘薛汉荣教授辨治支气管扩张用药经验研究[D].南昌:江西中医药大学,2022.
[21] 徐波,张静,樊长征,等.苗青自拟补中柴前连梅汤治疗支气管扩张症稳定期经验[J].中华中医药杂志,2017,32(1):163-165.
[22] 陆旭之. 疏肝清肺汤治疗肝火犯肺型支气管扩张症的临床观察[D].黑龙江:黑龙江省中医药科学院,2018.
[23] 李亚清,高雪,曲敬来,等.自拟咯血方治疗支气管扩张症临床观察[J].黑龙江中医药,2017,46(6):23-25.
[24] 钱雅琴,吴飞虎,朱玲,等.疏风解毒胶囊的临床应用进展[J].时珍国医国药,2018,29(8):1956-1958.
[25] 余静珠,居健惠,孙锦贤,等.疏风解毒胶囊联合桔芩汤治疗29例支气管扩张急性期临床观察[J].上海医药,2016,37(6):24-27.
[26] 胡静菊,黄凤丽.疏风解毒胶囊联合左氧氟沙星治疗支气管扩张症合并肺部感染急性发作期的疗效评价[J].北京中医药,2015,34(12):979-981.
[27] 王东兴,赵宁波.痰热清注射液抗耐药菌研究进展[J].中国中医急症,2018,27(9):1684-1687.
[28] 吴吉锋,李新爱,文梦丽.痰热清注射液雾化吸入联合静脉滴注治疗支气管扩张感染的临床疗效观察[J].江西中医药大学学报,2018,30(6):47-49.
[29] 郭祥君,李家树,史家欣,等.痰热清治疗支气管扩张合并铜绿假单胞菌定植和感染疗效观察[J].陕西中医,2017,38(3):287-288,291.
[30] 安恩强. 痰热清注射液对支气管扩张患者肺功能状态的影响研究[J].中国医药指南,2016,14(30):186.
[31] 刘书香. 垂体后叶素合云南白药治疗支气管扩张大咯血的临床疗效[J].实用中西医结合临床,2018,18(4):16-18.
[32] 孙诗佳. 云南白药联合注射用凝血酶对老年支气管扩张小量咯血的影响[J].中国医药指南,2017,15(5):184-185.
[33] 朱振侠. 支气管扩张的机制探讨及治疗策略研究[J].中医临床研究,2014,6(23):135-137.
[34] VIDAILLAC C, CHOTIRMALL S H.Pseudomonas aeruginosa in bronchiectasis: infection, inflammation, and therapies[J]. Expert Rev Respir Med,2021,15(5):649-662.
[35] 刘城鑫,洪森楷,施妙璇,等.基于中医传承辅助平台探讨中医药治疗支气管扩张的证治规律[J].中药新药与临床药理,2020,31(10):1244-1249.
[36] 朱亚南,杨七妹,张硕,等.黄芩苷与黄芩素药理作用及机制研究进展[J].时珍国医国药,2020,31(4):921-925.
[37] 许甘霏,王晶晶,吴大强,等.鱼腥草素钠及其与红霉素联用对产膜表皮葡萄球菌luxS、agr/RNAⅢ影响的研究[J].中国中药杂志,2017,42(11):2131-2138.
[38] AMATI F, SIMONETTA E, GRAMEGNA A, et al.The biology of pulmonary exacerbations in bronchiectasis[J].Eur Respir Rev,2019,28(154):190055.
[39] 陈吉. 消痈方对脾肺气虚型支气管扩张症稳定期患者临床症状的改善及作用机制初步探讨[J].四川中医,2018,36(8):56-59.
[40] 张邦禹,赵兰,徐瑛.阿奇霉素和支扩养阴颗粒联合给药对大鼠支气管扩张模型的影响及机制[J].中国抗生素杂志,2018,43(1):103-108.
[41] 甄利波,汤军,钱华,等.清金抗扩饮对支气管扩张症模型大鼠肺组织基质金属蛋白酶-9及其组织抑制物的作用研究[J].中华中医药学刊,2013,31(5):1079-1081,1222-1223.
[42] 桂坤,董亚琼,龙启忠,等.清解补肺汤辅助治疗支气管扩张对肺功能和BALF中MMP-9、MIP-2及TIMP-1的影响[J].中药材,2018,41(10):2201-2203.
[43] DE CAMARGO A A, DE CASTRO R A S, VIEIRA R P, et al. Systemic Inflammation and Oxidative Stress in Adults with Bronchiectasis: Association with Clinical and Functional Features[J].Clinics (Sao Paulo),2021,76:e2474.
[44] OLVEIRA G, OLVEIRA C, DORADO A, et al.Cellular and plasma oxidative stress biomarkers are raised in adults with bronchiectasis[J].Clin Nutr,2013,32(1):112-117.
[45] 朱汉平,张志敏,谢栩硕,等.宣肺降浊清肠汤治疗稳定期支气管扩张患者的有效性评价[J].湖北中医药大学学报,2022,24(1):67-69.
[46] 江霜霜,程璘令.122例支气管扩张症病因分析[J].广州医科大学学报,2021,49(5):31-33.
[47] 陈雨莎,袁梦鑫,梁斌苗,等.普通变异性免疫缺陷病并细胞免疫功能缺陷致支气管扩张、肝硬化一例并文献复习[J].中国呼吸与危重监护杂志,2019,18(2):169-173.
[48] NANDAN D, NAG V K, TRIVEDI N, et al.X-linked Hyper-IgM Syndrome with Bronchiectasis[J].J Lab Physicians,2014,6(2):114-116.
[49] 万毅刚,曹世宏,韩树人.中药与氧氟沙星治疗支气管扩张症的对比研究[J].南京中医药大学学报,1999(6):335-337.
[50] IRVIN C, ZAFAR I, GOOD J, et al.Increased frequency of dual-positive TH2/TH17 cells in bronchoalveolar lavage fluid characterizes a population of patients with severe asthma[J].J Allergy Clin Immunol,2014,134(5):1175-1186.
[51] BELLONE M, BREVI A, HUBER S.Microbiota-Propelled T Helper 17 Cells in Inflammatory Diseases and Cancer[J].Microbiol Mol Biol Rev,2020,84(2):e00064-19.
[52] 邓飞. 清金化痰汤加味联合纤支镜肺泡灌洗治疗支气管扩张合并感染疗效及对血清炎性因子的影响[J].现代中西医结合杂志,2017,26(11):1190-1192,1200.
[53] 俞万钧,姜昊,王华英.Th17细胞/Treg细胞免疫平衡在慢性气道炎症性疾病发展中的作用研究进展[J].中国慢性病预防与控制,2017,25(3):234-237.
[54] WESTHÖLTER D, BECKERT H, STRAßBURG S, et al. Pseudomonas aeruginosa infection, but not mono or dual-combination CFTR modulator therapy affects circulating regulatory T cells in an adult population with cystic fibrosis[J].J Cyst Fibros,2021,20(6):1072-1079.
[55] 汤洋,刘敬禹.新鱼腥草素钠联合西药治疗支气管扩张合并感染的临床效果[J].江苏医药,2020,46(2):127-129.