目的 探究雙歧桿菌四聯(lián)活菌輔助治療對(duì)慢性阻塞性肺疾?。–OPD）穩(wěn)定期患者BODE指數(shù)及免疫炎癥因子表達(dá)的影響。方法 選取2019年6月—2021年6月在解放軍總醫(yī)院第六醫(yī)學(xué)中心診治的穩(wěn)定期COPD患者112例，隨機(jī)數(shù)字表法將研究對(duì)象分為對(duì)照組和試驗(yàn)組，每組56例。對(duì)照組采用常規(guī)治療，試驗(yàn)組在對(duì)照組基礎(chǔ)上加用雙歧桿菌四聯(lián)活菌輔助治療。比較兩組療效、治療前后BODE指數(shù)、肺功能［第1秒用力呼氣量（FEV₁）、最大呼氣流速峰值（PEF）、最大肺活量（FVC）］、免疫功能（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）、炎癥因子水平［C反應(yīng)蛋白（CRP）、白細(xì)胞介素-6（IL-6）、可溶性血管細(xì)胞黏附分子1（sVCAM-1）］、不良反應(yīng)發(fā)生率。結(jié)果 試驗(yàn)組總有效率96.43%，較對(duì)照組82.14%顯著升高（P＜0.05）；治療后試驗(yàn)組BODE指數(shù)較對(duì)照組顯著降低（P＜0.05）；治療后試驗(yàn)組FEV₁、PEF、FVC較對(duì)照組顯著升高（P＜0.05）；治療后，試驗(yàn)組患者免疫功能明顯優(yōu)于對(duì)照組，差異顯著（P＜0.05）；治療后試驗(yàn)組血清CRP、IL-6、sVCAM-1水平較對(duì)照組顯著降低（P＜0.05）；兩組藥物不良反應(yīng)發(fā)生率比較，差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。結(jié)論 雙歧桿菌四聯(lián)活菌輔助治療穩(wěn)定期COPD患者，臨床效果好，可以很好緩解患者的癥狀，改善免疫功能和肺功能，減輕機(jī)體炎癥，安全性高。

Objective To investigate the effect of probiotics on BODE index and expression of inflammatory cytokines in patients with stable chronic obstructive pulmonary disease (COPD). Methods A total of 112 patients with stable COPD treated in the Sixth Medical Center of the PLA General Hospital were enrolled in the study from June 2019 to June 2021. The subjects were randomly divided into control group and experimental group by random number table method, each group contained 56 samples. The control group was treated with conventional therapy, and the experimental group was treated with probiotics on the basis of the control group. The efficacy, BODE index, pulmonary function (FEV1, PEF, and FVC), immune function (CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺), inflammatory factors (CRP, IL-6, and Svcam-1), and adverse reactions were compared between the two groups. Results The total effective rate of experimental group was 96.43%, which was higher than that of control group (82.14%, P < 0.05), the BODE Index of experimental group was lower than that of control group after treatment (P < 0.05) , the FEV1, PEF, FVC of experimental group were higher than that of control group after treatment (P < 0.05). After treatment, the levels of CRP, IL-6 and Svcam-1 in the experimental group were significantly lower than those in the control group (P < 0.05), there was no significant difference in the incidence of adverse drug reactions between the two groups (P > 0.05). Conclusion Probiotics as an adjunctive therapy for COPD patients in stable stage has a good clinical effect, which can relieve the symptoms, improve the immune function and lung function, and reduce the inflammation of the body, high security.

R974

海軍總醫(yī)院創(chuàng)新培育基金（CXPY201725）