连花清瘟对慢性阻塞性肺疾病急性加重期气道炎症影响的研究
发布时间：2018-12-14 15:20
【摘要】：目的： 观测慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗前后的临床表现以及血和痰中白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、白介素-17(IL-17)、白介素-23(IL-23)表达的变化,研究连花清瘟对AECOPD气道炎症的影响,探索此药在AECOPD患者中的作用机制,从而为中医中药治疗AECOPD提供了一种新的思路和途径。 方法： 选择符合纳入标准的AECOPD患者100例,分为2组(连花清瘟治疗组和常规治疗组),每组各50例。两组患者均予以AECOPD的基础治疗(吸入药物：沙美特罗氟替卡松250/50ug；支气管扩张剂：茶碱；祛痰解痉剂：氨溴索；抗菌药物：β-内酰胺类,如过敏给予氟喹诺酮类；控制性氧疗等),在连花清瘟治疗组患者中加用连花清瘟胶囊1.4g/次,3次/日,口服7天。所有患者在入组第1天和第7天评估CAT量表和中医证候评分量表；并留取静脉血3m1、痰液4-6ml,用ELISA法测定血和痰中IL-8、TNF-α、IL-17和IL-23的表达。 结果： CAT量表和中医证候评分量表中各组及亚组患者治疗后临床表现均有明显改善(P0.01),连花清瘟治疗组血IL-8和IL-17的表达在治疗后大幅度下降(P0.05),血TNF-α和IL-23虽有降低趋势,但尚未达到统计学意义；痰IL-8、TNF-α、IL-17和IL-23的表达较治疗前均有明显减少(P≤0.01),而常规治疗组仅在痰TNF-α和IL-23水平较前降低(P0.05)。按照GOLD指南进一步将连花清瘟治疗组和常规治疗组患者分为低风险亚组和高风险亚组,分别进行比较,发现结果与前基本一致。在中医证候评分量表高风险亚组患者连花清瘟治疗后症状体征改善较常规治疗后更加明显(P0.01),低风险亚组中血IL-8在连花清瘟治疗后有明显下降(P0.05),而高风险亚组中痰IL-8在连花清瘟治疗后明显下降(P0.05)。 结论： 连花清瘟可以显著改善慢性阻塞性肺疾病急性加重期患者的临床症状体征,在高风险亚组患者中尤为明显。其作用机制可能是通过抑制AECOPD患者炎症因子的释放,从而达到减轻气道炎症以及全身炎症反应的作用。
[Abstract]:Objective: to observe the clinical manifestations, serum and sputum levels of interleukin-8 (IL-8), tumor necrosis factor- 伪 (TNF- 伪), interleukin-17 (IL-17) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) before and after treatment. The change of interleukin-23 (IL-23) expression, to study the effect of Lianhuaqing blast on airway inflammation of AECOPD, and to explore the mechanism of this medicine in AECOPD patients, thus providing a new way for TCM to treat AECOPD. Methods: 100 patients with AECOPD were selected and divided into two groups (treatment group and routine treatment group) with 50 cases in each group. Patients in both groups were treated with basic treatment of AECOPD (inhaled drug: salmeterol / fluticasone 250 / 50ug; bronchiectator: theophylline; spasmolysis agent: ambroxol; antimicrobial agent: 尾-lactam, such as allergic administration of fluoroquinolones; Control oxygen therapy etc.), the patients in Lianhua Qingwen treatment group were treated with Lianhua Qingwen capsule 1.4g/, 3 times a day, orally for 7 days. The CAT scale and TCM syndrome score scale were evaluated on the 1st and 7th day, and the venous blood 3ml, sputum 4-6ml were retained, and the expression of IL-8,TNF- 伪, IL-17 and IL-23 in blood and sputum were measured by ELISA method. Results: the clinical manifestations of each group and subgroup were significantly improved after treatment in CAT scale and TCM syndrome score scale (P0.01). The expression of IL-8 and IL-17 in Lianhuaqing blast treatment group decreased significantly after treatment (P0.05). Although the blood TNF- 伪 and IL-23 decreased, they were not statistically significant. The expression of IL-8,TNF- 伪, IL-17 and IL-23 in sputum was significantly lower than that before treatment (P 鈮，
本文编号：2378842
[Abstract]:Objective: to observe the clinical manifestations, serum and sputum levels of interleukin-8 (IL-8), tumor necrosis factor- 伪 (TNF- 伪), interleukin-17 (IL-17) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) before and after treatment. The change of interleukin-23 (IL-23) expression, to study the effect of Lianhuaqing blast on airway inflammation of AECOPD, and to explore the mechanism of this medicine in AECOPD patients, thus providing a new way for TCM to treat AECOPD. Methods: 100 patients with AECOPD were selected and divided into two groups (treatment group and routine treatment group) with 50 cases in each group. Patients in both groups were treated with basic treatment of AECOPD (inhaled drug: salmeterol / fluticasone 250 / 50ug; bronchiectator: theophylline; spasmolysis agent: ambroxol; antimicrobial agent: 尾-lactam, such as allergic administration of fluoroquinolones; Control oxygen therapy etc.), the patients in Lianhua Qingwen treatment group were treated with Lianhua Qingwen capsule 1.4g/, 3 times a day, orally for 7 days. The CAT scale and TCM syndrome score scale were evaluated on the 1st and 7th day, and the venous blood 3ml, sputum 4-6ml were retained, and the expression of IL-8,TNF- 伪, IL-17 and IL-23 in blood and sputum were measured by ELISA method. Results: the clinical manifestations of each group and subgroup were significantly improved after treatment in CAT scale and TCM syndrome score scale (P0.01). The expression of IL-8 and IL-17 in Lianhuaqing blast treatment group decreased significantly after treatment (P0.05). Although the blood TNF- 伪 and IL-23 decreased, they were not statistically significant. The expression of IL-8,TNF- 伪, IL-17 and IL-23 in sputum was significantly lower than that before treatment (P 鈮，
本文编号：2378842
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