【摘要】：目的： 觀測(cè)慢性阻塞性肺疾病急性加重期(AECOPD)患者治療前后的臨床表現(xiàn)以及血和痰中白介素-8(IL-8)、腫瘤壞死因子-α(TNF-α)、白介素-17(IL-17)、白介素-23(IL-23)表達(dá)的變化,研究連花清瘟對(duì)AECOPD氣道炎癥的影響,探索此藥在AECOPD患者中的作用機(jī)制,從而為中醫(yī)中藥治療AECOPD提供了一種新的思路和途徑。 方法： 選擇符合納入標(biāo)準(zhǔn)的AECOPD患者100例,分為2組(連花清瘟治療組和常規(guī)治療組),每組各50例。兩組患者均予以AECOPD的基礎(chǔ)治療(吸入藥物：沙美特羅氟替卡松250/50ug；支氣管擴(kuò)張劑：茶堿；祛痰解痙劑：氨溴索；抗菌藥物：β-內(nèi)酰胺類,如過敏給予氟喹諾酮類；控制性氧療等),在連花清瘟治療組患者中加用連花清瘟膠囊1.4g/次,3次/日,口服7天。所有患者在入組第1天和第7天評(píng)估CAT量表和中醫(yī)證候評(píng)分量表；并留取靜脈血3m1、痰液4-6ml,用ELISA法測(cè)定血和痰中IL-8、TNF-α、IL-17和IL-23的表達(dá)。 結(jié)果： CAT量表和中醫(yī)證候評(píng)分量表中各組及亞組患者治療后臨床表現(xiàn)均有明顯改善(P0.01),連花清瘟治療組血IL-8和IL-17的表達(dá)在治療后大幅度下降(P0.05),血TNF-α和IL-23雖有降低趨勢(shì),但尚未達(dá)到統(tǒng)計(jì)學(xué)意義；痰IL-8、TNF-α、IL-17和IL-23的表達(dá)較治療前均有明顯減少(P≤0.01),而常規(guī)治療組僅在痰TNF-α和IL-23水平較前降低(P0.05)。按照GOLD指南進(jìn)一步將連花清瘟治療組和常規(guī)治療組患者分為低風(fēng)險(xiǎn)亞組和高風(fēng)險(xiǎn)亞組,分別進(jìn)行比較,發(fā)現(xiàn)結(jié)果與前基本一致。在中醫(yī)證候評(píng)分量表高風(fēng)險(xiǎn)亞組患者連花清瘟治療后癥狀體征改善較常規(guī)治療后更加明顯(P0.01),低風(fēng)險(xiǎn)亞組中血IL-8在連花清瘟治療后有明顯下降(P0.05),而高風(fēng)險(xiǎn)亞組中痰IL-8在連花清瘟治療后明顯下降(P0.05)。 結(jié)論： 連花清瘟可以顯著改善慢性阻塞性肺疾病急性加重期患者的臨床癥狀體征,在高風(fēng)險(xiǎn)亞組患者中尤為明顯。其作用機(jī)制可能是通過抑制AECOPD患者炎癥因子的釋放,從而達(dá)到減輕氣道炎癥以及全身炎癥反應(yīng)的作用。
[Abstract]:Objective: to observe the clinical manifestations, serum and sputum levels of interleukin-8 (IL-8), tumor necrosis factor- 偽 (TNF- 偽), 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- 偽, 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- 偽 and IL-23 decreased, they were not statistically significant. The expression of IL-8,TNF- 偽, IL-17 and IL-23 in sputum was significantly lower than that before treatment (P 鈮，

本文編號(hào)：2378842