千金苇茎汤加减对慢性阻塞性肺疾病急性加重患者核转录因子-κB的影响

Effect of modified Qianjin Weijing decoction (千金苇茎汤加减) on nuclear factor-κB of chronic obstructive pulmonary disease in acute deteriorated stage

目的:观察千金苇茎汤加减治疗慢性阻塞性肺疾病急性加重(AECOPD)患者的临床疗效以及对血浆炎症介质、核转录因子-κB(NF-κB)的影响。方法:将60例AECOPD患者随机分为两组。对照组单用常规西药治疗,治疗组在常规西药治疗基础上加用千金苇茎汤加减。治疗前和治疗7d后分别记录和测定两组患者的症状、体征、血气分析、肺功能及血浆NF-κB、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平,并进行临床分析。结果:治疗组总有效率(86.7%)明显高于对照组(66.7%,P<0.05)。两组治疗后血浆NF-κB、TNF-α、IL-8水平较治疗前明显改善(P均<0.01),且治疗组的改善程度明显优于对照组治疗后NF-κB为(3.10±0.12)×106比(13.02±0.47)×106,TNF-α为(4.34±0.07)μg/L比(15.23±0.75)μg/L,IL-8为(4.33±0.26)μg/L比(22.31±8.15)μg/L,P均<0.01;治疗组血气分析和肺功能也均较对照组改善更明显(P<0.05或P<0.01)。结论:千金苇茎汤加减可以通过抑制炎症细胞释放NF-κB,阻断炎症介质的释放,减轻AECOPD患者的炎症反应,发挥治疗作用。

Objectives To investigate the effect of modified Qianjin Weijing decoction （千金苇茎汤加减） in clinical treatment of chronic obstructive pulmonary disease （COPD） in acute deteriorated stage and its intervention effect on inflammatory mediator of nuclear factor -κB （NF -κB）. Methods ： Sixty patients who suffered from COPD in acute deteriorated stage were randomly divided into two groups. The patients of control group were treated with routine medicine only and the patients of treatment group were treated with modified Qianjin Weijing decoction beside the routine treatment. The symptoms and signs, artery blood gas analysis, respiration function, NF -κB, tumor necrosis factor -α （TNF -α）, interleukin - 8 （IL - 8） of plasma were recorded and analyzed in all patients before treatment and 7 days after treatment. Results： The total effective rate of patients＇ improvement on symptoms and signs in treatment group was higher than that in control group （86.7% vs. 66.7%, P〈0.05）. Although all patients were improved in the indices of plasma NF -κB, TNF -α, IL - 8 after treatment （all P〈0.01）, the indices of NF -κB [（3.10±0.12） ×10^6 vs. （13.02±0.47） ×10^6, TNF-α [（4. 34 ± 0. 07） μg/L vs. （15.23±0.75） μg/L] and IL-8 [（4.33± 0.26） μg/L vs. （22.31 ±8.15） μg/L] of plasma in the treatment group were better than those of control group （all P〈0.01）. The respiration function and result of blood gas analysis were improved significantly after treatment compared with those of the control group （P〈0.05 or P〈0.01）. Conclusion： It is confirmed that mediators of inflammation such as NF-κB, which released by macrophage and inflammatory cell, can be inhibited by modified Qianjin Weijing decoction. In other words, modified Qianjin Weijing decoction plays an important role in the treatment of COPD by restraining inflammation of the patient.