清热化痰方药对慢性阻塞性肺疾病急性加重期痰热壅肺证细胞因子的影响

Huatan Qingre Prescription Treatment of Chronic Obstructive Pulmonary Disease with Acute Exacerbation and Syndrome of Heat-phelgm Stagnating the Lung the Effects of Cytokines

目的:基于清热化痰方药治疗AECOPD痰热壅肺证临床疗效基础上,通过检测治疗前后患者外周血中白介素8(IL-8)、肿瘤坏死因子(TNF-a)、细胞间黏附分子-1(ICAM-1)、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)的水平变化,进而探讨清热化痰方药治疗AECOPD痰热壅肺证的作用机制。方法:选取符合入选标准的病例140例,随机分为两组。两组分别于治疗前及疗程结束后留取血清测定IL-8、TNF-α、ICAM-1水平,留取血浆测定ET-1、CGRP含量,并与健康组对照。结果:治疗后,两组TNF-α、ICAM-1、IL-8及ET-1水平均明显降低(P<0.01、P<0.05),CGRP水平明显升高(P<0.01);试验组治疗后TNF-α、ICAM-1、IL-8及ET-1水平的降低较对照组显著(P<0.05),CGRP升高较对照组明显(P<0.05)。结论:IL-8、TNF-α、ICAM-1、ET-1、CGRP细胞因子参与COPD的急性加重和形成,清热化痰方药能够降低AECOPD的TNF-α、ICAM-1、IL-8、ET-1高水平表达、升高CGRP表达水平,可能是清热化痰方药治疗AECOPD发挥临床疗效的作用机制之一。

Objective：Based on clinical efficacy evidence of the treatment with Qingre Huatan prescriptions of AECOPD with syndrome of heat-phelgm stagnating the lung,this paper aims to discuss the mechanism of the treatment with Qingre Huatan prescription of AECOPD with syndrome of heat-phelgm stagnating the lung,by detecting level changes in peripheral blood of patients with Interleukin-8 （IL-8）,tumor necrosis factor（TNF-α）,intercellular adhesion molecule-1（ICAM-1）,endothelin-1（ET-1）,calcitonin gene-related peptide （CGRP） before and after treatment.Methods：140 cases of patients who meet the inclusion criteria are selected and randomly divided into two groups.Before and after the course,the serum of the two groups is retained to detect the level of IL-8,TNF-α and ICAM-1,and the plasma is retained to detect the level of ET-1 and CGRP.Results：After treatment,TNF-α,ICAM-1,and IL-8 and ET-1 of the two groups are significantly lower then before （P0.01,P0.05）,CGRP levels are significantly higher （P0.01）;TNF-α,ICAM-1,IL-8 and ET-1 levels in pilot group is significantly lower than the control group after treatment（P0.05）,CGRP is significantly higher than the control group（P0.05）.Conclusion：Cytokines such as IL-8,TNF-α,ICAM-1,ET-1,and CGRP are involved in the acute exacerbation and the formation of COPD.Qingre Huatan AECOPD prescription can reduce the high-level expression of TNF-α,ICAM-I,IL-8 and ET -1,and increase the expression level of CGRP.This may be one of the mechanisms which functions in the treatment of AECOPD with Qingre Huatan prescription.