甘草对慢性阻塞性肺疾病患者糖皮质激素受体的影响

The effect of gancao on glucocorticoid receptors in chronic obstructive pulmonary disease

目的 研究甘草和甲泼尼龙对慢性阻塞性肺疾病（ＣＯＰＤ） 患者外周血白细胞糖皮质激素受体（ＧＣＲ）的影响。方法 将４５ 例ＣＯＰＤ患者根据用药情况分为甘草组、激素组和甘草、激素联合组各１５ 例。另选１０ 名健康体检者为正常组。应用放射配基结合试验检测患者治疗前后ＧＣＲ，放免法检测血浆皮质醇（Ｆ） 、促肾上腺皮质激素（ＡＣＴＨ） 水平，并同时检测肺功能。结果 ＣＯＰＤ 急性加重期患者Ｆ、ＡＣＴＨ 比正常组高，差异有显著性（ Ｐ＜ ０－００１） ，ＧＣＲ低于正常组（ Ｐ＜ ０－００１） ，甘草、激素、甘草激素联合组治疗后一秒种用力呼气容积占预计值百分比（ＦＥＶ１ 占预计值％ ） 均升高，尤以甘草激素联合组明显（ Ｐ＜０－００１） ，同时甘草上调ＧＣＲ，激素下调ＧＣＲ，二药联合应用ＧＣＲ 无显著变化。结论 甘草能够逆转激素对自身受体的下调作用，显著增强和延长激素疗效。

Objective To study the effect of gancao and glucocorticoid on glucocorticoid receptors Methods The number of GCR of peripheral blood leukocytes was determined and FEV 1% was assessed in 45 COPD patients and 10 control subjects. Results GCR was significantly lower in COPD patients during acute attack than in control subjects while F and ACTH were significantly higher ( P <0.001) In gancao, glucocorticoid and combination of gancao and glucocorticoid treated groups FEV 1% was higher after treatment, especially in the combination group( P <0.001) Gancao induced up regulation of GCR while glucocorticoid induced down regulation of GCR, but combination of gancao and glucocorticoid had no effect on GCR Conclusions Gancao might reverse the down regulation of glucocorticoid on GCR, thus enhance and prolong the effects of glucocorticoids