清肺化痰通络法对AECOPD患者IL-8、TNF-α及PCT的影响

Effects of Clearing Lung, Resolving Phlegm and Freeing Collaterals Method on PCT, IL-8 and TNF-α in Patients with AECOPD

目的:观察清肺化痰通络法对慢性阻塞性肺疾病急性加重期(AECOPD)"痰浊蕴肺、脉络瘀阻"证患者的临床疗效,以及对患者血清中白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、降钙素(PCT)水平变化的影响,进而探讨清肺化痰通络法治疗AECOP"D痰浊蕴肺、脉络瘀阻"证患者的作用机制。方法:选取符合纳入标准的患者66例,随机分为2组,对照组给予规范化治疗方案,治疗组在此基础上加用中药清肺痰通络法复方进行治疗,观察治疗前后患者的症状、体征,2组分别于治疗前及疗程结束后留取血清测定IL-8、TNF-α、PCT含量,并进行治疗前后及组间比较。结果:治疗后2组患者血清IL-8、TNF-α、PCT水平均较前下降(P<0.05),血清IL-8和TNF-α水平治疗组下降幅度大于对照组(P<0.05);治疗组临床症状及体征情况改善优于对照组(P<0.05)。结论:IL-8、TNF-α、PCT参与COPD的急性加重和形成,配合清肺化痰通络法治疗AECOPD,可以更明显的降低患者血清中IL-8、TNF-α、PCT高水平表达,提高临床疗效。

Objective： To observe clinical effects of clearing lung, resolving phlegm and freeing collaterals method on patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） of phlegm-turbidity accumulating lung and stagnation obstructing meridian pattern, also and its function on changes of IL-8, TNF-α and PCT in patients, therefore to explore the mechanism. Method： All 66 patients were randomized into two groups.The control group received normalized treatment and the patients in the treatment group were also given with drugs of clearing lung, resolving phlegm and freeing collaterals on the base of routine treatment. The symptom and body signs of patients were observed before and after treating, serum was taken before treating and after the courses of treatment to detect the contents of IL-8, TNF-α and PCT, the indexes were compared between before and after treating as well as both groups. Result： Levels of IL-8, TNF-α and PCT were lower after treating in patients of both groups than before treating（P〈0.05）, and the decrease of serum IL-8 and TNF-α in the treatment group were greater than that of the control group（P〈0.05）; the improvements of clinical symptom and body signs in the treatment group were superior to that of the control group （P〈0.05）. Conclusion： The method of clearing lung, resolving phlegm and freeing collaterals in treating AECOPD could improve clinical effects and obviously decrease the higher level ex- pression of IL-8, TNF-α and PCT, which participated the acute exacerbation and formation of COPD.