吸入剂联合定喘止咳汤治疗对咳嗽变异性哮喘患者气道重塑、炎症及PARC/CCL-18通路的影响

Effect of inhalant combined with Dingchuan Zhike decoction therapy on the airway remodeling,inflammation and PARC/CCL-18 pathways in patients with cough variant asthma

目的:探讨吸入剂联合定喘止咳汤治疗对咳嗽变异性哮喘患者气道重塑、炎症及PARC/CCL-18通路的影响。方法:收集在本院接受治疗的咳嗽变异性哮喘患者60例,按照单盲随机对照法将其分为接受常规吸入剂治疗的对照组30例、接受吸入剂联合定喘止咳汤治疗的观察组30例,持续治疗6月。治疗前、治疗6月后,采用高分辨率CT测定两组气道重塑指标水平,采用放射免疫法测定外周血气道重塑指标含量,采用酶联免疫吸附法(ELISA)测定诱导痰中炎症介质及血清中PARC/CCL-18含量。结果:治疗前,两组气道重塑程度、炎症介质及PARC/CCL-18含量差异无统计学意义(P>0.05)。治疗6月后,观察组CT气道重塑指标LA、TA水平高于对照组,WA水平低于对照组,外周血气道重塑指标CTGF、YKL-39、MMP-9、TIMP-1含量低于对照组(P<0.05);观察组诱导痰中炎症介质IL-5、IL-6、IL-8含量低于对照组,血清PARC/CCL-18含量低于对照组(P<0.05)。结论:吸入剂联合定喘止咳汤可抑制咳嗽变异性哮喘患者的气道重塑,减轻气道炎症反应。

Objective： To study the effect of inhalant combined with Dingchuan Zhike decoction therapy on the airway remodeling, inflammation and PARC/CCL-18 pathways in patients with cough variant asthma. Methods： A total of 60 patients with cough variant asthma who were treated in our hospital between January 2014 and May 2016 were collected and divided into the control group （n = 30） who received conventional inhalant treatment and the observation group （n = 30） who received inhalant combined with Dingchuan Zbike decoction treatment according to single-blind randomized controlled method, and the treatment lasted for 6 months. Before treatment and after 6 months of treatment, high-resolution CT was used to determine the airway remodeling index levels, RIA method was used to determine the peripheral airway remodeling index contents, and enzymelinked immunosorbent assay （ELISA） was used to determine the contents of inflammatory mediators in induced sputum and the PARC/CCL-18 in serum. Results： Before treatment, the differences in the airway remodeling degree as well as the contents of inflammatory mediators and PARC/CCL-18 were not statistically significant between the two groups （P〉0.05）. After 6 months of treatment, CT airway remodeling indexes LA and TA levels of observation group were higher than those of control group while WA level was lower than that of control group, and peripheral airway remodeling indexes CTGF, YKL-39, MMP- 9 and TIMP-1 contents were lower than those of control group （P〈0.05）; inflammatory mediators IL-5, IL-6 and IL-8 contents in induced sputum of observation group were lower than those of control group, and serum PARC/CCL-18 content was lower than that of control group （P 〈0.05）. Conclusions： Inhalant combined with Dingchuan Zhike decoction can inhibit the airway remodeling and reduce the airway inflammation in patients with cough variant asthma.