多索茶碱联合定掌汤治疗AECOPD的效果及对NLRP3mRNA、TLR4-MyD88通路的影响

Effects of Doxofylline Combined with Dingzhang Decoction on AECOPD and Its Influence on NLRP3 mRNA and TLR4-MyD88 Pathway

目的:探究多索茶碱联合定掌汤治疗慢性阻塞性肺疾病急性加重期(AECOPD)的效果及对NL-RP3 mRNA、TLR4MyD88通路的影响。方法:选择AECOPD患者120例,随机分为两组(n=60)。对照组使用多索茶碱治疗,观察组在对照组基础上联合定掌汤定掌汤治疗。比较两组血气指标、肺功能指标,检测并比较两组血清白细胞介素-1(IL-1)、白细胞介素-18(IL-18)以及外周血淋巴细胞NLRP3 mR-NA和TLR4MyD88通路相关蛋白表达水平。结果:观察组的有效率显著高于对照组(P<0.05)。治疗后两组血气指标均显著改善(P<0.05),观察组PaO_2高于对照组而和PaCO_2显著低于对照组(P<0.05)。治疗后两组肺功能指标均显著升高(P<0.05),观察组FEV1和PEF均显著高于对照组(P<0.05)。治疗后两组IL-1和IL-18均显著降低(P<0.05),观察组IL-1和IL-18均显著低于对照组(P<0.05)。治疗前两组NLRP3mRNA水平无显著差异(P>0.05),治疗后均显著降低(P<0.05),治疗后观察组外周血淋巴细胞NLRP3 mRNA水平显著低于对照组(P<0.05)。治疗前两组TLR4、MyD88蛋白水平比较无显著差异(P>0.05),治疗后均显著降低(P<0.05),治疗后观察组外周血淋巴细胞TLR4、MyD88蛋白水平显著低于对照组(P<0.05)。结论:定掌汤联合多索茶碱对AECOPD患者具有更好的临床疗效,可更好的改善血气指标和肺功能。定掌汤可显著的抑制淋巴细胞中TLR4-MyD88通路并下调NLRP3 mRNA的水平。

Objective:To investigate the effect of doxofylline combined with Dingzhang Decoction on acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its effect on NLRP3 mRNA and TLR4MyD88 pathway.Methods:120 patients with AECOPD from May 2017 to June 2018 were randomly divided into two groups(n=60).The control group was treated with doxofylline,and the observation group was treated with DingzhangTangdingzhang in the control group.Blood gas index and lung function index were compared between the two groups.Serum interleukin-1(IL-1),interleukin-18(IL-18)and peripheral blood lymphocyte NLRP3 mRNA and TLR4MyD88 pathway were detected and compared.Protein expression level.Result:The effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the blood gas indexes of both groups were significantly improved(P<0.05).PaO2 in the observation group was higher than that in the control group and PaCO 2 was significantly lower than the control group(P<0.05).After treatment,the lung function indexes of both groups were significantly increased(P<0.05).FEV1 and PEF in the observation group were significantly higher than the control group(P<0.05).After treatment,IL-1 and IL-18 were significantly decreased(P<0.05).IL-1 and IL-18 in the observation group were significantly lower than the control group(P<0.05).There was no significant difference in NLRP3 mRNA levels between the two groups before treatment(P>0.05),and it was significantly decreased after treatment(P<0.05).The level of NLRP3 mRNA in peripheral blood lymphocytes of the observation group was significantly lower than that of the control group(P<0.05).There was no significant difference in TLR4 and MyD88 protein levels between the two groups before treatment(P>0.05),and significantly decreased after treatment(P<0.05).The levels of TLR4 and MyD88 in peripheral blood lymphocytes of the observation group were significantly lower than those of the control group(P<0.05).Conclusion:Dingzhang Decoction combined with doxofylline has a better clinical effect on AECOPD patients,which can better improve blood gas index and lung function.Dingzhangtang significantly inhibited the TLR4-MyD88 pathway in lymphocytes and down-regulated the level of NLRP3 mRNA.