目的:评价加味玉屏风散联合常规西药治疗慢性阻塞性肺疾病(COPD)稳定期的临床疗效及安全性。方法:运用计算机检索Web of Science、Pubmed、Cochrane Library、维普中文期刊全文数据库、中国知网数据库、万方数据库、中国生物医学文献服...目的:评价加味玉屏风散联合常规西药治疗慢性阻塞性肺疾病(COPD)稳定期的临床疗效及安全性。方法:运用计算机检索Web of Science、Pubmed、Cochrane Library、维普中文期刊全文数据库、中国知网数据库、万方数据库、中国生物医学文献服务系统,筛选加味玉屏风散联合常规西药治疗COPD稳定期的随机对照临床试验(RCT),由2名研究员按照为本次分析制定的纳排标准独立筛选文献,选定文献后建立Excel表格录入所需数据,制作文献质量评估表,采用RevMan5.3软件进行数据分析。结果:共纳入19篇文献,样本量合计1511例。Meta分析结果显示采用加味玉屏风散联合西医常规治疗能够提高临床有效率[OR=0.26,95%CI(0.18,0.37)],可改善患者肺功能FEV1占预计值百分比(%)[MD=4.61,95%CI(2.43,6.79)],并且能够提高患者运动耐力6MWD[MD=43.90,95%CI(29.48,58.32)],提高患者体内的IgA水平[MD=0.25,95%CI(0.17,0.34)]。结论:加味玉屏风散联合常规西药治疗COPD稳定期可提高客观疗效,改善肺功能,提高免疫功能,且不良反应较小。但鉴于本次分析纳入的研究大多质量低下,结论证据支持力度较弱,有待更多方法学质量高,设计严谨,多中心的随机对照试验加以验证。展开更多
Background Nicotine,a major component of tobacco,is the main cause of smoking addiction.It was found that asthmatic patients who smoke were insensitive to glucocorticoid treatment.In this paper,we investigated whether...Background Nicotine,a major component of tobacco,is the main cause of smoking addiction.It was found that asthmatic patients who smoke were insensitive to glucocorticoid treatment.In this paper,we investigated whether nicotine could inhibit histone deacetylase 6 activity （HDAC6） and chaperone-dependent activation of the glucocorticoid receptor （GR） in A549 cells.Furthermore,the expression level of heat shock protein 90 （HSP90） was determined.Methods Quantitative real-time polymerase chain reaction was used to detect the levels of RNA transcription,and Western blotting was applied to analyze the levels of protein expression of HDAC6,GR,and HSP90 in A549 cells.Moreover,the effects of dexamethasone and trichostatin A were observed in A549 cells.Results A549 cell proliferation was inhibited in the presence of nicotine,and the level of RNA and protein expression of HDAC6 and GR were down-regulated.Conclusions Nicotine could inhibit HDAC6 activity and chaperone-dependent activation of GR.This might be the main reason why asthmatic patients who smoke show insensitivity to the glucocorticoid treatment.展开更多
文摘目的:评价加味玉屏风散联合常规西药治疗慢性阻塞性肺疾病(COPD)稳定期的临床疗效及安全性。方法:运用计算机检索Web of Science、Pubmed、Cochrane Library、维普中文期刊全文数据库、中国知网数据库、万方数据库、中国生物医学文献服务系统,筛选加味玉屏风散联合常规西药治疗COPD稳定期的随机对照临床试验(RCT),由2名研究员按照为本次分析制定的纳排标准独立筛选文献,选定文献后建立Excel表格录入所需数据,制作文献质量评估表,采用RevMan5.3软件进行数据分析。结果:共纳入19篇文献,样本量合计1511例。Meta分析结果显示采用加味玉屏风散联合西医常规治疗能够提高临床有效率[OR=0.26,95%CI(0.18,0.37)],可改善患者肺功能FEV1占预计值百分比(%)[MD=4.61,95%CI(2.43,6.79)],并且能够提高患者运动耐力6MWD[MD=43.90,95%CI(29.48,58.32)],提高患者体内的IgA水平[MD=0.25,95%CI(0.17,0.34)]。结论:加味玉屏风散联合常规西药治疗COPD稳定期可提高客观疗效,改善肺功能,提高免疫功能,且不良反应较小。但鉴于本次分析纳入的研究大多质量低下,结论证据支持力度较弱,有待更多方法学质量高,设计严谨,多中心的随机对照试验加以验证。
文摘Background Nicotine,a major component of tobacco,is the main cause of smoking addiction.It was found that asthmatic patients who smoke were insensitive to glucocorticoid treatment.In this paper,we investigated whether nicotine could inhibit histone deacetylase 6 activity （HDAC6） and chaperone-dependent activation of the glucocorticoid receptor （GR） in A549 cells.Furthermore,the expression level of heat shock protein 90 （HSP90） was determined.Methods Quantitative real-time polymerase chain reaction was used to detect the levels of RNA transcription,and Western blotting was applied to analyze the levels of protein expression of HDAC6,GR,and HSP90 in A549 cells.Moreover,the effects of dexamethasone and trichostatin A were observed in A549 cells.Results A549 cell proliferation was inhibited in the presence of nicotine,and the level of RNA and protein expression of HDAC6 and GR were down-regulated.Conclusions Nicotine could inhibit HDAC6 activity and chaperone-dependent activation of GR.This might be the main reason why asthmatic patients who smoke show insensitivity to the glucocorticoid treatment.
