Objective：To explore the effect of Tanreqing Injection（痰热清注射液,TRQI） on the treatment of acute exacerbation of chronic obstructive pulmonary disease（AECOPD） with Chinese medicine syndrome of retention of phl...Objective：To explore the effect of Tanreqing Injection（痰热清注射液,TRQI） on the treatment of acute exacerbation of chronic obstructive pulmonary disease（AECOPD） with Chinese medicine syndrome of retention of phlegm and heat in Fei（痰热阻肺证,RPHF）.Methods：In a prospective randomized controlled clinical trial,90 patients with AECOPD of RPHF syndrome were randomly assigned to 3 groups,TRQI and controls A and B,each with 30 cases.The TRQI group was administered with the intravenous injections of 20 mL TRQI once a day and conventional Western medicine treatment.Control group A was administered with the intravenous injection of 15 mg ambroxol hydrochloride twice a day and conventional Western medicine treatment,and control group B was administered with conventional Western medicine treatment only.The treatments were administered for 10 days.Chinese medical symptoms and signs were scored,and plasma concentrations of interleukin（IL）-8 and neutrophil elastase（NE） were recorded.Results：（1） The Chinese medical symptoms （cough,sputum amount,expectoration,dyspnea and fever） and signs（tongue and pulse） improved significantly in the TRQI group（P〈0.05 or P〈0.01）,and improvements in cough,sputum amount and expectoration were better in the TRQI group than control group B（P〈0.05）;there was no significant difference between the TRQI group and control group A（P〉0.05）.The sign of tongue was also improved significantly in the TRQI group （P〈0.05）.（2） The overall effects in the TRQI group and control group A were significantly better than in control group B（P〈0.05）,with no significant differences between the TRQI group and control group A（P〉0.05）.There was no significant difference in the total effective rate among the three groups（P〉0.05）.（3） After treatment, the plasma concentrations of IL-8 and NE decreased in the TRQI group and control group A（P〈0.05）,and the concentration of IL-8 in control group B decreased（P〈0.05）.The difference in IL-8 was greater in the TRQI group than in control group A and B before and after treatment,and the change in NE was greater in control group A than in the TRQI group and control group B,but there was no statistical significance among the three groups with regards to the change in IL-8 or NE（P〉0.05）.Conclusion：TRQI could improved the Chinese medical signs and symptoms in the patients with AECOPD,possibly because of the decreasing plasma levels of IL-8 and NE which could improve response to airway inflammation and mucus hypersecretion.展开更多
目的:探讨热毒宁注射液在慢性阻塞性肺疾病急性加重期(AECOPD)痰热阻肺证中的抗炎与免疫作用。方法:收集从2012年1月-2013年12月的住院患者110例,按照随机数字表方法分为治疗组(基础治疗方案+热毒宁注射液20 m L+5%葡萄糖注射液250 m L...目的:探讨热毒宁注射液在慢性阻塞性肺疾病急性加重期(AECOPD)痰热阻肺证中的抗炎与免疫作用。方法:收集从2012年1月-2013年12月的住院患者110例,按照随机数字表方法分为治疗组(基础治疗方案+热毒宁注射液20 m L+5%葡萄糖注射液250 m L每日1次静注)和对照组(基础治疗方案+生理盐水20 m L+5%葡萄糖注射液250 m L每日1次静注),每组各55例,疗程为14天。观察两组治疗前后中医症状积分、临床疗效、血常规、血气分析及T淋巴细胞亚群的改善情况。结果:在中医证候评分和临床疗效方面,治疗组治疗后中医症状评分及总积分除喘促气短、口干欲饮、面赤均较对照组改善明显(P<0.05),总有效率较对照组明显好转;在抗感染方面,治疗组治疗前后患者白细胞总数及中性粒细胞分类百分比,均较治疗前明显下降(P<0.05),但与对照组治疗后白细胞总数及中性粒细胞分类百分比,无统计学差异;血气分析方面,治疗组治疗后血气分析Pa CO2、Pa O2较对照组明显好转(P<0.05);在免疫调节方面,治疗组治疗后患者T淋巴细胞亚群CD3+、CD4+明显高于对照组,表达抑制/细胞毒细胞(CD8+)明显低于对照组(P<0.05),CD4+/CD8+比值恢复到正常参考值水平。结论:在AECOPD痰热阻肺证的治疗中,在西医对症治疗方案的基础上,辅以热毒宁注射液清热解毒化痰,能够明显改善患者临床症状,提高临床疗效,特别是针对感染诱发合并呼吸衰竭存在免疫功能低下的患者,可能疗效更为确切。展开更多
基金Supported by Scientific and Technolohical Project of Sichuan Science and Technology Agency(No.2006Z08-009).
文摘Objective：To explore the effect of Tanreqing Injection（痰热清注射液,TRQI） on the treatment of acute exacerbation of chronic obstructive pulmonary disease（AECOPD） with Chinese medicine syndrome of retention of phlegm and heat in Fei（痰热阻肺证,RPHF）.Methods：In a prospective randomized controlled clinical trial,90 patients with AECOPD of RPHF syndrome were randomly assigned to 3 groups,TRQI and controls A and B,each with 30 cases.The TRQI group was administered with the intravenous injections of 20 mL TRQI once a day and conventional Western medicine treatment.Control group A was administered with the intravenous injection of 15 mg ambroxol hydrochloride twice a day and conventional Western medicine treatment,and control group B was administered with conventional Western medicine treatment only.The treatments were administered for 10 days.Chinese medical symptoms and signs were scored,and plasma concentrations of interleukin（IL）-8 and neutrophil elastase（NE） were recorded.Results：（1） The Chinese medical symptoms （cough,sputum amount,expectoration,dyspnea and fever） and signs（tongue and pulse） improved significantly in the TRQI group（P〈0.05 or P〈0.01）,and improvements in cough,sputum amount and expectoration were better in the TRQI group than control group B（P〈0.05）;there was no significant difference between the TRQI group and control group A（P〉0.05）.The sign of tongue was also improved significantly in the TRQI group （P〈0.05）.（2） The overall effects in the TRQI group and control group A were significantly better than in control group B（P〈0.05）,with no significant differences between the TRQI group and control group A（P〉0.05）.There was no significant difference in the total effective rate among the three groups（P〉0.05）.（3） After treatment, the plasma concentrations of IL-8 and NE decreased in the TRQI group and control group A（P〈0.05）,and the concentration of IL-8 in control group B decreased（P〈0.05）.The difference in IL-8 was greater in the TRQI group than in control group A and B before and after treatment,and the change in NE was greater in control group A than in the TRQI group and control group B,but there was no statistical significance among the three groups with regards to the change in IL-8 or NE（P〉0.05）.Conclusion：TRQI could improved the Chinese medical signs and symptoms in the patients with AECOPD,possibly because of the decreasing plasma levels of IL-8 and NE which could improve response to airway inflammation and mucus hypersecretion.
文摘目的:探讨热毒宁注射液在慢性阻塞性肺疾病急性加重期(AECOPD)痰热阻肺证中的抗炎与免疫作用。方法:收集从2012年1月-2013年12月的住院患者110例,按照随机数字表方法分为治疗组(基础治疗方案+热毒宁注射液20 m L+5%葡萄糖注射液250 m L每日1次静注)和对照组(基础治疗方案+生理盐水20 m L+5%葡萄糖注射液250 m L每日1次静注),每组各55例,疗程为14天。观察两组治疗前后中医症状积分、临床疗效、血常规、血气分析及T淋巴细胞亚群的改善情况。结果:在中医证候评分和临床疗效方面,治疗组治疗后中医症状评分及总积分除喘促气短、口干欲饮、面赤均较对照组改善明显(P<0.05),总有效率较对照组明显好转;在抗感染方面,治疗组治疗前后患者白细胞总数及中性粒细胞分类百分比,均较治疗前明显下降(P<0.05),但与对照组治疗后白细胞总数及中性粒细胞分类百分比,无统计学差异;血气分析方面,治疗组治疗后血气分析Pa CO2、Pa O2较对照组明显好转(P<0.05);在免疫调节方面,治疗组治疗后患者T淋巴细胞亚群CD3+、CD4+明显高于对照组,表达抑制/细胞毒细胞(CD8+)明显低于对照组(P<0.05),CD4+/CD8+比值恢复到正常参考值水平。结论:在AECOPD痰热阻肺证的治疗中,在西医对症治疗方案的基础上,辅以热毒宁注射液清热解毒化痰,能够明显改善患者临床症状,提高临床疗效,特别是针对感染诱发合并呼吸衰竭存在免疫功能低下的患者,可能疗效更为确切。
