摘要
目的观察通腑泻肺方治疗肺系脓毒症(痰热壅肺证)的临床疗效。方法将60例患者随机分为对照组和治疗组,对照组在西医常规治疗基础上加用安慰剂,治疗组在西医常规治疗的基础上加用通腑泻肺方免煎颗粒。观察各组患者治疗前后中医证候评分变化,RT-PCR法检测治疗前后外周血单个核细胞中NLRP3、ASC的mRNA表达量,ELISA法检测治疗前后血清中Caspase-1、IL-1β、IL-18水平。结果 (1)治疗后第3日起治疗组的中医证候评分明显低于对照组(P=0.000);治疗组的结局疗效明显优于对照组(P=0.002)。(2)两组治疗后NLRP3 mRNA、ASC mRNA的表达水平均明显低于治疗前(P<0.001);治疗组治疗后的NLRP3mRNA和ASC mRNA表达水平均明显低于对照组(P<0.001)。(3)治疗组治疗后血清Caspase-1水平明显低于对照组(P<0.001);治疗组治疗前Caspase-1、IL-1β、IL-18水平明显高于治疗后(P<0.001,P<0.001,P=0.002);对照组治疗前IL-18水平明显高于治疗后(P=0.01)。结论通腑泻肺方联合西医治疗肺系脓毒症(痰热壅肺证)的疗效优于单纯西医治疗。同时具有下调NLRP3、ASC、Caspase-1的表达水平作用,可能与其作用机制相关。
Objectives： To explore the mechanism of Tongfuxiefei decoction in pulmonary sepsis （phlegm-heat obstructing lung syndrome） treatment by observing the clinical efficacy and effect on expression of NLRP3 in- flammasome. Methods： 60 patients in accordance with pulmonary sepsis （phlegm-heat obstructing lung syn- drome） were randomly divided into control group and treatment group. The patients of control group were treated with conventional therapy and placebo while the patients of treatment group were treated with Tongfuxiefei decoc- tion and conventional therapy for 10 days. The TCM syndrome scores of two groups before and after treatment were observed. The mRNA expressions of NLRP3 and ASC in the peripheral blood mononuclear cells were de- tected by RT-PCR before and after treatment. The Caspase-1 ,IL-1 beta,IL-18 and TNF alpha in serum were detected by ELISA before and after treatment. The changes of cellular immunity were observed before and after treatment. Results： （1）Since the third day after treatment,TCM syndrome score of treatment group was signifi- cantly lower than that of control group （P= 0.000）. Since the first day after treatment,severity of treatment group was significantly lower than that of control group（P= 0.04）. The curative effect of treatment group was significant- ly superior to that of control group （P=0.O02）. （2）The mRNA expressions of NLRP3 and ASC after treatment were significantly lower than before in both groups （P〈 0.001 ）. The mRNA expressions of NLRP3 and ASC of treatment group were significandy lower than those of control group after treatment （P〈 0.001）. （3）After treat- ment, Caspase-1 level of the treatment group were significantly lower than that of control group（P〈 0.001 ）. Before treatment, Caspase- 1, IL-113, IL-18 levels of treatment group were significantly higher after treatment （P〈 0.001 ,P〈 0.001 ,P= 0.002） and IL-18 levels of control group were significantly higher after treatment （P= 0.01 ）. Conclu- sion
出处
《中国中医急症》
2014年第10期1788-1790,1805,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
高等学校博士学科点专项科研基金(20113107110003)
关键词
脓毒症
通腑泻肺方
炎性体
肺与大肠相表里
Sepsis
Tongfuxiefei decoction
inflammasome
The interior and exterior relationship between thelung and large intestine
