摘要
目的探讨矽肺患者是否通过肺泡巨噬细胞(alveolar macrophage,AM)表面共刺激分子CD40途径参与矽肺纤维化的发生、发展,以及益气活血汤对矽肺患者纤维化的干预作用。方法采用随机数字表法将46例门诊及住院的矽肺患者分为西药常规治疗组及中药治疗组,每组23例。西药常规治疗组予抗炎、化痰及解痉平喘等常规对症支持治疗,中药治疗组在此基础上加用益气活血汤治疗,每天1剂,疗程为14天。另选18名经纤维支气管镜检及临床诊断肺部均无明显病变的慢性咳嗽、喉部异物感者作为正常对照组,给予对症支持治疗。疗程结束后收集3组肺泡灌洗液,分离并培养AM细胞,采用RT-PCR法检测各组AM表面CD40 mRNA表达水平,免疫印迹法检测其表面CD40蛋白表达水平。结果与正常对照组比较,西药常规治疗组肺泡灌洗液AM表面CD40 mRNA及CD40蛋白表达水平升高(P<0.01);与西药常规治疗组比较,中药治疗组肺泡灌洗液AM表面CD40 mRNA及CD40蛋白表达水平降低(P<0.01)。结论矽肺患者可能通过AM表面共刺激分子CD40的高表达,参与矽性肺纤维化的形成。益气活血汤可阻断其作用,抑制纤维化的进展,从而发挥对矽肺患者的干预治疗作用。
Objective To study whether co-stimulatory molecule CD40 of alveolar macrophage （AM） participated in the occurrence and development of silicosis, and to explore the intervention of Yiqi Huoxue Decoction （YHD） in the fibrosis of silicosis patients. Methods Totally 46 silicosis inpatients and outpatients were recruited and randomly assigned to the Western treatment group （A） and the Chinese medicine （CM） treatment group （B）, 23 in each group. Patients in Group A received routine symptomatic treatment such as anti-inflammation, phlegm resolving, anti-spasm, and asthma relief, and so on. Patients in Group B additionally took YHD, one dose daily for 14 successive days. Besides, another 18 patients with chronic cough and sense of laryngeal foreign bodies were recruited as the normal control group, who had no obvious lesion confirmed by bronchofibroscope and clinical diagnosis of the lung. They were treated by symptomatic supporting treatment. The alveolar lavage fluid was collected from all pa- tients and isolated, and AM cells were cultured. The level of CD40 mRNA was detected by RT-PCR. The expression of CD40 protein was detected by Western blot. Results Compared with the normal control group, expression levels of CD40 mRNA and CD40 protein significantly increased in Group A （P 〈0.01 ）. Compared with Group A, expression levels of CD40 mRNA and CD40 protein significantly decreased in Group B （P 〈0.01 ）. Conclusions Highly expressed co-stimulatory molecule CD40 of AM might participate in pulmonary fibrosis. YHD could hinder its roles, inhibit the progression of fibrosis, thereby playing an interventional role of treatment.
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2015年第2期179-183,共5页
Chinese Journal of Integrated Traditional and Western Medicine
基金
2011年杭州市科技计划引导项目(No.2011021)
