摘要
目的:观察清气化痰丸加减治疗慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)的临床疗效及对患者炎性反应、气道重塑和血栓形成机制的影响。方法:将80例患者按随机数字表法分为对照组与治疗组,各40例,对照组给予西医常规治疗,治疗组在对照组基础上加服清气化痰丸加减治疗,两组疗程均为14 d。比较两组患者治疗前后中医证候积分,COPD和支气管哮喘生理评分(CAPS),COPD患者自我评估测试问卷(CAT),肺功能及血气分析,血清核转录因子-κB(NF-κB),白细胞介素-6(IL-6),白细胞介素-8(IL-8),基质金属蛋白酶-2(MMP-2),金属蛋白酶组织抑制剂-2(TIMP-2),转化生长因子-β_1(TGF-β_1)和血浆组织型纤溶酶原激活剂(t-PA),纤溶酶原激活物抑制剂(PAI-1),血管性血友病因子(v-WF)水平,临床疗效和安全性指标。结果:治疗组临床疗效总有效率为94. 74%,对照组78. 38%,治疗组优于对照组(χ~2=4. 341,P <0. 05)。两组治疗后中医证候积分,CAPS,CAT,二氧化碳分压(PaCO_2),血清NF-κB,IL-6,IL-8,MMP-2,TIMP-2,TGF-β_1水平和血浆PAI-1,v-WF水平与本组治疗前比较均降低(P <0. 05);两组治疗后第1秒用力呼气容积(FEV_1),第1秒用力呼气容积占预计值百分比(FEV_1%),第1秒用力呼气容积占用力肺活量的百分比(FEV_1/FVC),血氧饱和度(SaO_2),血氧分压(PaO_2),血浆t-PA与本组治疗前比较均升高(P <0. 05);且治疗组改善优于对照组(P <0. 05)。结论:清气化痰丸加减治疗AECOPD疗效确切且安全,能够改善患者CAPS评分和肺功能,有效的抑制患者炎性反应、气道重塑和血栓形成,分析其机制可能是通过降低炎症细胞因子水平,调节MMP-2/TIMP-2和t-PA/PAI-1动态平衡起作用,改善细胞外基质和血管内皮功能,保护肺组织。
Objective:To explore the clinical efficacy of Modified Qingqi Huatan Wan in treatment of acute exacerbation of chronic obstructive pulmonary disease and its effect on inflammatory reaction,airway remodeling and thrombokinesis.Method:A total of 80 patients of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)were randomly divided into control group(40 cases)and therapy group(40 cases)by random number table.The control group was treated with conventional therapy.In addition to the therapy for the control group,the patients in therapy group also received modified Qingqi Huatan Wan.The treatment course was 14 days for both groups.Scores of traditional Chinese medicine(TCM)syndrome,chronic obstructive pulmonary disease and asthma physiology Score(CAPS),and chronic obstructive pulmonary disease patients self-assessment test questionnaire(CAT)were compared.The secondary indicators were pulmonary function,arterial blood gas analysis,and blood rheology indexes.In addition,the levels of serum nuclear factor kappa B(NF-κB),interleukin-6(IL-6),interleukin-8(IL-8),matrix metalloproteinase-2(MMP-2),tissue inhibitor of metalloproteinase-2(TIMP-2),transforming growth factor-beta1(TGF-β1)and plasma tissue-plasminogen activator(t-PA),plasminogen activator inhibitor-1(PAI-1),von-willebrand factor(v-WF),clinical efficacy and safety were evaluated.Result:The total clinical effective rate was 94.74%in therapy group,which was higher than 78.38%in control group(χ2=4.341,P<0.05).After treatment,scores of TCM syndrome,CAPS,CAT and levels of PaCO2,serum NF-κB,IL-6,IL-8,MMP-2,TIMP-2,TGF-β1 and plasma PAI-1,v-WF in therapy group were lower than those in control group(P<0.05).However,levels of plasma t-PA,SaO2,PaO2,FEV1,FEV1%,FEV1/FVC in therapy group were higher than those in control group(P<0.05),therapy group was alleviated more than control group(P<0.05).Conclusion:Modified Qingqi Huatan Wan can control the symptoms safely,alleviate CAPS and lung function,effectively reduce the inflammatory response and inhibit the f
作者
侯体保
刘锐
何嘉
叶传冬
HOU Ti-bao;LIU Rui;HE Jia;YE Chuan-dong(Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530011,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2019年第10期74-80,共7页
Chinese Journal of Experimental Traditional Medical Formulae
基金
广西自然科学基金青年基金项目(2013GCNSFBA019144)
广西壮族自治区中医药民族医药自筹经费科研课题(Z2013248)
关键词
慢性阻塞性肺疾病急性加重期
气道重塑
血栓形成
基质金属蛋白酶-2/金属蛋白酶组织抑制剂-2
组织型纤溶酶原激活剂/纤溶酶原激活物抑制剂-1
清气化痰丸加减
acute exacerbation of chronic obstructive pulmonary disease
airway remodeling
thrombokinesis
matrix metalloproteinase-2/tissue inhibitor of metalloproteinase-2(MMP-2/TIMP-2)
plasma tissue-plasminogen activator/plasminogen activator inhibitor-1(t-PA/PAI-1)
modified Qingqi Huatan Wan
