清气化痰丸加减治疗慢性阻塞性肺疾病急性加重期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

侯体保; 刘锐; 何嘉; 叶传冬

doi:10.13422/j.cnki.syfjx.20182427

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清气化痰丸加减治疗慢性阻塞性肺疾病急性加重期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

临床 | 更新时间：2021-02-09

- 清气化痰丸加减治疗慢性阻塞性肺疾病急性加重期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
- 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
- 中国实验方剂学杂志 2019年25卷第10期页码：74-80
- 作者机构：
  
  广西中医药大学　附属瑞康医院，南宁　 530011
- 作者简介：
  
  侯体保，硕士，住院医师，从事呼吸及心血管系统疾病的诊治研究，E-mail：yshoutibao@163.com
  *刘锐，博士，副主任医师，从事呼吸及心血管系统疾病的诊治研究，E-mail：dyshuxi@126.com
- 基金信息：
  
  广西自然科学基金青年基金项目(2013GCNSFBA019144);广西壮族自治区卫生厅自筹经费科研课题项目(Z2013248)
- DOI：10.13422/j.cnki.syfjx.20182427
  中图分类号： R22; R242; R2-031; R287
- 收稿日期：2018-07-13，
  
  网络出版日期：2018-09-27，
  
  纸质出版日期：2019-05-20
- 稿件说明：
移动端阅览
侯体保, 刘锐, 何嘉, 等. 清气化痰丸加减治疗慢性阻塞性肺疾病急性加重期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[J]. 中国实验方剂学杂志, 2019,25(10):74-80.

Ti-bao HOU, Rui LIU, Jia HE, et al. 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[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(10): 74-80.
侯体保, 刘锐, 何嘉, 等. 清气化痰丸加减治疗慢性阻塞性肺疾病急性加重期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[J]. 中国实验方剂学杂志, 2019,25(10):74-80. DOI： 10.13422/j.cnki.syfjx.20182427.

Ti-bao HOU, Rui LIU, Jia HE, et al. 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[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(10): 74-80. DOI： 10.13422/j.cnki.syfjx.20182427.

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-

B(NF-

B)，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-

(TGF-

)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(

＝4.341，

0.05)。两组治疗后中医证候积分，CAPS，CAT，二氧化碳分压(PaCO

)，血清NF-

B，IL-6，IL-8，MMP-2，TIMP-2，TGF-

水平和血浆PAI-1，v-WF水平与本组治疗前比较均降低(

0.05)；两组治疗后第1秒用力呼气容积(FEV

)，第1秒用力呼气容积占预计值百分比(FEV

%)，第1秒用力呼气容积占用力肺活量的百分比(FEV

/FVC)，血氧饱和度(SaO

)，血氧分压(PaO

)，血浆t-PA与本组治疗前比较均升高(

0.05)；且治疗组改善优于对照组(

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。

Abstract

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-

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-

) 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 (

=4.341

0.05). After treatment

scores of TCM syndrome

CAPS

CAT and levels of PaCO

serum NF-

IL-6

IL-8

MMP-2

TIMP-2

TGF-

and plasma PAI-1

v-WF in therapy group were lower than those in control group(

0.05). However

levels of plasma t-PA

SaO

PaO

FEV

/FVC in therapy group were higher than those in control group(

0.05)

therapy group was alleviated more than control group (

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 formation of airway remodeling and thrombosis

and its mechanism may be protect the lung tissue by reducing the level of inflammatory cytokines

regulating the balance of MMP-2/TIMP-2 and t-PA/PAI-1 and improving extracellular matrix and vascular endothelial function.

关键词

Keywords

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