黄芪 川芎嗪对慢性阻塞性肺疾病血浆内皮素 内毒素水平影响  

The Variety of Endotoxin and Endothelin-1 in Chronic Obstructive Pulmonary Disease Patients with or without Treatment of Membranous Milkvetch Root and/or Ligustrazine

作　　者：郑文龙[1] 楼正家[1] 李廷谦[2] 周法根[1] 诸葛丽敏[1] 

机构地区：[1]杭州市中医院,浙江杭州310007 [2]四川大学华西医院,四川成都610041

出　　处：《中华中医药学刊》2008年第1期160-163,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：杭州市卫生局青年基金资助项目(青9905)

摘　　要：目的:研究内毒素(ETx)在慢性阻塞性肺疾病(COPD)发病机制中的病理生理作用。方法:分层抽样、分段随机,将150例COPD患者随机分成黄芪组、川芎嗪组、黄芪川芎嗪组、阴性对照组和肝素对照组;同时设立健康对照组和肺心病组(CPHD组)。分别测定治疗前各组以及治疗后1周、治疗后2周和治疗后1月COPD患者的ET-1和ETx水平。结果:①健康对照组、COPD组治疗前和治疗后以及肺心病组血浆ETx水平分别为:(36.39±38.90)、(117.96±45.21)、(49.35±40.06)和(258.23±210.67)pg/mL;ET-1水平分别为:(39.60±16.51)、(61.96±8.98)、(45.59±9.02)和(104.70±17.11)ng/L。COPD组治疗后与健康对照组比较差异显著(P<0.05),COPD组治疗前与CHPD组和健康对照组、COPD组治疗前后比较均具有非常显著性差异(P<0.01);②血浆ET-1和ETx之间存在具有统计学意义的正相关关系;③应用黄芪或(和)川芎嗪治疗后血浆ET-1、ETx水平降低较阴性对照组明显,两种药物有较好的协同作用。结论:COPD的病理生理改变与ETx、ET-1有关;内毒素血症可以激活血管内皮系统,引起ET-1升高。长期的高内毒素血症是COPD病情进展的重要因素之一。黄芪、川芎嗪能有效地清除ETx、降低ET-1,保护血管内皮功能。Background： It was hypothesized that Endotoxin（ETx） associated with acute lung injury and it would accelerate the progress of pulmonary hypertension in COPD patients. Objective ： The aim of this study was to examine a possible correlation between endothelin - 1 （ ET - 1 ） and endotoxin and to determine the therapeutic effect of membranous milkvetch root and ligustrazine in COPD patients with endotoxemia. Methods ： 150 COPD patients were randomized into 5 groups of 30 patients each： membranous milkvetch root group, ligustrazine group, membranous milkvetch root plus ligustrazine group,negative control group（NCG） and heparin control group（HCG） respectively. The normal control group and chronic pulmonary heart disease （CPHD） group had been set as additional control groups. The plasma ETx and ET - 1 were observed before and after 1 week,2 weeks and 1 month of treatment. Results ：The results described as follow：① Compared with the normal control group, the ET - 1 and ETx level elevated obviously in COPD and CPHD patients, even after 1 month of therapy;②Plasma ET - 1 level was positively correlated with ETx in those patients ;③After membranous milkvetch root and/or ligustrazine therapy, plasma ETx and ET - 1 declined significantly. Conclusion： It can be concluded that ：①Endotoxemia leads to vascular endothelium injure and pick ET - 1 level up in COPD patients. ②Combined use of membranous milkvetch root and ligustrazine showed a therapeutic effect better than that of two drugs used separately or heparin treatment. It would be likely to postpone the progress of pulmonary hypertension.

关 键 词：慢性阻塞性肺疾病 内毒素 内皮素-1 黄芪 川芎嗪 

分 类 号：R285.6[医药卫生—中药学]