清热化痰对慢性阻塞性肺疾病急性发作患者氧化应激和炎症的影响  

Therapeutic effects of Qingfeihuatan prescription on acute exacerbations of chronic obstructive pulmonary disease

作　　者：荆小莉[1] 王东平[1] 李慧[1] 崔喜梅[1] 高锦辉[1] 

机构地区：[1]中山大学第一附属医院急诊科,广州510080

出　　处：《中华临床医师杂志（电子版）》2009年第4期33-37,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：广东省科技计划项目(2007B031402005;2007B031504001)

摘　　要：目的观察清热化痰方(苇茎汤加减)治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床疗效以及对血浆氧化应激和炎症介质的影响。方法74例AECOPD患者随机分为两组。对照组参照2004年美国胸科学会和欧洲呼吸学会在COPD全球防治倡议的方案进行常规西药治疗,治疗组在常规西药治疗基础上加用清热化痰祛瘀方治疗10d。治疗前后分别记录和测定两组患者的症状和体征积分、肺功能、血浆丙二醛(MDA)、还原型谷胱甘肽(GSH)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、NF-κB、肿瘤坏死因子α(TNF-α)及白细胞介素8(IL-8)水平,并进行临床疗效分析。结果两组患者治疗后临床症状、体征积分均较治疗前明显改善,且治疗组优于对照组。治疗组总有效率(86.49%)明显高于对照组(70.27%,P<0.05)。两组患者治疗后MDA、GSH、SOD、GSH-Px、NF-κB、TNF-α、IL-8水平及肺功能较治疗前明显改善,且治疗组更优于对照组(P均<0.01)。结论清热化痰法可直接抑制AECOPD患者核转录因子和炎性因子释放,同时又可清除氧化剂,从而改善患者的临床表现和肺功能,有利于AECOPD患者的治疗。Objective To investigate the clinical therapeutic effects of Qingfeihuatan prescription on acute exacerbations of chronic obstructive pulmonary disease （AECOPD） and its regulative effect on inflammatory response and oxidative stress. Methods Seventy-four patients suffering from COPD in acute deteriorated stage were randomly divided into two groups（ n = 37 ）. The control group was treated according to global initiative for chronic obstructive lung disease （GOLD） in 2004 and the treatment group was added Qingfeihuatan simul. The scores of symptoms and signs, pulmonary function, plasma maleic dialdehyde （ MDA）, glutathione （ GSH ）, superoxide dismutase （ SOD）, glutathione peroxidase （ GSH-Px ）, tumor necrosis factor-α （ TNF-α）, interleukin -8 （ IL-8 ） and nuclear factor - kappa B （ NF -KB） of all patients were monitored and analyzed before and after treatment. Results The scores of symptoms and signs were markedly improved in the two groups after treatment compared with those before treatment with the treatment group better than the control group （ both P 〈 0. 01 ）. The total effective power of treatment group （ 86. 49% ） was obviously higher than that of control group （70. 27 %, P 〈 0. 05 ）. Although all patients were improved in the indexes of pulmonary funetion,MDA, GSH, SOD, GSH-Px, TNF-α, IL-8 and NF-KB in plasma, the differences between them indicated that the treatment group was better than the control one （all P 〈 0.01 ）. Conclusions Qingfeihuatan prescription can not only inhibit nuclear factor, inflammatory mediator and eliminate free radicals in plasma,but also improve the pulmonary function and symptoms of the patients. The prescription has beneficial effects on AECOPD.

关 键 词：肺疾病 慢性阻塞性 清热化痰 氧化性应激 炎症介导素类 

分 类 号：R259[医药卫生—中西医结合]