三步序贯法对激素依赖型哮喘患者TGF-β1/Smad信号通路及肺功能的影响  

Influence of three-stage sequential therapy on TGF-β1/Smad signaling pathway and lung function of steroid-dependent asthma patients

作　　者：田彦 崔红生 张鑫 TIAN Yan;CUI Hong-sheng;ZHANG Xin(Beiyuan Street Community Health Service Centers,Tongzhou District,Beijing 101100,China;Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]北京市通州区北苑街道社区卫生服务中心,北京101110 [2]北京中医药大学第三附属医院,北京100029 [3]首都医科大学附属北京中医医院,北京100010

出　　处：《中华中医药杂志》2019年第9期4413-4416,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金资助项目(No.81273689)~~

摘　　要：目的:观察三步序贯法对激素依赖型哮喘(SDA)患者TGF-β1/Smad信号通路及肺功能的影响。方法:将86例阴虚火旺证SDA患者随机分为治疗组(45例)与对照组(41例)。撤减激素期间,治疗组干预方式:撤减前期为第一步方颗粒,观察期为2周,撤减中期为第二步方颗粒,观察期为3个月,撤减后期为第三步方颗粒,观察期为2周,每次1袋,每日2次,口服;对照组干预药物为布地奈德粉吸入剂400μg/吸,每日2次吸入。干预前后采用酶联免疫吸附法(ELISA)测定血清及常规痰上清液内TGF-β1、Smad2、Smad3、Smad6、Smad7浓度以及肺功能FEV1%、FEV1/FVC%。结果:两组干预后,血清内TGF-β1、Smad2、Smad3浓度均较干预前显著降低(P<0.01),Smad6、Smad7浓度则均较干预前显著升高(P<0.01),常规痰上清液内TGF-β1、Smad2浓度均较干预前显著降低(P<0.01),肺功能FEV1%、FEV1/FVC%均较干预前显著升高(P<0.01),两组上述指标干预后比较,差异无统计学意义。痰上清液TGF-β1与血清TGF-β1呈正相关性(P<0.01),痰上清液TGF-β1、血清TGF-β1与肺功能呈负相关(P<0.01)。结论:三步序贯法能够降低SDA患者痰上清液和血清中TGF-β1、Smad2、Smad3含量,升高血清内Smad6、Smad7浓度,改善SDA患者肺功能,可能是通过对TGF-β1/Smad信号转导通路的阻抑来实现的。Objective: To observe the influence of three-stage sequential therapy on the relevant indicators concentration of TGF-β1/Smad signaling pathway and the lung function of steroid-independent asthma(SDA) patients. Methods: A total of 86 SDA patients, diagnosed to be fire excess from yin deficiency by TCM syndrome, were randomly divided into the treatment group(45 patients) and control group(41 patients). In the early stage, lasted 2 weeks, the treatment group was treated with the firststage formula, the middle stage, lasted 3 months, it was treated with the second-stage formula, and the late stage, lasted 2 weeks, it was treated with the third-stage formula, 1 bag twice a day po during the process of steroid withdrawal. The control group was treated with Budesonide Powder for Inhalation respules 400μg twice a day inhale. The TGF-β1, Smad2, Smad3, Smad6, Smad7 concentration in routine sputum supernate and serum of TGF-β1/Smad signaling pathway were compared by using ELISA and the lung function FEV1%, FEV1/FVC%. Results: After treatment, the concentration of TGF-β1, Smad2 and Smad3 obviously reduced(P<0.01);Smad6 and Smad7 obviously increased(P<0.01) in the two groups serum;TGF-β1, Smad2 obviously reduced(P<0.01) in routine sputum supernate;the FEV1%, FEV1/FVC% of lung function obviously increased(P<0.01), but comparing between groups the above indicators had no statistical significance. There were positive correlations in TGF-β1 between routine sputum supernate and serum(P<0.01), and there were negative correlations between routine sputum supernate TGF-β1 with lung function and the same with serum TGF-β1 and lung function(P<0.01). Conclusion: The three-stage sequential therapy could reduce the TGF-β1, Smad2, Smad3 in serum and sputum, increase Smad6, Smad7 in the serum of SDA patients and improve their lung function, which might work from inhibitory to the TGF-β1/Smad signaling pathway.

关 键 词：三步序贯法 哮喘 激素撤减 TGF-Β1/SMAD 

分 类 号：R28[医药卫生—中药学]