基于TGF-β1/Smad信号通路探讨芪白平肺方对慢性阻塞性肺疾病急性加重期(痰瘀阻肺证)患者诱导痰炎症因子及气道重塑的影响  

The Influence of Qibai Pingfei Prescription(芙白平肺方)on Induction Phlegm Inflammatory Factors and Airway Remodeling in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease(Phlegm Stasis Obstructing Lung Syndrome)According to TGF-β1 Smad Pathway

作　　者：苏军[1] 荆晶[1] SU Jun;JING Jing(Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University,Urumqi Xinjiang 830000,China)

机构地区：[1]新疆医科大学附属中医医院,新疆乌鲁木齐830000

出　　处：《中医药导报》2021年第6期81-85,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：新疆维吾尔自治区应用技术与开发计划(KS2019056)。

摘　　要：目的:基于TGF-β1/Smad信号通路探讨芪白平肺方对慢性阻塞性肺疾病急性加重期(痰瘀阻肺证)患者诱导痰炎症因子及气道重塑的影响。方法:选择92例慢性阻塞性肺疾病急性加重期(痰瘀阻肺证)患者进行前瞻性研究,采用随机数字表法将纳入病例分为治疗组和对照组,两组患者均根据治疗指南行基础对症治疗,治疗组患者在此基础上加服芪白平肺方进行治疗,两组患者均连续治疗10 d,疗程结束后统计疗效。比较两组患者治疗前后中医证候积分、肺功能,检测诱导痰中基质金属蛋白酶9(MMP-9)、金属蛋白酶组织抑制因子-1(TIMP-1)、白细胞介素-5(IL-5)和γ干扰素(IFN-γ)含量,以及外周血转化生长因子-β1(TGF-β1)、Smad3、Smad7含量。结果:治疗组患者疗效明显优于对照组(P<0.05)。治疗后两组患者各项中医证候积分均低于治疗前(P<0.05),且治疗组患者治疗后各项中医证候积分明显低于对照组(P<0.05)。治疗后两组患者FVC和FEV1%明显高于治疗前(P<0.05),且治疗组患者治疗后FVC和FEV1%明显高于对照组(P<0.05)。治疗后两组患者诱导痰IL-5含量低于治疗前,IFN-γ含量明显高于治疗前(P<0.05),且治疗组患者治疗后诱导痰IL-5低于对照组,IFN-γ含量明显高于对照组(P<0.05)。治疗后两组患者诱导痰MMP-9、TIMP-1含量明显低于治疗前(P<0.05),且治疗组患者治疗后诱导痰MMP-9、TIMP-1含量明显低于对照组(P<0.05)。治疗后两组患者外周血TGF-β1、Smad3含量明显低于治疗前(P<0.05),Smad7含量明显高于治疗前(P<0.05)。治疗后治疗组患者外周血TGF-β1、Smad3含量明显低于对照组(P<0.05),Smad7含量明显高于对照组(P<0.05)。结论:芪白平肺方治疗慢性阻塞性肺疾病急性加重期(痰瘀阻肺证)疗效较好,可有效提高患者肺功能,降低诱导痰中炎症因子含量并纠正MMP-9、TIMP-1水平,其作用机制可能是通过调节TGF-β1/Smad信号通路而促进细胞外基质和�Objective:To explore the influence of Qibai Pingfei Prescription on induction phlegm inflammatory fac tors and airway remodeling in patients with acute exacerbation of chronic obstructive pulmonary disease(phlegm stasis obstructing the lung syndrome)according to the TGF-β1 Smad pathway.Methods:Totally 92 patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)were selected for prospective study.The random number table method was used to divide the included cases into the treatment and control groups.Patients received basic symptomatic treatment according to the treatment guidelines in two groups,and the treatment group was treated with Qibai Pingfei Prescription on this basis.Patients in both groups were treated for 10 consecutive days,and the curative effect was calculated after the treatment.The TCM syndrome scores,lung function,matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1),interleukin-5(IL-5),γinterferon(IFN-γ)in induced sputum,and peripheral TGF-β1,Smad3 and Smad7 content were compared between the two groups,before and after treatment.Results:The treatment group showed better efficacy than control group(P<0.05).After treatment,patients in two groups showed lower TCM syndrome scores than before treatment(P<0.05),and the treatment group showed lower TCM syndrome scores than control group(P<0.05).After treatment,patients showed higher FVC and FEV1%than before treatment in two groups(P<0.05),and the treatment group showed higher FVC and FEV1%than control group(P<0.05).After treatment,patients showed lower IL-5 in induced sputum while higher IFN-γin induced sputum,than before treatment in two groups(P<0.05),and the treatment group showed lower IL-5 while higher IFN-γin induced sputum,than control group(P<0.05).Af ter treatment,patients showed lower MMP-9 and TIMP-1 contents in induced sputum than before treatment in two groups(P<0.05),and the treatment group showed lower MMP-9 and TIMP-1 contents than control group(P<0.05).After treatment,patients sh

关 键 词：慢性阻塞性肺疾病 痰瘀阻肺证 芪白平肺方 炎症因子 气道重塑 TGF-Β1/SMAD信号通路 

分 类 号：R256.14[医药卫生—中医内科学]