苗药吉祥草在COPD治疗中的抗炎作用及对TLR7/IL-17通路的抑制作用  

Anti-inflammatory effect of Miao medicine Jixiangcao in the treatment of COPD and its inhibitory effect on TLR7/IL-17 pathway

作　　者：刘炜 李江 李同瑶 谢友良 LIU Wei;LI Jiang;LI Tong-Yao(The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州中医药大学第二附属医院,贵州贵阳550002

出　　处：《中国老年学杂志》2023年第7期1570-1574,共5页Chinese Journal of Gerontology

基　　金：国家自然科学基金地区科学基金项目(81760774);贵州省教育厅科技拔尖人才支持计划(黔教合KY字〔2016〕076)。

摘　　要：目的苗药吉祥草在慢性阻塞性肺疾病(COPD)治疗中的抗炎作用及对Toll样受体(TLR)7/白细胞介素(IL)-17通路的抑制作用。方法118例COPD患者采用随机数字表法分为对照组和观察组,每组各59例。患者均给予常规监护治疗,对照组口服吸入给予噻托溴铵粉雾剂,观察组给予苗药吉祥草联合噻托溴铵粉雾剂,对比两组治疗两个月前后肺功能指标与运动耐量指标、TLR7表达分析、炎性因子和炎性因子水平。结果治疗前两组肺功能指标及运动耐量指标水平均无明显差异(P>0.05),治疗后两组第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC和6 min步行实验(6MWT)水平均明显改善,且观察组FEV1、FVC、FEV1/FVC和6MWT水平均明显高于对照组(P<0.05)。治疗后观察组TLR7水平明显降低,且观察组TLR7水平明显低于对照组(P<0.05)。治疗前两组肿瘤坏死因子(TNF)-α、IL-2、IL-17、IL-6、IL-23和超敏C反应蛋白(hs-CRP)水平均无明显差异(P>0.05),治疗后两组IL-2水平明显升高,且观察组IL-2水平明显高于对照组(P<0.05),治疗后两组TNF-α、IL-17、IL-6、IL-23和hs-CRP水平均明显降低,且观察组TNF-α、IL-17、IL-6、IL-23和hs-CRP水平均明显低于对照组(P<0.05)。治疗后两组免疫球蛋白(免疫球蛋白A、免疫球蛋白M和免疫球蛋白G)水平均明显升高,且观察组明显高于对照组(P<0.05)。结论噻托溴铵和苗药吉祥草可通过不同机制改善COPD患者的肺功能、生活质量及免疫球蛋白水平。苗药吉祥草中多种有效成分存在协同作用,可显著抑制机体TLR7通道,并传递式阻滞IL-17等一系列炎症信号通路,从而改善机体呼吸道和肺部的异常炎症反应。Objective The anti-inflammatory effect of Miao medicine Jixiangcao in the treatment of chronic obstructive pulmonary disease(COPD)and its effects on Toll-like receptor(TLR)7/interleukin(IL)-17 pathway inhibition.Methods 118 patients with COPD were divided into control group and observation group using a random number table method,with 59 patients in each group.All patients with COPD were given routine monitoring and treatment.The control group was given oral inhalation with tiotropium bromide powder aerosol,and the observation group was given Miao medicine Jixiangcao combined with tiotropium bromide powder aerosol.Lung function indexes and exercise tolerance indexes,TLR7 expression analysis,inflammatory factors and inflammatory factor levels were compared between the two groups before and after two months of treatment.Results Before treatment,there was no significant difference in the levels of lung function indexes and exercise tolerance indexes between the two groups(P>0.05).After treatment,the levels of forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC and 6 min walking experiment(6MWT)in the two groups were significantly improved,and the FEV1,FVC,FEV1/FVC and 6MWT in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the TLR7 level in the observation group was significantly reduced,and the TLR7 level in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in the levels of〔tumor necrosis factor(TNF)-α,IL-2,IL-17,IL-6,IL-23 and hypersensitive C-reactive protein(hs-CRP)〕between the two groups before treatment(P>0.05).After treatment,the levels of IL-2 in two groups were significantly increased,and the IL-2 level in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the levels of TNF-α,IL-17,IL-6,IL-23 and hs-CRP in the two groups were significantly reduced,and the levels of TNF-α,IL-17,IL-6,IL-23 and hs-CR

关 键 词：慢性阻塞性肺疾病 苗药吉祥草 炎性因子 TOLL样受体7 白细胞介素-17 

分 类 号：R563.2[医药卫生—呼吸系统]