二陈汤加味对慢性阻塞性肺疾病急性加重期老年患者免疫功能及CCL18，CC16，IL-8和sICAM-1的影响

目的:观察二陈汤加味对慢性阻塞性肺疾病急性加重期(acute exacerbation period of COPD,AECOPD)患者肺功能、细胞和体液免疫功能,细胞趋化因子18(chemoattractant cytokine18,CCL18),白细胞介素-8(interleukin-8,IL-8),Clara细胞蛋白(Clara cell protein,CC16)和可溶性细胞间黏附分子-1(soluble intercellular adhesion molecular-1,s ICAM-1)的影响。方法:选取符合纳入标准的老年AECOPD患者120例,分为治疗组与对照组,每组60例。两组均在常规治疗的基础上,治疗组给予二陈汤加味,每日2次,疗程14 d。14 d后评价两组患者临床疗效,检测肺功能、免疫球蛋白、外周血淋巴细胞亚群,酶联免疫吸附试验(ELISA)测定患者血浆和呼气冷凝液(exhale breath condensat,EBC)中CCL18,CC16,IL-8,s ICAM-1浓度。结果:与对照组治疗后比较,治疗组总有效率高于对照组(P0.05);治疗组1 s用力呼气容积(FEV_1),1 s用力呼气量/用力肺活量(FVC)均增大(P0.01);炎细胞总数、中性粒细胞数、单核细胞和淋巴细胞均减少(P0.05)。与本组治疗前比较,Ig G,Ig A,Ig M无明显差异;CD3~+,CD4~+,CD4~+/CD8~+均增加,CD8~+降低(P0.05);血浆CCL18,CC16,IL-8,s ICAM-1均降低(P0.05),EBC中CCL18,CC16均降低(P0.05)。结论:二陈汤加味可调节T淋巴细胞亚群功能,增强细胞免疫,降低老年AECOPD患者血浆,EBC中CCL18,CC16,IL-8,s ICAM-1水平,对老年AECOPD有一定的抗炎作用。

Effect and Mechanism of Modified Erchentang on Immune Function, CCL18, CC16, IL-8 and sICAM-1 in Patients at Acute Exacerbation Stage of COPD

Objective: To observe the effect and mechanism of modified Erchentang on immune function, chemoattractant cytokine 18 (CCL18), interleukin-8 (IL-8), clara cell protein (CC16) and soluble intercellular adhesion molecular-1 (sICAM-1) in patients at acute exacerbation stage of COPD (AECOPD). Method: Totally 120 cases of elder AECOPD patients were randomly divided into modified Erchentang group and placebo-controlled group, with 60 cases in each group. In addition to western drugs, modified Erchentang was also used in modified Erchentang group, and placebo was also used in control group for 14 days. Their pulmonary function was detected, and euzyme-linked immunosorbent assay was used to determine the levels of CCL18, CC16, IL-8 and sICAM-1 in patients'' plasma and exhaled breath condensate of all groups before and after treatment. Result: Compared with control group, treatment group showed increases in total effective rate (P<0.05), and FEV₁ and FEV₁% (P<0.01), but decreases in total inflammatory cell counts, neutrophil counts, monocytes and lymphocytes (P<0.05). Compared with before treatment, the group showed no significant difference in IgG, IgA, IgM, increases in CD3⁺, CD4⁺, CD4⁺/CD8⁺ and decreases in CD8⁺, CCL18, CC16, IL-8, sICAM-1, CCL18 and CC16 in EBC (P<0.05). Conclusion: Modified Erchentang has an anti-inflammatory effect on AECOPD by reducing level of inflammation medium CCL18, CC16, IL-8 and sICAM-1, preventing inflammation progress and adjusting the immune function.