痰热清注射液对AECOPD肺部感染合并T2DM疗效机制及巨噬细胞异质性途径干预作用探讨

目的：观察痰热清注射液对AECOPD（慢性阻塞性肺疾病急性加重期）合并T2DM（2型糖尿病）患者的疗效机制探讨其对肺泡巨噬细胞异质性途径的干预作用。方法：选取某院呼吸科2017年09月-2018年3月住院患者90例，随机分为对照组和观察组，治疗7 d后分别观察2组临床疗效，WBC计数、肺功能，并使用ELisa法检测2组患者外周血中的中的MSP（巨噬细胞刺激蛋白）、NF-κB（核因子κB）、iNOS（诱导型一氧化氮合酶）、COX-2（环氧化酶2）的含量。结果：2组患者治疗前肺部感染症状体征、白细胞计数、肺功能、MSP、NF-κB，iNOS、COX-2表达无明显差异，且MSP与NF-κB，iNOS、COX-2表达呈正相关（r=0.992、r=0.992、r=0.983），证明NF-κB，iNOS、COX-2的表达与MSP存在显著相关性；治疗后症状体征积分比较，在喘息、咳嗽、咳痰、哮鸣音方面观察组优于对照组（P<0.05），白细胞计数观察组明显优于对照组（P<0.01），差异具有显著性。MSP、NF-κB，iNOS、COX-2观察组明显优于对照组（P<0.01），差异具有显著性。结论：肺泡异质途径在肺部感染中发挥了一定作用，痰热清注射液能够有效治疗AECOPD合并T2DM患者肺部感染，干预肺泡异质途径，从而提高临床疗效。

Effect of Tanreqing injection on AECOPD pulmonary infection complicated with T2DM and intervention of macrophage heterogeneity pathway

OBJECTIVE To observe the therapeutic mechanism of Tanreqing injection on AECOPD (acute exacerbation of chronic obstructive pulmonary disease) combined with T2DM and explore its intervention effect on alveolar macrophage heterogeneity pathway.METHODS Ninety hospitalized patients from September 2017 to March 2018 in the Respiratory Department of Kaizhou District People's Hospital of Chongqing were randomly divided into control group and observation group. After 7 days of treatment, the clinical efficacy, WBC count and pulmonary function of the two groups were observed respectively. ELisa method was used to determine the contents of MSP (macrophage stimulating protein), NF-κB (nuclear factor kappa B), iNOS (inducible nitric oxide synthase) and COX-2 (cyclooxygenase-2) in the peripheral blood of the two groups.RESULTS There was no significant difference in the expression of symptoms and signs of pulmonary infection, white blood cell count, lung function, MSP, NF-kappa B, iNOS and COX-2 between the two groups before treatment, and MSP was positively correlated with the expression of NF-kappa B, iNOS and COX-2 (r=0.992, r=0.983), which indicated that the expression of NF-kappa B, iNOS and COX-2 was significantly correlated with MSP. After treatment, the scores of symptoms and signs in the observation group were superior to those in the control group with regard to wheezing, coughing, expectoration and wheezing sound, P<0.05. The difference was statistically significant. The white blood cell count in the observation group was significantly better than that in the control group (P<0.01), and the difference was statistically significant. The levels of MSP, NF-kappa B, iNOS and COX-2 were significantly better in the observation group than those in the control group (P<0.01). CONCLUSION Alveolar heterogeneous pathway plays a role in pulmonary infection. Tanreqing injection can be used as an effective medication to treat pulmonary infection in patients with AECOPD complicated with T2DM, and intervene in alveolar heterogeneous pathway, so as to improve clinical efficacy.