Li Weng, Mao Bing, Wang Gang, Wang Lei, Chang Jing, Zhang Ying, Wan Mei-hua, Guo Jia
Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China.
Zhong Xi Yi Jie He Xue Bao. 2008 Aug;6(8):799-805. doi: 10.3736/jcim20080806.
To explore the effects of Tanreqing injection, a traditional Chinese herbal preparation for clearing heat and resolving phlegm, in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) by improving airway inflammation and airway mucus hypersecretion.
A randomized controlled trial (RCT) was designed. Ninety AECOPD patients were randomly divided into Tanreqing group, ambroxol hydrochloride group and control group. The patients in the three groups were all treated with conventional therapy. Furthermore, intravenous drip infusion of 20 ml Tanreqing injection (once daily) and 15 mg ambroxol hydrochloride injection (twice daily) were administered respectively to the patients in the Tanreqing group and ambroxol hydrochloride group. They were all treated for 10 days. Symptom score of traditional Chinese medicine (TCM), plasma concentrations of interleukin-8 (IL-8), IL-10 and neutrophil elastase (NE) were detected before and after treatment.
Cough, sputum amount, expectoration, dyspnea, fever, coated tongue and pulse tracings were improved obviously in Tanreqing group (P<0.05), and the effects of Tanreqing on improving cough, sputum amount and expectoration were better than the conventional therapy (P<0.05), while there was no significant difference between Tanreqing group and ambroxol hydrochloride group (P>0.05). Compared with ambroxol hydrochloride group and the control group, the coated tongue was improved obviously in Tanreqing group (P>0.05). After treatment, plasma concentrations of IL-8, IL-10 and NE were decreased in Tanreqing group and ambroxol hydrochloride group (P<0.05), and the levels of IL-8 and IL-10 in the control group were decreased (P<0.05). The change of IL-8 level before and after treatment in Tanreqing group was greater than that in ambroxol hydrochloride group and the control group. The changes of IL-10 and NE levels in ambroxol hydrochloride group were greater than those in Tanreqing group and the control group, while there was no significant difference in the changes of serum levels of IL-8, IL-10 and NE among the three groups (P>0.05). Total response rates in Tanreqing group and ambroxol hydrochloride group were higher than that in the control group (P<0.05), while there was no significant difference in total response rate between Tanreqing group and ambroxol hydrochloride group (P>0.05). There was no significant difference in total response rate among the three groups (P>0.05).
Tanreqing injection can improve TCM signs and symptoms in AECOPD patients, and the mechanism maybe due to the decrease of serum levels of IL-8 and NE and improvement of IL-10 level.
探讨具有清热化痰作用的中药制剂痰热清注射液通过改善气道炎症和气道黏液高分泌来治疗慢性阻塞性肺疾病急性加重期（AECOPD）的效果。
设计一项随机对照试验（RCT）。将90例AECOPD患者随机分为痰热清组、盐酸氨溴索组和对照组。三组患者均接受常规治疗。此外，痰热清组患者静脉滴注20 ml痰热清注射液（每日1次），盐酸氨溴索组患者静脉滴注15 mg盐酸氨溴索注射液（每日2次）。两组均治疗10天。治疗前后检测中医症状评分、血浆白细胞介素-8（IL-8）、IL-10和中性粒细胞弹性蛋白酶（NE）浓度。
痰热清组咳嗽、咳痰量、咯痰、呼吸困难、发热、舌苔和脉象明显改善（P<0.05），痰热清在改善咳嗽、咳痰量和咯痰方面的效果优于常规治疗（P<0.05），而痰热清组与盐酸氨溴索组之间无显著差异（P>0.05）。与盐酸氨溴索组和对照组相比，痰热清组舌苔明显改善（P>0.05）。治疗后，痰热清组和盐酸氨溴索组血浆IL-8、IL-10和NE浓度降低（P<0.05），对照组IL-8和IL-10水平降低（P<0.05）。痰热清组治疗前后IL-8水平的变化大于盐酸氨溴索组和对照组。盐酸氨溴索组IL-10和NE水平的变化大于痰热清组和对照组，而三组血清IL-8、IL-10和NE水平变化无显著差异（P>0.05）。痰热清组和盐酸氨溴索组的总有效率高于对照组（P<0.05），而痰热清组与盐酸氨溴索组的总有效率无显著差异（P>0.05）。三组总有效率无显著差异（P>0.05）。
痰热清注射液可改善AECOPD患者的中医症状和体征，其机制可能是血清IL-8和NE水平降低以及IL-10水平升高。
