The Observation Of Curative Effect And Influence Of Tumor Necrosis Factor-α And Interleukin-10 In Stable Phase Of Chronic Obstructive Pulmonary Disease With Deficiency Of Both Lung And Spleen By Qiangji Jianli Oral Liquid

Objective:To observe the curative effect and influence of tumor necrosis factorα(TNF-α)and interleukin-10(IL-10)of chronic obstructive pulmonary disease with deficiency of both lung and spleen in stable phase by Qiangji Jianli Oral Liquid(QJOL)from clinical and empirical study.Method:1.Clinical Research:40 patients conformed to the research conditions were randomly divided into the treating group or control group.The treating group was treated with QJOL combined with slow-release aminophylline,while the control group was treated only with slow-release aminophylline.The course of treatment was three months,and then observe the variance of zhenghou of TCM,pulmonary function,the density of TNF-αand IL-10.2.Empirical Study:20 SD rats were randomly divided into four groups, including the normal group,the model group,the high herb group and the low herb group.The COPD rat model was established by intratracheal instillation of lipopolysaccharide and daily exposured to cigarette smoking,then the rats were treated with gastric infusion of senna leaf steep.When the therapy finished,observed the variance of lung tissue pathology,excretory rate of D-xylose,the density of TNF-αand IL-10 in each group.Result:1.Clinical Research 1.1 Comparing post-treatment with prior treatment,all the symptoms of the zhenghou of TCM in the treating group had significant difference(P＜0.05 or＜0.01),but in the control group,except for the symptoms of expectoration, tachypnea and gasping,there was no significant difference(P＞0.05). Post-treatment,except for the symptom of tachypnea and gasping,all symptoms in the treatmenting group had significant improvement comparing with those in the control group(P＜0.05 or＜0.01).The total effective rate in the treatmenting group and the control group were 89.47%and 66.7% respectively,the treatmenting group was more higher(P＜0.05).1.2 Pulmonary function test:Post-treatment,the index of FEV₁,FVC,FEV₁% and FEV₁/FVC in both groups had significant improvement comparison with those prior treatment(P＜0.05).The melioration of pulmonary function had no significant difference between the two groups after three-months' therapy. It showed therapeutic equivalence between the two groups.1.3 Comparing post-treatment with prior treatment,the density of TNF-αdescended significantly in two groups(P＜0.01),and more lower in the treatmenting group(P＜0.05).The level of IL-10 ascended significantly in two groups(P＜0.01),and more higher in the treatmenting group(P＜0.05).2.Empirical Study2.1 The changes in histopathology in the animal model were similar to those in COPD patients.Both groups of QJOL lessen apparently than the model group about the changes in histopathology.2.2 The excretory rate of D-xylose in the model group was obviously lower than the normal group(P＜0.05),prompting that it was successful to establish the splenasthenic syndrome.The excretory rate of D-xylose in the high herb group was obviously higher than the low herb group(P＜0.05),but there was no difference between the low herb group and model group(P＞0.05),prompting that the high density of QJOL can effectively improve the splenasthenic syndrome in the rats.2.3 The density of TNF-αin the model group was higher than the normal group,while the high herb group was lower than the model group,and both had significant difference(P＜0.05 or＜0.01).It prompted that the high density of QJOL could restrain the generation of TNF-α.2.4 The density of IL-10 in the model group was lower than the normal group, while the high herb group was higher than the model group,and both had significant difference(P＜0.05 or＜0.01).It prompted that the high density of QJOL could up-regulation the generation of IL-10.Conclusion:1.The results indicate that the treatment of QJOL combined with slow-release aminophylline can significantly improve the zhenhou of TCM. Meanwhile,QJOL can obviously reduce the level of TNF-α,up-regulation the level of IL-10 and make Th1/Th2 to equilibrium.But the improvement of pulmonary function,there is no significant difference in the two groups.2.The QJOL can improve the general conditions of COPD rat models,relieve the pathology form of emphysema,elevate the excretory rate of D-xylose, regulate the level of TNF-αand IL-10,thus reveal the mechanism of action of QJOL from the domain of cytokine.