The Effect Of Lianhuaqingwen (LHQW) On The Airway Inflammation In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease(AECOPD)

OBJECTIVE:To discuss the effect of Lianhuaqingwen (LHQW) on the airway inflammation in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) by observation the clinical symptoms and the expression of interleukin8(IL-8), tumor necrosis factor alpha (TNF-a), interleukin-17(IL-17), interleukin-23(IL-23) in serum and sputum. To explore the mechanism of drug application in AECOPD patients, thus develop traditional Chinese medicine for the treatment of AECOPD.METHODS:100COPD patients with an acute exacerbation were divided into two groups (lianhuaqingwen therapy group and conventional therapy group), each50cases. Each group was given based treatments (including inhaled medications:Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation250/50ug; bronchodilator:theophylline, expectorant and spasmolysis agent:ambroxol; antimicrobial:β-lactam antibiotics or fluoroquinolone if with allergies; and controlling oxygen therapy, et al), meanwhile adding Lianhuaqingwen capsule1.4g/time,3times/day,7days of oral in the lianhuaqingwen therapy group.’All of the patients were evaluated by CAT(COPD assessment test) and Chinese Medicine Symptom Complex Score scale in day one and day seven. At the same time, the IL-8, TNF-α, IL-17and IL-23contents in blood serum and sputum were measured by ELISA RESULTS:The CAT and Chinese Medicine Symptom Complex Score scale of the two groups were dramatically improved after treatment (P<0.01). The IL-8and IL-17contents in blood serum of lianhuaqingwen therapy group were obviously lower compared to the before (P<0.05), and the TNF-α and IL-23contents in blood serum were also decreased, but no significant change. The expression of sputum IL-8, TNF-α, IL-17and IL-23declined sharply by the therapy of Liahuaqingwen (P≤O.01), while only TNF-α and IL-23in conventional therapy group were dropped (P<0.05). According to the GOLD guideline, two groups were divided into low risk subgroup and high risk subgroup, respectively. We found the results were consistent with the former. In the high risk subgroup, Chinese Medicine Symptom Complex Score scale of the lianhuaqingwen therapy group was significantly reduced than that of the conventional therapy group (P<0.01). The IL-8contents in blood serum of low risk subgroup were obviously decreased after treated by lianhuaqingwen (P<0.05),as well as in sputum of high risk subgroup (P<0.05)CONCLUSIONS:In conclusion, LHQW had a better clinical effect during acute exacerbations of COPD, particularly in patients with high risk. Its mechanism may be suppress bronchioles inflammatory reaction and relieve systemic inflammatory response, through controlling the release of inflammatory cytokines of patients with AECOPD...