Clinical Effect and Mechanism of Heat-clearing and Phlegm-resolving Recipe in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (Phlegm Heat and Phlegm Turbidity in Lungs)_West China Medical Journal

Authors：

 JIANGHong-li ¹ , ZHOUWei ² , MINJie ¹ ,  MAOBing ¹

1. Department of Integrated Traditional Chinese Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Respiratory Medicine, Chengdu First People's Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

MAOBing, Email: maobing@medmail.com.cn

Keywords：

Chronic obstructive pulmonary disease; Chinese heat-clearing and phlegm-resolving recipe; Interleukin-8; Interleukin-10; Bactericidal/permeability increasing protein

DOI：

10.7507/1002-0179.20150258

Video：

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Objective To investigate the clinical effect and mechanism of Chinese heat-clearing and phlegm-resolving recipe in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A randomized controlled trial (RCT) was conducted. A total of sixty in-patients with AECOPD of phlegm heat and phlegm turbidity in lungs were randomly allocated to treatment group and control group with an equal number of patients between October 2009 and March 2010. The treatment duration was 10 days. Symptom scores of traditional Chinese medicine (TCM), pulmonary function, white blood cell count, polymorphonuclear neutrophils, C-reactive protein and the plasma concentration of bactericidal/permeability increasing protein (BPI) and interleukin (IL)-8 and IL-10 were detected. Results For TCM syndrome of phlegm heat and phlegm turbidity, there was a statistical difference between the two groups after treatment (P<0.05). Cough, sputum amount, expectoration and coated tongue were improved obviously in the treatment group (P<0.05). The total explicit efficiency rate and effective rate were 56.0% and 84.0% in the control group and 82.1% and 92.9% in the treatment group respectively. The total explicit efficiency rate was significantly different between the two groups (P<0.05), while the total effective rate was not significantly different (P>0.05). Plasma concentration of IL-8 decreased markedly in the treatment group and IL-10 and BPI increased obviously. There was no significant difference in the change of BPI, IL-8 between the two groups (P>0.05), except for IL-10 (P<0.05). Conclusion Chinese heat-clearing and phlegm-resolving recipe can improve signs and symptoms of TCM in the treatment of AECOPD (phlegm heat and phlegm turbidity in lungs), by the potential mechanism of increasing the level of IL-10.

Citation： JIANGHong-li, ZHOUWei, MINJie, MAOBing. Clinical Effect and Mechanism of Heat-clearing and Phlegm-resolving Recipe in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (Phlegm Heat and Phlegm Turbidity in Lungs). West China Medical Journal, 2015, 30(5): 905-910. doi: 10.7507/1002-0179.20150258 Copy

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2. World Health Organization. The global burden of disease:2004 update[R/OL].[2015-02-01]. http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/.
3. Fuhrman C, Delmas MC. Epidemiology of chronic obstructive pulmonary disease in France[J]. Rev Mal Respir, 2010, 27(2):160-168.
4. Caballero A, Torres-Duque CA, Jaramillo C. Prevalence of COPD in five Colombian cities situated at low, medium, and high altitude (PREPOCOL study)[J]. Chest, 2008, 133(2):343-349.
5. Greskevitch M, Kullman G, Bang KM. Respiratory disease in agricultural workers:mortality and morbidity statistics[J]. J Agromedicine, 2008, 12(3):5-10.
6. Halbert RJ, Natoli JL, Gano A, et al. Global burden of COPD:systematic review and meta-analysis[J]. Eur Respir J, 2006, 28(3):523-532.
7. Vestbo J, Hurd SS, Agustí AG, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease:GOLD executive summary[J]. Am J Respir Crit Care Med, 2013, 187(4):347-65.
8. 中华医学会呼吸病学分会. 慢性阻塞性肺疾病诊治指南(2007年修订版)[J]. 中华结核与呼吸杂志, 2007, 30(1):8-17.
9. 郑筱萸. 中药新药临床研究指导原则(试行)[M]. 北京:中国医药科技出版社, 2002:54-58.
10. 李文, 毛兵, 王刚, 等. 从气道炎症和气道黏液高分泌泌研究清热化痰法治疗慢性阻塞性肺疾病急性加重期痰热阻肺证的机制[J]. 中西医结合学报, 2008, 6(8):799-805.
11. 张颖, 李廷谦, 王刚, 等. 痰热清注射液治疗慢性阻塞性肺病急性加重期(痰热阻肺证)的随机对照试验[J]. 中国循证医学杂志, 2004, 4(5):300-305.
12. Bhowmik A, Seemungal TA, Sapsford R J, et al. Relation of sputum inflammatory markers to symptoms and lung function changes in COPD exacerbation[J]. Thorax, 2000, 55(2):114-120.
13. Takanashi S, Hasegawa Y, Kanehira Y, et al. Interleukin-10 level in sputum is reduced in bronchial asthmas, COPD and in smokes[J]. Eur Respir J, 1999, 14(2):309-314.
14. Hubbard R, Tattersfield A. Inhaled corticosteroids, bone mineral density and fracture in older people[J]. Drugs Aging, 2004, 21(10):631-638.
15. Mannion BA, Weiss J, Elsbach P. Separation of sublethal and lethal effects of polymorphonuclear leukocytes on Escherichia coli[J]. J Clin Invest, 1990, 86(2):631-641.
16. Mannion BA, Weiss J, Elsbach P. Separation of sublethal and lethal effects of the bactericidal/permeability increasing protein on Escherichia coli[J]. J Clin Invest, 1990, 85(3):853-860.
17. 杨艳娟, 程德云, 李熙霞, 等. 慢性阻塞性肺疾病急性加重期病原菌检出情况与病情评估[J]. 四川大学学报:医学版, 2007, 38(4):742-744.
18. 李婷, 阚全程, 余祖江. 巢式PCR检测慢性支气管炎患者外周血BPI mRNA的表达水平[J]. 医药论坛杂志, 2007, 28(22):13-15.

West China Medical Journal

Clinical Effect and Mechanism of Heat-clearing and Phlegm-resolving Recipe in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (Phlegm Heat and Phlegm Turbidity in Lungs)

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