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目的:观察二陈汤加味对COPD急性期加重期(acute exacerbation period of COPD,AECOPD)患者血浆、呼气冷凝液(exhale breath condensat,EBC)中克拉拉细胞蛋白(Clara cell protein,CC16),肺表面活性蛋白-D(pulmonary surfactant associated protein-D,SP-D)含量及外周血单个核细胞(peripheral blood mononuclear cell,PBMC)中组蛋白乙酰基转移酶(histone acetyl transferase,HAT)及组蛋白去乙酰基酶(histone deacetylase,HDAC)活性的影响,评价二陈汤加味对AECOPD的作用及机制。方法:选取符合纳入标准AECOPD患者200例,随机分成对照组和治疗组,每组100例。两组均在西医常规治疗的基础上,对照组给予安慰剂,治疗组接受二陈汤加味治疗,疗程14 d。检测肺功能,酶联免疫吸附试验(ELISA)法测定血浆,EBC中白细胞介素-17(interleukin-17,IL-17),C反应蛋白(C-reactive protein,CRP),CC16,SP-D及PBMC中HDAC1,HDAC2浓度。酶联免疫荧光法测定PBMC中HAT及HDAC活性。结果:与对照组治疗后比较,治疗组血浆及EBC中CRP,IL-17,CC16和SP-D水平均明显降低(P<0.05,P<0.01),PBMC中HAT活性明显降低(P<0.05),HDAC活性,HDAC2含量均明显增高(P<0.05)。结论:二陈汤加味可能调整HAT/HDAC的平衡,发挥抗炎作用,保护气道和肺的结构与功能。
Objective: To observe the effect of Erchen Decoction on the plasma and Clara cell protein (CC16) in the lungs of patients with acute exacerbation of COPD (AECOPD), exhale breath condensate (EBC) (SP-D), histone acetyl transferase (HAT) and histone in peripheral blood mononuclear cell (PBMC) Acetyl enzyme (histone deacetylase, HDAC) activity, evaluation Erchen decoction of AECOPD effect and mechanism. Methods: A total of 200 AECOPD patients were enrolled and randomly divided into control group and treatment group, 100 cases in each group. Both groups were based on routine treatment of Western medicine, the control group was given placebo, the treatment group received Erchen Decoction treatment, treatment for 14 days. The lung function was measured and the levels of interleukin-17, C-reactive protein (CRP), CC16 and SP-D in plasma and EBC were measured by enzyme linked immunosorbent assay (ELISA) And HDAC1, HDAC2 concentrations in PBMCs. HAT and HDAC activity in PBMCs were determined by enzyme-linked immunosorbent assay. Results: Compared with the control group, the levels of CRP, IL-17, CC16 and SP-D in plasma and EBC of the treated group were significantly decreased (P <0.05, P <0.01), and the activity of HAT in PBMC was significantly decreased ), HDAC activity, HDAC2 content were significantly increased (P <0.05). Conclusion: Erchen decoction may adjust the balance of HAT / HDAC, exert anti-inflammatory effect and protect the structure and function of airway and lung.