摘要
目的探讨参蛤止咳胶囊联合沙美特罗替卡松粉吸入剂对老年慢性阻塞性肺疾病(COPD)稳定期患者TGF-β1/Smad信号通路、氧化损伤及预后的影响。方法选取2019年5月—2021年5月收治的300例老年COPD稳定期患者,根据治疗方案的不同分为观察组和对照组各150例。对照组予沙美特罗替卡松粉吸入剂治疗,观察组予参蛤止咳胶囊联合沙美特罗替卡松粉吸入剂治疗。比较2组临床疗效,治疗前后肺功能指标[第1秒最大呼吸容积(FEV1)、用力肺活量(FVC)],治疗前后TGF-β1/Smad信号通路相关蛋白[转化生长因子-β1(TGF-β1)、Smad3、Smad7],治疗前后氧化损伤指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、总抗氧化能力(T-AOC)],治疗前后炎性因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)],以及随访期间急性加重次数。结果观察组治疗总有效率高于对照组(P<0.01)。治疗后,2组FEV1、FVC均升高,且观察组高于对照组(P<0.05,P<0.01)。治疗后,2组TGF-β1、Smad3表达降低,Smad7表达升高,且观察组TGF-β1、Smad3表达低于对照组,Smad7表达高于对照组(P<0.05,P<0.01)。治疗后,2组MDA水平均降低,SOD、T-AOC水平均升高,且观察组MDA水平低于对照组,SOD、T-AOC水平高于对照组(P<0.05,P<0.01)。治疗后,2组IL-6、IL-8、TNF-α、IFN-γ水平均降低,且观察组低于对照组(P<0.05,P<0.01)。观察组治疗后6、12个月急性加重次数均少于对照组(P<0.01)。结论参蛤止咳胶囊联合沙美特罗替卡松粉吸入剂治疗老年COPD稳定期患者效果显著,可有效增强肺功能,调节TGF-β1/Smad信号通路,减轻氧化及炎性损伤,改善患者预后。
Objective To investigate the effect of Shenha Zhike Capsules combined with Salmeterol and Ficasone Powder Inhalation on TGF-β1/Smad signaling pathway,oxidative damage and prognosis in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods A total of 300 elderly patients with stable COPD treated in our hospital from May 2019 to May 2021 were selected and divided into the observation group(n=150)and the control group(n=150)according to different treatment regimens.The control group was treated with Salmeterol and Ticasone Powder Inhalation,and the observation group was treated with Shenha Zhike Capsules combined with Salmeterol and Ticasone Powder Inhalation.The clinical efficacy,pulmonary function indexes[forced expiratory volume in one second(FEV1),forced vital capacity(FVC)],and TGF-β1/Smad signaling pathway-related proteins[transforming growth factor-β1(TGF-β1),Smad3,Smad7]before and after treatment,oxidative damage indicators[malondialdehyde(MDA),superoxide dismutase(SOD),total antioxidant capacity(T-AOC)]before and after treatment,inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8),interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α)]before and after treatment,and the number of acute exacerbations during follow-up were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.01).After treatment,FEV1 and FVC in both groups were increased,which were higher in the observation group than in the control group(P<0.05,P<0.01).After treatment,the expressions of TGF-β1 and Smad3 in the two groups were decreased,while the expression of Smad7 was increased;the expressions of TGF-β1 and Smad3 in the observation group were lower than those in the control group,while the expression of Smad7 was higher than that in the control group(P<0.05,P<0.01).After treatment,the levels of MDA in both groups were decreased,while the levels of SOD and T-AOC were increased;the levels of MDA in the observation group were lower than those in the control group,while the levels of SOD and T-AOC were higher than those in the control group(P<0.05,P<0.01).After treatment,the levels of IL-6,IL-8,TNF-αand IFN-γin both groups were decreased,which were lower in the observation group than in the control group(P<0.05,P<0.01).The number of acute exacerbations in the observation group was less than that in the control group at 6 and 12 months after treatment(P<0.01).Conclusion Shenha Zhike Capsules combined with Salmeterol and Ficasone Powder Inhalation in the treatment of elderly patients with stable COPD has a significant effect,can effectively enhance pulmonary function,regulate TGF-β1/Smad signaling pathway,reduce oxidative and inflammatory damage,and improve the prognosis of patients.
作者
涂勇
冒勇
吴庆华
TU Yong;MAO Yong;WU Qing-hua(Department of Pulmonary Diseases,Suzhou Hospital of Integrated Traditional Chinese and Western Medicine,Suzhou,Jiangsu 215000,China;Department of Respiratory Medicine,the Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215000,China)
出处
《解放军医药杂志》
CAS
2022年第9期101-106,共6页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
苏州市中西医结合医院院级课题(YJ2018003)。
