[A study of the mechanism of Qingre Huatan therapy in treatment of acute exacerbation of chronic obstructive pulmonary disease by improving airway inflammation and mucus hypersecretion].
OBJECTIVE
To explore the effects of Tanreqing injection, a traditional Chinese herbal preparation for clearing heat and resolving phlegm, in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) by improving airway inflammation and airway mucus hypersecretion.


METHODS
A randomized controlled trial (RCT) was designed. Ninety AECOPD patients were randomly divided into Tanreqing group, ambroxol hydrochloride group and control group. The patients in the three groups were all treated with conventional therapy. Furthermore, intravenous drip infusion of 20 ml Tanreqing injection (once daily) and 15 mg ambroxol hydrochloride injection (twice daily) were administered respectively to the patients in the Tanreqing group and ambroxol hydrochloride group. They were all treated for 10 days. Symptom score of traditional Chinese medicine (TCM), plasma concentrations of interleukin-8 (IL-8), IL-10 and neutrophil elastase (NE) were detected before and after treatment.


RESULTS
Cough, sputum amount, expectoration, dyspnea, fever, coated tongue and pulse tracings were improved obviously in Tanreqing group (P<0.05), and the effects of Tanreqing on improving cough, sputum amount and expectoration were better than the conventional therapy (P<0.05), while there was no significant difference between Tanreqing group and ambroxol hydrochloride group (P>0.05). Compared with ambroxol hydrochloride group and the control group, the coated tongue was improved obviously in Tanreqing group (P>0.05). After treatment, plasma concentrations of IL-8, IL-10 and NE were decreased in Tanreqing group and ambroxol hydrochloride group (P<0.05), and the levels of IL-8 and IL-10 in the control group were decreased (P<0.05). The change of IL-8 level before and after treatment in Tanreqing group was greater than that in ambroxol hydrochloride group and the control group. The changes of IL-10 and NE levels in ambroxol hydrochloride group were greater than those in Tanreqing group and the control group, while there was no significant difference in the changes of serum levels of IL-8, IL-10 and NE among the three groups (P>0.05). Total response rates in Tanreqing group and ambroxol hydrochloride group were higher than that in the control group (P<0.05), while there was no significant difference in total response rate between Tanreqing group and ambroxol hydrochloride group (P>0.05). There was no significant difference in total response rate among the three groups (P>0.05).


CONCLUSIONS
Tanreqing injection can improve TCM signs and symptoms in AECOPD patients, and the mechanism maybe due to the decrease of serum levels of IL-8 and NE and improvement of IL-10 level.
Li
Weng
W
Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China.
Mao
Bing
B
Wang
Gang
G
Wang
Lei
L
Chang
Jing
J
Zhang
Ying
Y
Wan
Mei-hua
MH
Guo
Jia
J
D000368:Aged; D000551:Ambroxol / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D005100:Expectorants / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D009093:Mucus / Q000378:metabolism; D008517:Phytotherapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*
D000893:Anti-Inflammatory Agents; D004365:Drugs, Chinese Herbal; D005100:Expectorants; D016209:Interleukin-8; C540817:tanreqing; D016753:Interleukin-10; D000551:Ambroxol; D019272:Leukocyte Elastase