| Background and aimChronic obstructive pulmonary disease (COPD) is an obstructive airway disorder characterized by a slowly progressive and irreversible decrease in FEV1. COPD is a major worldwide health problem that has an increasing prevalence and mortality. Oxidative stress, which can be defined as an increased exposure to oxidants and /or decreased antioxidant capacities, is widely recognized as a central feature of many diseases. Considerable evidence now links COPD with increased oxidative stress. There is now considerable evidence for an increased oxidant burden in smokers, particularly in those smokers who develop chronic obstructive pulmonary disease (COPD), as shown by increased markers of oxidative stress in the airspaces, breath, blood and urine. The presence of increased oxidative stress is a critical feature in the pathogenesis of COPD, since it results in inactivation of antiproteinases, airspace epithelial injury, mucus hypersecretion, increased sequestration of neutrophils in the pulmonary microvasculature, and gene expression of pro-inflammatory mediators.A number of abnormalities and measurement of biomarkers have suggested that increased oxidative stress is occurring and is detrimental in cigarette smokers with COPD. The most convincing way to determine the involvement of oxidative stress in COPD is to directly measure oxygen radicals in lung tissue or exhaled air. However, direct measurement is difficult since oxygen radicalsare highly reactive, short-lived species, and electron spin resonance and other direct techniques cannot be easily applied to the lung. The alternative has been to measure damage inflicted by oxygen radicals upon various lung biomolecules, usually lipids, proteins, or DNA. Markers of oxidative stress have been demonstrated in the epithelial lining fluid, in the breath, and in the urine in cigarette smokers and patients with COPD, and there has been interest in evidence of systemic oxidative stress, measured in the blood. We measured the levels of plasma SOD ^ GSH> GSH-Px^ MDA in patients with COPD during acute exacerbations by chemistry colorimetric methods, in order to evaluate systemic oxidative stress .Having demonstrated evidence of an oxidant/ antioxidant imbalance in smokers and its probable role in the pathogenesis of COPD, Various approaches have been tried to redress this imbalance. N-acetylcysteine and Ambroxol are the most widely investigated drugs with antioxidant properties those have been used in both experimental and clinical settings which are relevant to COPD. A recent study has shown Astragalus especilly TFA and ISA could protect lipid peroxidation of cell membrane. The purpose of this study is to explore the potential role of Astragalus injection on redressing oxidants/antioxidants imblance in patients with acute exacerbations of COPD.Research design and methods1. Subjects1. 1 COPD group: 52 patients with acute exacerbations of COPD(male 35, female 17, age 71.87+12.8 years, course of disease 5-33 years), who met the criteria of china(1997) for diagnosis and classification of COPD, participated in the study. 52 patients were randomly divided into two groups(26 cases for each group). (1)A group: Astragalus injection treated group(male 17, female 9, age 72.04 + 6.37 years, course of disease 5-33 years); (2)B group: Conventional treated group(male 18, female 8, age 71.69 + 7.22 years, course of disease 5~32 years). 1.2 Control group: C group, a total of 20 healthy persons (male 12, female 8, age 70.70 + 7.12 years)were recruited to the studyacting as control group. All control subjects are nonsmokers and take no medications in recent 6 months.2. MethodsSimilar antibiotics and same bronchodilators were used to both two groups(A group and B group). Additionally, in Astragalus injection treated group(A group) Astragalus injection 20ml+5% glucose in normal saline 250ml or 500ml infused intravenously once a day were added for 14 days as a therapeutic course. Corticosteroids^ N-acetylcysteine ^ AmbroxoK VitE> VitC were no... |
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