The Effect Of The Cytokines And Efficacy With The Management Of Clearing Away Heat-evil And Resolving Phlegm In Patients With Acute Exacerbations Of Chronic Obstructive Pulmonary Disease And System Inflammatory Response Syndrome

Objective:To observe the curative effect on Acute Exacerbations of Chronic Obstructive Pulmonary Disease(AECOPD) and System Inflammatory Response Syndrome(SIRS) with the Chinese traditional medicine of clearing away heat-evil and resolving phlegm by analyzing the symptoms, sighs, the levels of plasma tumor necrosis factor-a(TNF-a),interleukin-6(IL-6) in the blood.Method:one hundred hospitalized AECOPD patients with retention of phlegm and heat syndrome in the lung in TCM are randomly divided into two groups of control group (based on western medicine treatment group) and the treatment group (Traditional Chinese Medicine and Western Medicine therapy group). The control group accept the treatment of COPD norms WHO issued by the "chronic obstructive pulmonary disease Global Initiative" (GOLD), conventional controlled oxygen treatment, intravenous or oral administration of aminophylline , inhalation Antispasmodic drugs, antibiotics, phlegm drugs. The treatment group take the Chinese medicine which have the efficacy of clearing away heat-evil and resolving phlegm, and simultaneously accept conventional therapy of the western medicine same as the control group. The period of treatment is 7 days. To compare the result of two groups before and after treatment by analyzing clinical symptom and signs, the level of TNF-a, IL-6 in the blood.Result: 1. Compared to western medicine treatment, the traditional Chinese medicine and western medicine treatment is more effective to patients with AECOPD and SIRS.2. Clinical therapeutic effect: After treatment, melioration of clinical symptom and sign in both groups have significant difference. Compared with the control group, melioration of the treatment group, such as cough, expectoration, breathing, wheezing and pulmonary signs is greater , showing significant differences. Integral two symptoms after treatment than before treatment will be significantly under (p<0.01), compared with two groups, the treatment group is more dropped significantly (p<0.05), and symptom improvement rate of the two groups were statistically significant (p<0. 05). The treatment group also controls the efficient, with statistical significance. That the two groups of patients were treated effectively, and the effect of the treatment group than in control group.3. TNF-a in the blood: TNF-a in the blood of both groups before and after treatment reduce, showing significant difference (p<0.01). And TNF-a reduce more greatly in the treatment group, there has been a significant difference (p<0. 01). So we can see that the effect of the treatment group on reducing TNF-a in the blood is more significant than the control group.4. IL-6 in the blood: IL-6 in the blood of both groups before and after treatment reduce, showing significant difference (p<0.01). And IL-6 reduce more greatly in treatment group, there has been a significant difference (p<0. 05). So we can see that the effect of the treatment group on reducing IL-6 in the blood is more significant than the control group.5. This study found no liver and kidney function adverse events that traditional Chinese medicine in clinical treatment of relatively safe, no significant side effectsConclusion:1. The Traditional Chinese medicine with clearing away heat-evil and resolving phlegm can treat AECOPD with SIRS. It can improve clinical symptoms and signs, improve the efficacy.2. The Traditional Chinese medicine with clearing away heat-evil and resolving phlegm can treat AECOPD with SIRS. It can be less inflammatory response, the better to reduce blood TNF-a,IL-6 levels and reduce inflammation.