| BackgroundChronic obstructive pulmonary disease (COPD) is a disease characterized with limited air flow, which is not fully reversible, showing progressive development. And its main pathophysiological characteristics are chronic airway inflammation and the imbalance between oxidation and antioxidant. The chronic airway inflammation which exits no matter at acute exacerbation or remission of COPD is very important to the occurrence and development of COPD, and it probably plays a crucial role in airway remodeling in COPD, airway obstruction, and the occurrence and development of pulmonary hypertension. In recent years, composite treatment of Chinese medicine has made some achievements in relieving the chronic airway inflammation of COPD. So making a better understanding of the airway inflammation in different syndromes of remission of COPD, and analyzing the features of the syndromes, obtain understanding of the laws, which provides the basis for Chinese medicine multi-target treatment of COPD. It has very important practical significance. Recently studies have suggested that smoking promotes the development of inflammation in the airway, so it's also significant to understand the correlation between the amount of smoking and the severity of airway inflammation, and so is finding impact of smoking cessation to airway inflammation.ObjectivesApproach the relationship between the levels of tumor necrosis factor a (TNF-α), interleukin 8 (IL-8) and syndromes, and smoking. Find out the features of the airway inflammation of different syndromes, and understand the correlation between smoking and the airway inflammation. Probe the clinical significance of pulmonary function tests for evaluation of the airway inflammation in the remission of COPD.MethodsBrought in 40 patients with stable COPD, whose syndromes were deficiency-excess miscellaneous syndromes. According to deficiency syndromes, they were divided into pulmonary qi deficiency syndrome, spleen qi deficiency syndrome, kidney qi deficiency syndrome. According to excess syndromes, they were divided into phlegm-turbid syndrome, blood stasis syndrome, phlegm-blood stasis syndrome. In order find out differences of airway inflammations in different syndromes, detected TNF-αand IL-8 levels of sputum.10 cases were non-smokers,30 cases were smokers. According to comparing whether they smoke, the smoking index (number of packages each year of smoking), smoking amount, length of smoking period, evaluated the impact of smoking, smoking index, smoking and length of smoking cessation period on the level of airway inflammation. And according to comparing results of lung function tests, came to understand whether the pulmonary function tests reflect the severity of airway inflammation.ResultAccording to excess syndromes, they are divided into phlegm-turbid syndrome, blood stasis syndrome, phlegm-blood stasis syndrome. Compared different levels of IL-8 or TNF-αin sputum of different syndromes groups, no difference of levels of IL-8 between groups was significant(P>0.05).But difference of levels of TNF-αbetween groups is significant(P＜0.05), difference between phlegm-turbid syndrome and blood stasis syndrome, and difference between phlegm-turbid syndrome and phlegm-blood stasis syndrome, both of them were significant (P＜0.05), no difference between blood stasis syndrome and phlegm-blood stasis syndrome is significant (P＜0.05). According to deficiency syndromes, they were divided into pulmonary qi deficiency syndrome, spleen qi deficiency syndrome, kidney qi deficiency syndrome. Compared different levels of IL-8 or TNF-αin sputum of different syndromes groups, no difference of levels of IL-8 between groups was significant (P＞ 0.05).But difference of levels of TNF-a between groups was significant(P <0.05), difference between pulmonary qi deficiency syndrome and p spleen qi deficiency syndrome is significant (P＜0.01), difference between other groups was not significant. The study found that the difference of airway inflammation between smokers and non-smokers was significant (P＜0.05),Results suggested that the airway inflammation of smokers was higher than non-smokers', levels of IL-8 and TNF-a in sputum of patients with stable COPD were positively correlated, so IL-8, TNF-a and smoking index, smoking amount were, but both of them was not statistically correlated with the length of smoking cessation period. Compared different levels of IL-8 or TNF-a basis on pulmonary function classification, no difference between groups is significant (P>0.05), and none of them is significantly correlated with FEV1 or FEV1% Pred(P>0.05).ConclusionThe study found that TNF-a level in blood stasis syndrome group, phlegm and blood stasis syndrome group were higher than the phlegm, which indicated that blood stasis syndrome group, phlegm and blood stasis syndrome group may be higher than the level of airway inflammation phlegm group. AND TNF-a levels in lung qi deficiency group than in spleen qi deficiency group, which indicated that airway inflammation in the lung qi group level may be higher than spleen deficiency group. This study found that airway inflammation of smokers was higher than non-smokers', both smoking index and smoking total were positively correlated with the level of airway inflammation, and it indicated that the more a person smoked, the higher the level of airway inflammation was. Classification of lung function, FEV1, FEV1% Pred can reflect the degree of airflow limitation of patients with stable COPD, but could not accurately reflect their different levels of airway inflammation.
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