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Journal of Chinese Integrative Medicine ›› 2008, Vol. 6 ›› Issue (8): 799-805.doi: 10.3736/jcim20080806

• Original Clinical Research • Previous Articles     Next Articles

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

Weng Li1,2, Bing Mao1(), Gang Wang1, Lei Wang1, Jing Chang1, Ying Zhang1, Mei-hua Wan1, Jia Guo1   

  1. 1. Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China
    2. Department of Respiratory Medicine, the First People, s Hospital of Chengdu City, Chengdu, Sichuan Province 610000, China
  • Received:2008-02-20 Online:2008-08-20 Published:2008-08-15

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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).
Conclusion: Tanreqing injection can improve TCM signs and symptoms in AECOPD patients, and the mechanism may be due to the decrease of serum levels of IL-8 and NE and improvement of IL-10 level.

Key words: chronic obstructive airway disease, clearing heat and resolving phlegm, randomized controlled trial, interleukin-8, interleukin-10, neutrophil elastase

CLC Number: 

  • R563.9

Table 1

Traditional Chinese medicine symptom score in three groups (x±s)"

Group n Symptom score Score difference
Pre-treatment Post-treatment
Control 26 12.4±4.7 6.1±5.6** 6.8±4.5
Ambroxol hydrochloride 24 13.8±4.8 3.3±2.3** 10.5±4.6△△
Tanreqing 28 15.0±4.2 3.7±2.9** 11.3±3.9△△

Table 2

Clinical effects in three groups[Cases (%)]"

Group n Cure Obvious effect Improvement Failure Total obvious effect Total response
Control 26 6 (23.08) 9 (34.61) 7 (26.92) 4 (15.39) 15 (57.69) 22 (84.61)
Ambroxol hydrochloride 24 6 (25.00) 14 (58.33) 2 (8.33) 2 (8.33) 20 (83.33)△ 22 (91.67)
Tanreqing 28 7 (25.00) 16 (57.14) 3 (10.72) 2 (7.14) 23 (82.14)△ 26 (92.86)

Table 3

Traditional Chinese medicine symptom in three groups (Cases)"

Group n Degree of pre-treatment Degree of post-treatment
0 2 4 6 0 2 4 6
Cough
Control 26 1 14 8 3 11 10 3 2*
Ambroxol hydrochloride 24 1 10 6 7 16 8 0 0**△
Tanreqing 28 2 10 12 4 19 9 0 0**△
Sputum amount
Control 26 1 11 12 2 10 11 2 3**
Ambroxol hydrochloride 24 2 10 4 8 15 9 0 0**△
Tanreqing 28 0 11 13 4 15 13 0 0**△
Expectoration
Control 26 2 10 7 7 10 11 3 2*
Ambroxol hydrochloride 24 1 7 6 10 15 9 0 0**△
Tanreqing 28 0 6 11 11 16 12 0 0**△
Dyspnea
Control 26 9 7 7 3 15 7 2 2**
Ambroxol hydrochloride 24 7 3 9 5 12 11 1 0**
Tanreqing 28 7 4 8 9 13 13 1 1**
Fever
Control 26 21 3 2 0 23 1 1 1
Ambroxol hydrochloride 24 22 1 1 0 23 1 0 0
Tanreqing 28 23 3 2 0 28 0 0 0

Table 4

Changes of coated tongue in three groups (Cases)"

Group n
 Pre-treatment Post-treatment
Normal Abnormal Normal Abnormal
Control 26 5 21 11 15
Ambroxol hydrochloride 24 2 22 14 10**△
Tanreqing 28 3 25 24 4**△△▲▲

Table 5

Changes of pulse tracings in three groups (Cases)"

Group n Pre-treatment Post-treatment
Normal Abnormal Normal Abnormal
Control 26 26 3 10 16*
Ambroxol hydrochloride 24 24 1 8 16*
Tanreqing 28 28 2 10 18*

Table 6

Levels of IL-8 and IL-10 in blood plasma before and after treatment in three groups"

Group n IL-8 IL-10
Pre-treatment Post-treatment Pre-treatment Post-treatment
Control (x±s, ng/L) 26 2.04±1.42 1.63±1.26** 3.94±3.10 1.92±1.37**
Ambroxol hydrochloride (x±s, ng/L) 24 2.15±1.75 1.41±0.56* 4.28±3.94 2.07±1.68**
Tanreqing (median, ng/L) 28 2.19 1.42* 3.15 1.32**

Table 7

Levels of NE in blood plasma before and after treatment in three groups (x±s, ng/L)"

Group n NE
Pre-treatment Post-treatment
Control 26 14.36±9.91 11.65±2.16
Ambroxol hydrochloride 24 16.99±13.47 13.32±9.60**
Tanreqing 28 15.43±10.02 12.25±9.03**
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