Effect of Maxing Loushi Decoction on Inflammatory Factors， Immune Function， and PD-1/PD-L1 Signaling Pathway in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Phlegm Turbidity Obstructing Lung Syndrome
10.13422/j.cnki.syfjx.20251793
- VernacularTitle:麻杏蒌石汤对慢性阻塞性肺疾病急性加重痰浊阻肺证炎症因子、免疫功能和PD-1/PD-L1信号通路的影响
- Author:
Yuexin SHI
1
;
Zhi YAO
2
;
Jun YAN
1
;
Caijun WU
1
;
Li LI
1
;
Yuanzhen JIAN
1
;
Guangming ZHENG
1
;
Yanchen CAO
1
;
Haifeng GUO
1
Author Information
1. Dongzhimen Hospital， Beijing University of Chinese Medicine，Beijing 100700，China
2. Fangshan Hospital， Beijing University of Chinese Medicine，Beijing 102488，China
- Publication Type:Journal Article
- Keywords:
acute exacerbation of chronic obstructive pulmonary disease;
Maxing Loushi decoction;
inflammatory factor;
immune function;
programmed death-1（PD-1）/programmed death-ligand 1（PD-L1） signaling pathway
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2025;31(17):143-150
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo evaluate the clinical efficacy of Maxing Loushi decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） with phlegm turbidity obstructing lung syndrome， and to investigate its effects on inflammatory factors， immune function， and the programmed death-1（PD-1）/programmed death-ligand 1 （PD-L1） signaling pathway. MethodsA randomized controlled study was conducted， enrolling 90 hospitalized patients with AECOPD and phlegm turbidity obstructing lung syndrome in the Respiratory and Emergency Departments of Dongzhimen Hospital， Beijing University of Chinese Medicine， from April 2024 to December 2024. Patients were randomly assigned to a control group and an observation group using a random number table， with 45 patients in each group. The control group received conventional Western medical treatment， while the observation group received additional Maxing Loushi decoction for 14 days. Clinical efficacy， COPD Assessment Test （CAT） score， modified Medical Research Council Dyspnea Scale （mMRC）， 6-minute walk test （6MWT）， serum inflammatory factors， T lymphocyte subsets， and serum PD-1/PD-L1 levels were compared between the two groups before and after treatment. ResultsThe total clinical effective rate was 78.57% （33/42） in the control group and 95.35% （41/43） in the observation group， with the observation group showing significantly higher efficacy than that of the control group. The difference was statistically significant （χ2 = 5.136， P<0.05）. After treatment， both groups showed significant reductions in CAT and mMRC scores （P<0.05， P<0.01） and significant increases in 6MWT compared to baseline （P<0.01）. The observation group demonstrated significantly greater improvements than the control group in this regard. Levels of inflammatory markers including C-reactive protein （CRP）， procalcitonin （PCT）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， monocyte chemoattractant protein-1（MCP-1）， and macrophage inflammatory protein-1α （MIP-1α） were significantly reduced in both groups （P<0.05， P<0.01）， with greater reductions in the observation group （P<0.05， P<0.01）. CD8+ levels were significantly reduced （P<0.01）， while CD3+， CD4+， and CD4+/CD8+ levels were significantly increased in both groups after treatment （P<0.05， P<0.01）， with more significant improvements observed in the observation group （P<0.05， P<0.01）. Serum PD-1 levels were reduced （P<0.05， P<0.01）， and PD-L1 levels were increased significantly in both groups after treatment （P<0.05， P<0.01）， with more pronounced changes in the observation group （P<0.05）. ConclusionMaxing Loushi decoction demonstrates definite therapeutic efficacy as an adjunctive treatment for patients with AECOPD and phlegm turbidity obstructing lung syndrome. It contributes to reducing serum inflammatory factors， improving immune function， and regulating the PD-1/PD-L1 signaling pathway.
