Objective: To explore the clinical efficacy of modified Qingqi Huatan Wan in treatment of acute exacerbation of chronic obstructive pulmonary disease (syndrome of phlegm-heat obstructing lung) and investigate its effects on serum tumor necrosis factor-alpha (TNF-α),interleukin-8(IL-8) and matrix metalloproteinase-9(MMP-9).Method: Sixty-four patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were randomly divided into control group (32 cases) and treatment group (32 cases) by random number table.The control group was treated with routine western medicine therapy according to the guidance and disease conditions.Based on treatment in control group,patients in treatment group also received modified Qingqi Huatan Wan.The treatment course was 14 days for both groups.The scores of traditional Chinese medicine (TCM) syndrome,chronic obstructive pulmonary disease (COPD) assessment test (CAT),and modified version of the British Medical Research Council's Respiratory Questionnaire (mMRC),pulmonary function,blood gas analysis indicators,levels of serum TNF-α,IL-8 and MMP-9,clinical efficacy and safety were evaluated and compared once before treatment and 14 d after treatment.Result: The total clinical effective rate was 96.67% in treatment group,higher than 76.67% in control group (χ²=5.192,P<0.05).After treatment,scores of TCM syndrome,CAT and mMRC were reduced in both groups (P<0.05),and the scores in treatment group were all lower than those in control group (P<0.05).Levels of forced expiratory volume in one second (FEV₁),percent of FEV₁ in predicted value (FEV₁%),and ratio of FEV₁ to forced vital capacity (FEV₁/FVC) were increased in both groups after treatment (P<0.05),and the above levels in treatment group were higher than those in control group (P<0.05).After treatment,oxygen saturation (SaO₂) and partial pressure of oxygen (PaO₂) were increased in both groups,while partial pressure of carbon dioxide (PaCO₂) was decreased (P<0.05),and SaO₂ and PaO₂ in treatment group were higher than those in control group,while PaCO₂ was lower than that in control group (P<0.05).After treatment,serum TNF-α,IL-8 and MMP-9 were decreased in both groups (P<0.05),and the levels in treatment group were lower than those in control group (P<0.05).Conclusion: Modified Qingqi Huatan Wan can control the symptoms safely and ameliorate pulmonary function,reduce the levels of serum TNF-α,IL-8,MMP-9 and inflammation in treatment of AECOPD.

Objective:To explore the clinical efficacy of Modified Qingqi Huatan Wan in treatment of acute exacerbation of chronic obstructive pulmonary disease and its effect on inflammatory reaction, airway remodeling and thrombokinesis. Method:A total of 80 patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were randomly divided into control group (40 cases) and therapy group (40 cases) by random number table. The control group was treated with conventional therapy. In addition to the therapy for the control group, the patients in therapy group also received modified Qingqi Huatan Wan. The treatment course was 14 days for both groups. Scores of traditional Chinese medicine(TCM) syndrome, chronic obstructive pulmonary disease and asthma physiology Score (CAPS), and chronic obstructive pulmonary disease patients self-assessment test questionnaire (CAT) were compared. The secondary indicators were pulmonary function, arterial blood gas analysis, and blood rheology indexes. In addition, the levels of serum nuclear factor kappa B (NF-κB), interleukin-6 (IL-6), interleukin-8 (IL-8), matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase-2 (TIMP-2), transforming growth factor-beta1 (TGF-β₁) and plasma tissue-plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), von-willebrand factor (v-WF), clinical efficacy and safety were evaluated. Result:The total clinical effective rate was 94.74% in therapy group,which was higher than 78.38% in control group (χ²=4.341,P<0.05). After treatment, scores of TCM syndrome, CAPS, CAT and levels of PaCO₂, serum NF-κB, IL-6, IL-8, MMP-2, TIMP-2, TGF-β₁ and plasma PAI-1, v-WF in therapy group were lower than those in control group(P<0.05). However, levels of plasma t-PA, SaO₂, PaO₂, FEV₁, FEV₁%, FEV₁/FVC in therapy group were higher than those in control group(P<0.05), therapy group was alleviated more than control group (P<0.05). Conclusion:Modified Qingqi Huatan Wan can control the symptoms safely, alleviate CAPS and lung function, effectively reduce the inflammatory response and inhibit the formation of airway remodeling and thrombosis, and its mechanism may be protect the lung tissue by reducing the level of inflammatory cytokines, regulating the balance of MMP-2/TIMP-2 and t-PA/PAI-1 and improving extracellular matrix and vascular endothelial function.