Effects of Reduning injection combined with budesonide and ambroxol inhalation on inflammation and sputum MUC5AC,NE and MMP-9 in patients with AECOPD
Objective To observe the effects of thermotoxic injection combined with budesonide and ambroxol inhalation on inflammatory response and sputum mucin(MUC)5AC,neutrophil elastase(NE),and matrix metalloproteinase-9(MMP-9)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 66 AECOPD patients treated with conventional therapy+budesonide and ambroxol inhalation+Reduning injection were selected as the experimental group.Another 66 AECOPD patients treated with conventional therapy+budesonide and ambroxol inhalation were selected as the basic group.Both groups were compared in terms of levels of lung function[forced expiratory volume in one second as a percentage of the predicted value(FEV1%pred)and forced vital capacity(FVC)],sputum levels of MUC5AC,NE,and MMP-9,and serum levels of related factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-17(IL-17),and lin-28 homolog B(LIN28B),chemokine ligand 18(CCL18),Clara cell protein 16(CC16)],blood gas indicators[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),oxygenation index(OI),and pH value]levels,Chronic Obstructive Pulmonary Disease Morning Symptom Diary(COPD-MSD)score,traditional Chinese medicine syndrome score,and adverse reactions occurrence.Results After treatment,FEV1%pred and FVC in both groups were higher than those before treatment;the experimental group had FEV1%pred of(65.45±8.52)%and FVC of(2.69±0.47)L,which were higher than(58.41±7.33)%and(2.28±0.42)L in the basic group(P<0.05).After treatment,the sputum MUC5AC,NE and MMP-9 in both groups were lower than those before treatment;the experimental group had MUC5AC of(93.45±43.13)ng/ml,NE of(1.17±0.21)ng/ml,and MMP-9 of(87.14±25.54)ng/ml,which were lower than(115.41±52.08),(1.30±0.26),and(101.56±33.69)ng/ml in the basic group(P<0.05).After treatment,the serum hs-CRP,IL-17,LIN28B and CCL18 in both groups were lower than those before treatment;the experimental group had serum hs-CRP of(45.06±6.92)mg/L,IL-17 of(25.12±3.64)pg/ml,LIN28B of(6.64±1.63)ng/ml,and CCL18(3.45±0.82)ng/ml,which were lower than(64.12±7.74)mg/L,(30.47±4.17)pg/ml,(7.76±1.87)ng/ml,and(4.67±1.08)ng/ml in the basic group(P<0.05).After treatment,the serum CC16 in both groups was higher than that before treatment,and the serum CC16 of(76.31±10.11)µg/L in the experimental group was higher than(71.43±9.32)µg/L in the basic group(P<0.05).After treatment,PaO2,OI and pH value in both groups were higher than those before treatment;the experimental group had PaO2 of(86.21±8.23)mm Hg(1 mm Hg=0.133 kPa),OI of(268.14±41.15)mm Hg,and pH of(7.43±0.31),which were higher than(74.86±7.54)mm Hg,(227.41±36.96)mm Hg,and(7.28±0.26)in the basic group(P<0.05).After treatment,PaCO2 in both groups decreased compared with that before treatment,and PaCO2 of(42.12±4.53)mm Hg in the experimental group was lower than(45.98±4.77)mm Hg in the basic group(P<0.05).After treatment,COPD-MSD score and traditional Chinese medicine syndrome score in both groups were lower than those before treatment;the experimental group had COPD-MSD score of(28.47±5.23)points and traditional Chinese medicine syndrome score of(3.81±0.66)points,which were lower than(36.21±6.14)and(6.35±1.14)points in the basic group(P<0.05).The incidence of adverse reactions in the experimental group was 3.03%(2/66),which was not statistically significant compared with 4.55%(3/66)in the basic group(P>0.05).Conclusion Reduning injection combined with budesonide and ambroxol inhalation can reduce sputum MUC5AC,NE,and MMP-9 levels,inhibit inflammation,improve lung function,and promote the recovery of blood gases in AECOPD patients.
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