清热化痰法对慢性阻塞性肺疾病急性加重期痰热证大鼠气道黏液高分泌的影响

目的：研究循清热化痰法组方的蒌芩止嗽煎通过影响慢性阻塞性肺疾病急性加重（ AECOPD）大鼠气道黏液高分泌，提高抗生素在肺内的药物浓度的机制。方法50只Wistar雄性大鼠随机分为正常组、模型组、氨溴索组、二陈汤组、蒌芩止嗽煎组，每组各10只。用熏吸香烟加气管内注射内毒素及鼻腔滴入金黄色葡萄球菌，合并风热刺激的方法建立大鼠AECOPD痰热证模型。模型建立后，氨溴索组腹腔内注射氨溴索6 mg／（kg· d），二陈汤组及蒌芩止咳煎组分别灌胃相应的中药3．33 g／（kg· d），共7 d。 AB-PAS染色，镜下观察杯状细胞酸性黏蛋白的分泌；病理组织使用Image-Pro Plus 6．0软件计数每个视野下杯状细胞总数，计算杯状细胞占所有上皮细胞比例；ELISA法检测支气管灌洗液中肺组织黏蛋白（ MUC5AC）含量及血清中中性粒细胞弹性蛋白酶（NE）含量。结果与模型组比较，各药物组杯状细胞分泌的MUC5AC及气道杯状上皮细胞计数均明显降低（P＜0．05），且蒌芩止嗽煎组NE及MUC5AC降低更为明显（P＜0．05），而其余各组无明显差异。结论蒌芩止嗽煎提高抗生素在肺组织内转运能力的机制，可能是通过减少黏蛋白和气道杯状上皮细胞数量，降低血清NE和灌洗液中MUC5AC，减少气道黏液分泌，减轻气道阻塞，促进抗生素在肺组织内的正相扩散作用而实现的。

Effect of the method of clearing heat and resolving phlegm on the airway mucus hypersecretion of the AECOPD rat model with phlegm-heat syn-drome

Objective To study the effect of Louqin Zhisou decoction ( LQZSD) , a Chinese herbal medi-cine compound formulated by the TCM method of clearing heat and resolving phlegm, on the airway mu-cus hypersecretion of the AECOPD rat model, so as to improve the transportation of antibiotics in lung tis-sue .Methods Altogether 50 Wistar male rats were randomly divided into normal group , model group , ambroxol group , Erchen decoction ( ECD) group, Louqin Zhishou decoction( LQZSD) group ( each n=10) .The rat model of AECOPD with phlegm-heat syndrome was established by passive cigarette smok-ing,intratracheal instillation of lipopolysacchricle ( LPY) and intranose instillation of staphylococcus au-reus combined with wind-heat stimulation.After modeling, ambroxol group was intraperitoneally injected ambroxol at dose of 6 mg/kg per day, ECD group and LQZSD group were intragastrically administered ECD and LQZSD at dose of 3.33 g/kg per day respectively.The treatment duration was seven days.The secretion of acidic mucin in goblet cells was observed by using AB-PAS staining.The goblet cells in each visual field were counted and the proportion of goblet cells to epithelial cells was calculated .The contents of serum neutrophil elastase ( NE) and MUC5AC in bronchoalveolar lavage fluid ( BALF) were detected by using ELISA assay.Results Compared with model group, the secretion of acidic mucin and the number of goblet cells significantly decreased in each treatment group(P<0.05).Furthermore, serum NE and MUC5AC both decreased in LQZSD group significantly(P<0.05), while there were no statisti-cal differences in the other treatment groups.Conclusion The potential mechanism of LQZSD improving the transportation of antibiotics would be related to reduction the secretion of acidic mucin and the number of goblet cells, as well as decrease the contents of serum NE and MUC5AC in BALF;as the result, the reduction of the secretion of mucus in airway led to clearance the airway obstruction and promotion the forward diffusion of antibiotics in rat’ s lung tissue.