吴倩;邓扬嘉;孙小平;许峰;

• 1:重庆市中医院

摘要(Abstract)：

目的 观察解毒化痰平喘汤对重症肺炎患者氧化应激反应的影响。方法 收集60例重症肺炎病例，随机分为对照组与试验组各30例。对照组给予常规西医治疗，试验组在常规西医治疗基础上加用解毒化痰平喘汤治疗。检测两组治疗前后肺泡灌洗液中肺泡巨噬细胞内过氧化物酶6(PRDX6)蛋白表达及血过氧化脂质（LPO）水平，检测谷胱甘肽过氧化物酶（GSH-Px活性）变化。结果 1）解毒化痰平喘汤可增加肺泡巨噬细胞内PRDX6蛋白表达，降低LPO水平，增加GSH-Px活性，减轻重症肺炎患者氧化应激反应。2）解毒化痰平喘汤可减少急性生理学与慢性健康状况评分Ⅱ评分，降低血乳酸、C反应蛋白、降钙素原水平，提示其对肺炎严重程度及预后的改善。结论 解毒化痰平喘汤可改善重症肺炎患者氧化应激反应。

关键词(KeyWords)： 重症肺炎;解毒化痰平喘汤;过氧化物酶6;过氧化脂质;谷胱甘肽过氧化物酶

Abstract:

Keywords:

基金项目(Foundation): 重庆市卫生计生委中医药科技项目（ZY201802060）

作者(Authors): 吴倩;邓扬嘉;孙小平;许峰;

参考文献(References)：

• [1]梁雨.连续性血液净化在重症肺炎合并多器官功能衰竭中的作用分析[J].当代医学，2014,20(18):63-64.
• [2] S Huang,C Feng,L Chen,et al. Molecular mechanisms of mild and severe pneumonia:insights from RNA sequencing[J]. Med Sci Monit,2017,23(14):1662-1673.
• [3] M Rushefski,R Aplenc,N Meyer,et al. Novel variants in the PRDX6 Gene and the risk of Acute Lung Injury following major trauma[J].BMC Med Genet,2011,12(5):77.
• [4] JV Bonventre,M Swidler. Calcium dependency of prostaglandin E2 production in rat glomerular mesangial cells. Evidence that protein kinase C modulates the Ca2+dependent activation of phospholipase A2[J]. J Clin Invest,1988,82(1):168-176.
• [5] W Pruzanski,P Vadas. Phospholipase A2-a mediator between proximal and distal effectors of inflammation[J]. Immunol Today,1991,12(5):143-146.
• [6] LA Mandell,RG Wunderink,A Anzueto,et al. Infectious diseases society of America/American thoracic society consensus guidelines on the management of community-acquired pneumonia in adults[J]. Clin Infect Dis,2007,44(2):S27-72.
• [7]国家中医药管理局.中医病证诊断疗效标准：ZY/T001.1-94[S].南京：南京大学出版社，1994.
• [8]朱文锋.中医常见证诊断标准（上）[J].湖南中医药大学学报，2008,28(5):3-8,20.
• [9]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京：中国医药科技出版社，2002:29-30.
• [10] S Ewig,M Woodhead,A Torres. Towards a sensible comprehension of severe community-acquired pneumonia[J]. Intensive Care Med,2011,37(2):214-223.
• [11] WI Sligl,TJ Marrie. Severe community-acquired pneumonia[J]. Crit Care Clin,2013,29(3):563-601.
• [12] S Trefler,A Rodríguez,I Martín-Loeches,et al. Oxidative stress in immunocompetent patients with severe communityacquired pneumonia. A pilot study[J]. Med Intensiva,2014,38(2):73-82.
• [13]吴倩，许峰，邓扬嘉.中医集束化治疗对呼吸机依赖患者的影响研究[J].中国中医急症，2021,30(2):253-256.
• [14] SY Krishnaiah,C Dodia,EM Sorokina,et al. Binding sites for interaction of peroxiredoxin 6 with surfactant protein A[J].Biochim Biophys Acta,2016,1864(4):419-425.
• [15] Y Min,SM Wi,D Shin,et al. Peroxiredoxin-6 negatively regulates bactericidal activity and NF-κB activity by Interrupting TRAF6-ECSIT complex[J]. Front Cell Infect Microbiol,2017,7:94.
• [16] AB Fisher. Peroxiredoxin 6:a bifunctional enzyme with glutathione peroxidase and phospholipase A activities[J]. Antioxid Redox Signal,2011,15(3):831-844.
• [17] S Chatterjee,SI Feinstein,C Dodia,et al. Peroxiredoxin 6phosphorylation and subsequent phospholipase A2 activity are required for agonist-mediated activation of NADPH oxidase in mouse pulmonary microvascular endothelium and alveolar macrophages[J]. J Biol Chem,2011,286(13):11696-11706.
• [18]郝金香，许俊旭，梁勇，等. miR-122联合APACHEⅡ评分对ARDS患者预后的评估价值[J].中华危重病急救医学，2019,31(6):694-698.
• [19] G Richards,H Levy,PF Laterre,et al. CURB-65,PSI,and APACHEⅡto assess mortality risk in patients with severe sepsis and community acquired pneumonia in PROWESS[J].J Intensive Care Med,2011,26(1):34-40.
• [20] B Demirel. Lactate levels and pneumonia severity index are good predictors of in-hospital mortality in pneumonia[J].Clin Respir J,2018,12(3):991-995.
• [21] M Karakioulaki,D Stolz. Biomarkers in pneumonia-beyond procalcitonin[J]. Int J Mol Sci,2019,20(8):2004.
• [22] EJ Shaddock. How and when to use common biomarkers in community-acquired pneumonia[J]. Pneumonia(Nathan),2016,8(10):17.
• [23] A Ito,T Ishida. Diagnostic markers for community-acquired pneumonia[J]. Ann Transl Med,2020,8(9):609.
• [24] T Li,YN Wu,H Wang,et al. Dapk1 improves inflammation,oxidative stress and autophagy in LPS-induced acute lung injury via p38MAPK/NF-κB signaling pathway[J]. Mol Immunol,2020,120(4):13-22.