To examine the responses of some immune factors to integrated Chinese and Western Medicine treatment in a rat model with phlegm-heat syndrome during the acute exacerbation to stable stage of COPD.

A study was implemented between September 2019 and December 2020. Sixty SPF Sprague-Dawley rats were selected, and divided into five groups using the RAND function in Excel: control, COPD, acute exacerbation of COPD (AECOPD) , Western Medicine, and integrated Chinese and Western Medicine. Except the control group, other groups were exposed to cigarette smoke and heat, and received intranasal administration of lipopolysaccharide to develop COPD in acute exacerbation to stable stage with phlegm-heat syndrome. The intervention in the acute exacerbation stage lasted for 8 days, during which Western Medicine group received intragastric administration of solution containing moxifloxacin hydrochloride tablets (0.027 g·kg^-1·d^-1) and salbutamol sulfate tablets (0.41 mg·kg^-1·d^-1) , integrated Chinese and Western Medicine group received intragastric administration of solution containing Tongsai granules (7.2 g·kg^-1·d^-1) , moxifloxacin hydrochloride tablets (0.027 g·kg^-1·d^-1) , and salbutamol sulfate tablets (0.41 mg·kg^-1·d^-1) , the other three groups received intragastric administration of isotonic (0.9%) sodium chloride 2 ml per day. Subsequently, the intervention in the stable period lasted for 14 days, during which western medicine group received intragastric administration of salbutamol sulfate tablets 0.41 mg·kg^-1·d^-1, and the integrated Chinese and Western Medicine group received intragastric administration of BufeiYishen formula 4.42 g·kg^-1·d^-1 and salbutamol sulfate tablets 0.41 mg·kg^-1·d^-1. The other three groups received intragastric administration of isotonic (0.9%) sodium chloride 2 ml per day. The forced vital capacity (FVC) , forced expiratory volume during the first 300 milliseconds (FEV_0.3) , FEV_0.3/FVC ratio, and sIgA, as well as CD₃⁺ and CD₄⁺, in the lung and gut were detected after the interventions.

The FVC, FEV_0.3, FEV_0.3/FVC ratio, sIgA in the lung and gut, as well as expression level of CD₃⁺ in the lung, showed a trend of successive decrease across control group, COPD group, and AECOPD group (P<0.05) . The above-mentioned parameters were lower in AECOPD group than those of Western Medicine group or integrated Chinese and Western Medicine group (P<0.05) . And they were lower in Western Medicine group than those of integrated Chinese and Western Medicine group (P<0.05) .

Integrated Chinese and Western Medicine treatment may improve immunity of the rat model via repairing the immune barrier function of the lung and gut by increasing the expression of sIgA, CD₃⁺, and CD₄⁺ in the lung and gut, which provides evidence for the prevention and treatment of COPD with Chinese medicine.

观察中西医结合治疗COPD痰热证急性加重-稳定期大鼠对部分免疫因子的影响。

2019年9月至2020年12月选取SPF级SD大鼠60只，采用EXCEL RAND函数法将60只大鼠随机分为对照组、COPD稳定期（COPD）组、COPD急性加重期（AECOPD）组、西药组、中西医结合组。采用香烟烟雾及热暴露联合鼻腔内滴注脂多糖溶液方法制备COPD痰热证急性加重-稳定期大鼠模型。急性加重期干预8 d，西药组给予盐酸莫西沙星片0.027 g·kg^-1·d^-1和硫酸沙丁胺醇片0.41 mg·kg^-1·d^-1，中西医结合组给予通塞颗粒7.2 g·kg^-1·d^-1、盐酸莫西沙星片0.027 g·kg^-1·d^-1和硫酸沙丁胺醇片0.41 mg·kg^-1·d^-1；稳定期干预14 d，西药组给予硫酸沙丁胺醇片0.41 mg·kg^-1·d^-1，中西医结合组给予补肺益肾方4.42 g·kg^-1·d^-1和硫酸沙丁胺醇片0.41 mg·kg^-1·d^-1；对照组、COPD组及AECOPD组全程灌胃0.9%氯化钠溶液2 ml/d。干预结束后检测用力肺活量（FVC）、第0.3秒用力呼气容积（FEV_0.3）、FEV_0.3/FVC，肺、肠组织的分泌型免疫球蛋白（sIgA），CD₃⁺和CD₄⁺表达水平。

FVC、FEV_0.3、FEV_0.3/FVC、肺肠sIgA及肺CD₃⁺表达水平，COPD组低于对照组（P<0.05），AECOPD组低于COPD组（P<0.05），西药组、中西医结合组高于AECOPD组（P<0.05），中西医结合组高于西药组（P<0.05）。

中西医结合治疗可能通过提高大鼠肺组织和肠组织的sIgA和CD₃⁺、CD₄⁺的表达水平，修复肺组织和肠组织的免疫屏障功能，从而为COPD的中医药防治提供参考依据。