Page 53 - 中国全科医学2022-30

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4.Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education
Ministry of P.R. China，Henan University of Chinese Medicine，Zhengzhou 450046，China
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Corresponding author：MAO Jing，Lecturer；E-mail：13838149747@163.com
【Abstract】 Background Themucosal structure of the respiratory tract is similar to that of the gastrointestinal tract in
humans，which is the body's first line of defense against the invasion of pathogens through the function of mucosal barrier. When
the respiratory tract infection stimulates the airway mucosa to produce a local immune response，it affects the intestinal tract
through migration and homing，resulting in the weakening of the local mucosal anti-infection ability，inducing mucosal barrier
damage，and further aggravating chronic obstructive pulmonary disease（COPD）. Objective To explore the effects of Bufei
Jianpi Formula on the expression levels of inflammatory factors in lung tissue，and the content of lung-gut related peptides in lung
and colon tissues in a rat model of stable COPD based on a typical viscera theory of Traditional Chinese Medicine，namely“the
lungs and large intestines are interior-exteriorly related”. Methods This experiment was carried out from September 2019
to December 2020. Fifty SPF SD rats were selected，and equally and randomly divided into control，model，Bufei Jianpi，
aminophylline and probiotics groups. Except for the control group，the rats in other groups received cigarette smoke exposure
combined with intranasal instillation of lipopolysaccharide（LPS）in the first eight weeks of intervention for establishing a COPD
model. From the ninth week of intervention，rats in the control and model groups received intragastric administration of 0.9%
sodium chloride solution，and those in Bufei Jianpi，aminophylline and probiotics groups received intragastric administration
of Bufei Jianpi Formula，aminophylline and probiotics，respectively. The rats were sacrificed after 12 weeks of intervention.
The pathological changes of lung and colon tissues were observed under an optical microscope，the expression levels of tumor
necrosis factor-α（TNF-α）and interleukin-10（IL-10）in lung tissue were detected by immunohistochemistry. The contents
of secretory immunoglobulin A（SIgA）in bronchoalveolar lavage fluid（BALF），substance P（SP）and vasoactive intestinal
peptide（VIP）in lung and colon tissues were detected by enzyme-linked immunosorbent assay（ELISA）. Results In terms of
morphology，the lung and colon tissue structures of rats in the control group were basically intact. In the model group，the trachea
was narrowed and surrounded by a lot of inflammatory cells with thickened bronchial wall. The improvement in histopathology
of the lung tissues was the most obvious in Bufei Jianpi group. The colon tissue of rats in the model group was damaged，which
was manifested by numerous shed epithelial cells，and crypts in different shapes and sizes. Bufei Jianpi group demonstrated
better improvement in histopathology of the colon tissue. There were statistically significant differences in the expression levels
of TNF-α，IL-10，SP and VIP in the lung tissue of the five groups of rats（F TNF-α =70.640，F IL-10 =8.444，F SP =108.700，
F VIP =4.665，P<0.05）. The expression level of SIgA in BALF differed significantly across five groups of rats（F=26.370，
P<0.05）. The expression levels of SP and VIP in colon tissue also varied significantly across five groups of rats（F SP =136.600，
F VIP =13.980，P<0.05）. Compared with the control group，the expression levels of TNF-α and SP in the lung tissue and those
of SP and VIP in the colon tissue of the model group were increased（P<0.05）；the expression levels of IL-10 and VIP in the
lung tissue，and expression level of SIgA in the BALF of the model group were decreased（P<0.05）. Compared with the model
group，the expression levels of TNF-α and SP in the lung tissue and those of SP and VIP in the colon tissue of the Bufei Jianpi
group were decreased（P<0.05）；the expression levels of IL-10 and VIP in the lung tissue，and expression level of SIgA in the
BALF of the Bufei Jianpi group were increased（P<0.05）. Conclusion Compared with the model group，the improvement in
the lung-gut related peptides indices in three treatment groups was better，and the improvement was the best in the Bufei Jianpi
group. Bufei Jianpi Formula could improve symptoms of lung inflammation and pathological damage of lung and intestine tissues.
The mechanism may be related to the involvement in regulating the content of SIgA，SP and VIP，and enhancing local mucosal
immunity and barrier function.
【Key words】 Pulmonary disease，chronic obstructive；Immunity，mucosal；Vasoactive intestinal peptide；Bufei
Jianpi Formula；Rats

慢 性 阻 塞 性 肺 疾 病（chronic obstructive pulmonary 能障碍引起的黏膜屏障受损、肠胃运动功能受阻是导致
disease，COPD）是一种常见的呼吸系统疾病，具有较 COPD 病情加重的重要因素 ［5］ 。分泌型免疫球蛋白 A
高的发病率与死亡率，据统计，在我国 40 岁以上人群 （secretory immunoglobulin A，SIgA）是一类存在于黏膜
中 COPD 的患病率高达 13.7%，每年大约有 100 万人死 表面通过阻止病原体黏附和定植、中和病菌等发挥免疫
于 COPD ［1-3］ 。COPD 发病机制复杂尚不完全清楚，主 功能的抗体 ［6-7］ 。COPD 发生时，患者体内 SIgA 的缺
要与气道慢性炎症、氧化与抗氧化失衡、蛋白酶与抗蛋 失或下降，导致局部黏膜屏障功能降低，细菌、毒素入
白酶失衡、肠道功能障碍等机制有关 ［4］ ，其中肠道功 侵进一步加重屏障损伤 ［8-9］ 。P 物质（SP）、血管活性