Randomized Controlled Trial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2024; 12(18): 3482-3490
Published online Jun 26, 2024. doi: 10.12998/wjcc.v12.i18.3482
Effects of acetylcysteine on micro-inflammation and pulmonary ventilation in chronic obstructive pulmonary disease exacerbation
Li-Yuan Huang, Bin Huang, Zheng Lv, Xiao-Dan Lu
Li-Yuan Huang, Department of Integration of Traditional Chinese and Western Medicine, School of Clinical Medicine, Changchun University of Chinese Medicine, Changchun 130021, Jilin Province, China
Bin Huang, Department of Infectious Diseases, Affiliated People's Hospital of Jiangsu University, Zhenjiang 212002, Jiangsu Province, China
Zheng Lv, Department of Zoology, School of Life Sciences, Changchun Normal University, Changchun 130032, Jilin Province, China
Xiao-Dan Lu, Precision Medical Center, Jilin Province General Hospital, Changchun 130021, Jilin Province, China
Author contributions: Huang LY was the guarantor and designed the study; Lu XD and Huang B participated in the acquisition, analysis, and interpretation of the data and drafted the initial manuscript; Lv J, Lu XD, and Huang LY revised the article critically for important intellectual content; all authors participated in this study and jointly reviewed and edited the manuscript.
Institutional review board statement: This study was reviewed and approved by the Medical Ethics Committee of the School of Clinical Medicine at the Changchun University of Traditional Chinese Medicine.
Clinical trial registration statement: This study is registered in clinical practice. https://www.researchregistrv.com (Researchregistry9933).
Informed consent statement: Informed consent was obtained from patients or their guardians.
Conflict-of-interest statement: Dr. Lu has nothing to disclose.
Data sharing statement: No data available.
CONSORT 2010 statement: The authors read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Dan Lu, PhD, Doctor, Precision Medical Center, Jilin Province General Hospital, No. 1183 Gongnong Street, Chaoyang District, Changchun 130021, Jilin Province, China. luxiaodan@ccsfu.edu.cn
Received: March 7, 2024
Revised: April 22, 2024
Accepted: April 23, 2024
Published online: June 26, 2024
Processing time: 103 Days and 0.7 Hours
Abstract
BACKGROUND

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a serious complication of chronic obstructive pulmonary disease, often characterized by increased morbidity and mortality. In traditional Chinese medicine, AECOPD is linked to phlegm-heat and blood-stasis, presenting symptoms like thick sputum, fever, and chest pain. It has been shown that acetylcysteine inhalation in conjunction with conventional therapy significantly reduced inflammatory markers and improved lung function parameters in patients with AECOPD, suggesting that acetylcysteine may be an important adjunctive therapy for patients with phlegm-heat-blood stasis type AECOPD.

AIM

To investigate the effect of acetylcysteine on microinflammation and lung ventilation in patients with phlegm-heat and blood-stasis-type AECOPD.

METHODS

One hundred patients with phlegm-heat and blood-stasis-type AECOPD were randomly assigned to two groups. The treatment group received acetylcysteine inhalation (10% solution, 5 mL, twice daily) along with conventional therapy, whereas the control group received only conventional therapy. The treatment duration was 14 d. Inflammatory markers (C-reactive protein, interleukin-6, and tumor necrosis factor-alpha) in the serum and sputum as well as lung function parameters (forced expiratory volume in one second, forced vital capacity, and peak expiratory flow) were assessed pre- and post-treatment. Acetylcysteine inhalation led to significant reductions in inflammatory markers and improvements in lung function parameters compared to those in the control group (P < 0.05). This suggests that acetylcysteine could serve as an effective adjunct therapy for patients with phlegm-heat and blood-stasis-type AECOPD.

RESULTS

Acetylcysteine inhalation significantly reduced inflammatory markers in the serum and sputum and improved lung ventilation function parameters in patients with phlegm-heat and blood-stasis type AECOPD compared with the control group. These differences were statistically significant (P < 0.05). The study concluded that acetylcysteine inhalation had a positive effect on microinflammation and lung ventilation function in patients with this type of AECOPD, suggesting its potential as an adjuvant therapy for such cases.

CONCLUSION

Acetylcysteine inhalation demonstrated significant improvements in reducing inflammatory markers in the serum and sputum, as well as enhancing lung ventilation function parameters in patients with phlegm-heat and blood-stasis type AECOPD. These findings suggest that acetylcysteine could serve as a valuable adjuvant therapy for individuals with this specific type of AECOPD, offering benefits for managing microinflammation and optimizing lung function.

Keywords: Acute exacerbation, Chronic obstructive pulmonary disease, Traditional Chinese medicine, Acetylcysteine, Phlegm-heat and blood-stasis, Lung ventilation function

Core Tip: When used alongside conventional therapy, acetylcysteine inhalation significantly reduces inflammatory markers and improves lung function in patients with phlegm-heat and blood-stasis-type acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study highlights the potential of acetylcysteine as an effective adjunct treatment for this specific type of AECOPD, aiding in the management of microinflammation and the optimization of lung function.