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.