| Objects: Research the changes of body weight, lung index, lung tissue morphology in Young asthmatic rats. And the expression of ERK1, P-ERK1, Ras protein in young asthmatic rats; Detection the lung function and symptom scores on children asthma control. Combine animal experiments and clinical observation to explore the strengthening spleen nourishing lung reducing phlegm prescription intervention asthma biological mechanism of action, comprehensive Judge of the clinical efficacy of treatment of children with asthma by use the strengthening spleen nourishing lung reducing phlegm prescription,Provide a more reliable basis for better clinical application.Methods:1.Experimental research Take 120 clean SD rats(weight95±5g), divided into normal group: 4 weeks, 8 weeks and 12 weeks, model group: 4 weeks, 8 weeks and 12 weeks,the strengthening spleen nourishing lung reducing phlegm prescription group(Simply called the chinese Medicine group) : 4 weeks, 8 weeks, 12 weeks and DXM group(Simply called the western Medicine group): 4 weeks, 8 weeks and 12 weeks,The total of 12 groups, each group have 10 rats,and have 120 rats Altogether. By intraperitoneal injection the mixture of 1ml/rat with gel of OVA(100 mg)+Al(OH)3(100 mg) of first day and eighth day to sensitization rats, trigger asthma with albumin solution atomization in 15 th day, give different drugs respectively Starting from the16 th day, according to the different time nodes, each group with regular feeding respectively according to kill the rats 4 weeks, 8 weeks, 12 weeks later. Using instruments and image analysis software, to observe weight index and lung biopsy in each group of rats; Using Western blot method(Western blot) respectively to detect the time point of ERK1, P-ERK1, Ras protein expression change;2.Clinical research Choose the Patients of 60 cases of acute episode of asthma who was diagnosed by pediatric clinic in affiliated hospital of an hui traditional Chinese medicine between January 2014 and January 2015, by taking the strengthening spleennourishing lung reducing phlegm prescription, pulmonary function tests before and after the use of self-control, clinical observation and survey questionnaires, observation before treatment, after treatment three months, three months after the withdrawal of lung function in children with asthma, and control of TCM symptom scores.Result:1.Experimental results(1) Weight: each time the normal rats got the highest weight, the model group got the minimum weight, traditional Chinese medicine and western medicine group was not statistically significant.(2) Pulmonary Index: each time the model group got the highest lung index, the normal group got the lowest lung index, Chinese medicine and western medicine group was not statistically significant.(3) Lung morphology: normal lung tissue sections no pathological changes were seen more than three slices of pathological changes in the model group showed obvious airway wall thickening and infiltration of inflammatory cells, the normal group and western medicine group may have a small amount of airway wall thickening and inflammatory cell infiltration.(4) Ras: normal Ras protein expression at different time points lower than the same time about the other groups, there was a significant difference(P<0.01 or P<0.05). 4weeks and 12 weeks of traditional Chinese medicine and western medicine group Ras protein Ras protein group was not statistically significant(P>0.05). 8 weeks group WM group is lower than the Medicines Ras protein Ras protein content and a significant difference(P<0.01).(5) ERK1: ERK1 expression point about normal group at each time point lower than the same time in other groups,there have more significant differences(P<0.01 or P<0.05), the expression of ERK1 model set point above about the same time each time point of each of the other groups, there was a significant difference(P<0.01 or P<0.05).4 weeks when the Medicines ERK1 expression than Western medicine group decreased,there was no significant difference(P> 0.05). But 8 weeks and 12 weeks compared with western medicine group ERK1 expression group reduced and there are differences(P<0.01 or P <0.05).(6) PERK1: expression point PERK1 normal group at each time point below about the same time the other groups, there was a significant difference(P <0.01), the expression of points PERK1 model group at each time point above about the same time the other groups, there was a significant difference(P <0.01 or P <0.05). 4 weeks expression when compared with the Medicines PERK1 reduce medicine group showed no significant difference(P> 0.05). But eight weeks and 12 weeks compared with western medicine group PERK1 expression group reduced and there are differences(P <0.01 or P <0.05).2.The result of clinical research(1) Pulmonary function: After treatment three months and three months after treatment,the pulmonary function of FEV1, FVC, PEF values than those before treatment improved(P<0.05), and after 3 months of treatment discontinuation 3 three months after the primary efficacy endpoint significantly improved compared with before treatment, there was a significant difference(P<0.01).(2) The primary efficacy evaluation: the withdrawal of lower respiratory tract infection after three months and the number of episodes of asthma compared with a decrease of 3months after treatment, but there was no significant difference(P> 0.05). March and after treatment discontinuation in clinical effective rate of more than 95%, but the difference was not statistically significant compared to the two(P> 0.05) 3 months later.(3) TCM symptom score evaluation: 3 months of treatment with the previous 3 months after discontinuation of TCM symptom score was significantly higher than that of treatment(P <0.05), after stopping in March TCM symptom score of less than 3 months after treatment, but no comparison results statistically significant(P> 0.05).3.Conclusion:1. The strengthening spleen nourishing lung reducing phlegm prescription can reduce lung index asthmatic rats, increased body weight of rats with asthma.2.ERK1, PERK1, Ras expression in airway remodeling in rats were increased, spleen and lungs and Phlegm Party after use, the three expression were significantly reduced.Show ERK1, PERK1, Ras in airway remodeling work, spleen and lungs and Phlegm down side by ERK1, PERK1, Ras achieve suppression of airway remodeling.3. Asthma remission by the strengthening spleen nourishing lung reducing phlegm prescription can improve the overall efficacy in children after treatment, to improve lung function in children with primary efficacy endpoint, so TCM symptom score decreased, suggesting that the clinical efficacy of treatment regimens asthma control is remarkable. |
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