| 1. Clinical research1.1Objective : Through the observation of clinical symptoms, signs, comprehensive clinical effect and improvement of pulmonary function, to explore the clinical efficacy of Jian Pi Bu Fei Hua Tan Fang curing Childhood asthma and provide theoretical basis for curing asthma.1.2Method:A total of 60 cases of children with asthma in outpatient department of pediatrics and inpatient from august 2014 to august 2015 from The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine. They were randomly divided into treatment group(A: western medicine plus Jian Pi Bu Fei Hua Tan Fang group)and control group(western medicine group), with 30 cases of each group. After3-month treatment, the TCM syndrome scores, the comprehensive effect and the changes of pulmonary function were observed and compared between the two groups.1.3 Results1.3.1 Comprehensive effect: the total effective rate of the treatment group was 90.0%and the control group was 66.7%. After statistical processing, the treatment group compared with the control group(P<0.05), the difference was statistically significant. It indicates the two groups of treatment have effect on childhood asthma, and the treatment group was better than the control group.1.3.2 Pulmonary function: There were no significant differences in PEF, FEV1 and FVC before treatment in two groups(P>0.05), after treatment, the two groups of children with PEF, FEV1 and FVC were significantly improved(P<0.01), and the treatment group pulmonary function was better than the control group.1.3.3 TCM syndrome scores: The syndrome scores of two groups after treatment was lower than before treatment, and the difference was statistically significant(P<0.05).After treatment, the TCM in two groups were statistically significant(P<0.01),indicating that the two group had improved clinical symptoms, and the treatment group was better than the control group.2.Experimental research2.1Objective : By observing the levels of Jian Pi BuFei Hua Tan Fang on VCAM-1,ICAM-1 and VEGF of asthma rats, to investigate the effect of Jian Pi Bu Fei Hua Tan Fang on airway remodeling in asthma.2.2Method:Clean young male 40 rats, randomly divided into 4 groups: normal control groups, model group, Jian Pi Bu Fei Hua Tan Fang group, DXM group, each group of 10.After 7 days of adaptive feeding,the model of asthma was established By intraperitoneal injection of freshly prepared OVA(OVA100mg,Al(OH)3 100 mg) on first day and eighth day to sensitization rats, normal group was replaced by normal saline. From fifteenth days, asthma groups atomization inhalation 1% OVA to stimulate asthma, every other day, atomization flow 5ml/min, 30 minutes each time, normal group was replaced by normal saline, total 8 weeks. At the same time, each group was treated with different drugs for 8 weeks. Observing the general condition and lung index of each group and testing the levels of VEGF, ICAM-1 and VCAM-1in arterial blood by use of ABC-ELISA method.2.3 Results2.3.1 General condition: After atomization excitation, the rats in normal group were full of spirit and energy, sleek fur, smooth breathing, agile activity, normal diet and gained obviously in weight. Other groups of rats showed restlessness, scratching, licking the body, sneezing, always on the move. The model group challenged soon after inhalation,the rats showed ecphysesis, restlessness, irritability, mild cyanosis, stool and urine increased, some rats can be heard loud expiratory phase wheezing and irregular breathing. And with the increase of the number of excitation, the symptoms mentioned above were gradually aggravated. The rats fur becoming dry and tarnish, listlessness or unresponsive, weight decline. Compared with model group, the symptoms of the Jian Pi Bu Fei Hua Tan Fang group and DXM group were slight relief. The rats had no cyanosis and expiratory phase wheezing, only showed restlessness and mild shortness of breath. Their gloss and spirit were better, but slightly worse than the normal group.2.3.2 Lung weight,bodyweight and the lung index:There were no differences in lung weight rats in each group(P>0.05). Compared to the normal weight group,there was significant difference between model group and DXM group(P<0.01). There was no significant difference between the normal group and the Jian Pi Bu Fei Hua Tan Fang group(P>0.05). The weight of the DXM group and the Jian Pi Bu Fei Hua Tan Fang group has difference(P<0.05)。compared with the the normal group, the lung index of the model group and the DXM group was significantly different(P<0.01). There was no significant difference of the lung index between the normal group and the Jian Pi Bu Fei Hua Tan Fang group(P>0.05). The lung index between the DXM group and the Jian Pi Bu Fei Hua Tan Fang group has different(P<0.05).2.3.3 Serum: The levels of VCAM-1、ICAM-1 and VEGF were higher in the asthma groups than in the normal group. Jian Pi Bu Fei Hua Tan Fang group and DXM group were lower than model group and the difference was statically significant(P<0.01). There was no significant difference between Jian Pi Bu Fei Hua Tan Fang group and DXM group(P>0.05).3. Conclusion3.1 Jian Pi BuFei HuaTan Fang can improve the clinical symptoms and signs, the pulmonary function and clinical efficacy of children with asthma.3.2 Jian Pi BuFei HuaTan Fang can reduce the level of serum VCAM-1 、 ICAM-1 and VEGF in asthmatic rats. It suggests that the mechanism of Jian Pi Bu Fei Hua Tan Fang treating asthma may be to improve airway inflammation and inhibit airway remodeling. |
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