| Objective1、To comparative analysis of the clinical efficacy of western medicine and traditional Chinese and western medicine in the treatment of bronchial asthma, explore the advantages of Chinese medicine in the treatment of bronchial asthma.2 、 To investigate the effects of Yanghe Pingchuan Granules on the pathological changes, pulmonary function changes, IL-17, TNF-α and IFN- g changes in serum,MUC5 AC and MUC5 B changes in BLAF, the m RNA and protein expression changes of AQP1 and AQP5 in lung tissue and explore the mechanism of Yanghe Pingchuan Granules on treating bronchial asthma from anti-inflammatory, improvement immune function, regulation of water metabolism balance and regulatory airway mucus secretion.Methods1 、 Access to relevant literature and developing the clinical efficacy of asthma questionnaire, compare general information(gender, age and course of disease) and treatment effects of western medicine and traditional Chinese and western medicine on bronchial asthma from the overall effect, improvement in lung function and inflammatory cell changes, respectively. To evaluate the clinical efficacy of western medicine and traditional Chinese and western medicine on bronchial asthma and reveal the advantages of traditional Chinese medicine(TCM) in the treatment of asthma.2、Totally 120 SD rats were randomly divided into normal group, model group, low,medium and high dose groups of Yanghe Pingchuan Graules and dexamethasone group with 20 rats in each group.Intraperitoneal injection of ovum albumin to sensitization(intraperitoneal injection of 0.5m L, each side of the groin injection of 0.25 m L) at the first and 7th day, and aerosol inhalation 1% OVA(every 15 mins, once a day, 14 days) to build models of asthma rat, and used intraperitoneal injection of hydrocortisone to replicate models of kidney-yang deficiency. Meanwhile, the normal group was treated with the same dose saline.On the 28 th day, the low, medium and high dose of Yanghe Pingchuan Graules groups were respectively given intragastric administration of 1.62, 3.24 and 6.48g/Kg,and dexamethasone group was given intragastric administration of 0.5mg/Kg, once a day for 14 days. Meanwhile, the normal group and model group were given intragastric administration with the same amount of saline for same time.After the last administration 24 hours, pulmonary function test apparatus was used to test the changes of pulmonary functions;HE and AB-PAS staining was applied to detect pathology changes of lung tissue and secretion situation of airway mucins;ELISA assay was applied to test the expression of IL-17, TNF-a and IFN-g in serum and the expression of MUC5 AC and MUC5 B in bronchoalveolar lavage fluid;Real-time PCR and Western blot were used to test the m RNA and protein expression of AQP1 and AQP5; Immunohistochemistry was applied to discover the tissue distribution and intensity of AQP1 and AQP5.Results1、Comparison analysis the data of 240 patients with asthma showed that the gender composition, age distribution and course of disease distribution were not statistically different in two groups. Compared with before treatment, both Western medicine and Chinese and western medicine treatment could significantly improve the clinical symptoms of asthma, improve lung function(P<0.01), reduce serum leukocyte content of eosinophils, neutrophils, and CRP(P<0.01), the overall response rate was 88.3% and97.5%,respectively. Compared with Western medicine treatment, the effect of traditional Chinese and western medicine treatment on bronchial asthma was more significant(P<0.01), especially on ameliorating lung function and improving clinical symptoms(P<0.05).2、Pulmonary function test results showed that lung function parameters FVC,FEV1,FEV1/FVC and PEF were significantly lower in model group(P<0.01), and improved after treatment with low, medium and high dose of Yanghe Pingchuan Graules(P<0.05,P<0.01,P<0.01).3、HE staning showed that there was extensive infiltration of inflammatory cells, airway stenosis, enlargement of alveolar space in model group. After treatment with low,medium and high dose of Yanghe Pingchuan Graules and Dexamethasone, the lung tissue morphology structure, airway lumen size significantly restored.4、AB-PAS staining showed that only a little of mucin in alveolar and airway in normal group, while much and mass in model group. Compared with model group, the mucin secretion significantly decreased in low, medium and high dose of Yanghe Pingchuan Graules groups.5、ELISA results showed that the expression of IL-17, TNF-α, MUC5 AC and MUC5 B is significantly higher in model group than in normal group, but IFN- g is obviously lower(P<0.01). Compared with model group, the levels of IL-17, TNF-α, MUC5 AC and MUC5 B decreased notably after treated with low, medium and high dose of Yanghe Pingchuan Graules groups, while IFN-g levels increased(P<0.05,P<0.01,P<0.01).6 、 Real-time PCR and Western blot results showed that the m RNA and protein expression of AQP1 and AQP5 in model group was significantly lower than in normal group(P<0.01). Compared with model group, the expression of AQP1 and AQP5 highly increased after treated with low, midium and high dose of Yanghe Pingchuan Granules groups(P<0.05, P<0.01, P<0.01).7 、 Immunohistochemistry showed that AQP1 was expressed on the epical and basolateral membranes of micro-vascular endothelial cells, including in both capillary and submucosal micro-vessels of the upper and lower airways and in the apical membranes of type Ⅱalveolar epithelia; AQP5 was distributed on the luminal side of the bronchial epithelia and in the apical membranes of type Ⅰ alveolar epithelia.Meanwhile, the results show that compared with normal group, the number of positive cells of AQP1 and AQP5 significantly decreased in model group(P<0.01); Compared with the model group, the number of positive cells of AQP1 and AQP5 was significantly increased in each treatment groups(P<0.05,P<0.01,P<0.01).Conclusions1、TCM treatment could significantly improve the clinical symptoms with asthma by individual therapy and improve the clinical efficacy of asthma.2、Yanghe Pingchuan Granules could reduce the inflammatory cell infiltration, improve immunity, regulate the airway mucus secretion and achieve results of treatment of bronchial asthma. |
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