| 1 Retrospective Study 1.1 Objective: By exploring the distribution regularity on hidden wind stagnation and lodge phlegm syndromes of children in acute phase of asthma who were at the age of 5 to 14 by retrospective study to explore the tutor’s new understanding of “hidden wind stagnation and lodge phlegm” pathogenesis.Lay the foundation for clinical and experimental research.1.2 Methods: According to the tutor’s new understanding of “hidden wind stagnation and lodge phlegm” pathogenesis,formulate the judgment standards for the syndromes of “hidden wind stagnation and lodge phlegm” by referring to relative literatures,draft asthmatic children information statistics table in order to investigate the medical records of children with asthma in the First Affiliated Hospital of Henan University of traditional Chinese medicine from June 2013 to June 2016,according to the diagnostic and exclusion criteria,116 cases were enrolled,then fill in the questionnaire according to the original medical record,to analysis the main risk factors of asthma and the distribution of syndrome of hidden wind,stagnation and lodge phlegm.1.3 Results: 116 cases of children with asthma in acute phase 87 cases were boy(75.0%),girls 29 cases(25.0%),predisposing factors in 86 cases of respiratory tract infection(74.1%),with a history of eczema of the 45 cases(38.7%)and rhinallergosis of the 36 cases(31.0%),adherence to the guidelines for the prevention and treatment of childhood asthma were only 21(18.1%),116 cases conform to the syndrome of hidden wind(100.0%),115 cases conform to the syndrome of lodge phlegm(99.1%),85 cases conform to the syndrome of stagnation(73.3%),115 cases conform to the syndrome of hidden wind and lodge phlegm(99.1%),85 cases conform to the syndrome of hidden wind and stagnation(73.3%),84 cases conform to the syndrome of lodge phlegm and hidden wind(72.4%),84 cases conform to the syndrome of hidden wind,stagnation and lodge phlegm(72.4%).All of the 115 children,who were treated with TCM,drugs for relieving exterior syndrome,apophlegmatisant and the treatment of cough and asthma were used;In the course of the disease all of them were treated with digestion drugs;heat clearing drugs were used in 108 of them;103 children used drugs for calming liver to stop endogenous wind;There were 17 cases of children taking diuretics for eliminating dampness;There were 36 cases of children in the latter period of treatment with yin tonics;52 children taking Qi medicine;drug for invigorating blood circulation and eliminating stasis were used in 42 children.It is indicated that the treatment of asthma is more forcused on removal of wind,heat,eliminating phlegm and relieving asthma.Only a small number of children are given the product of Qi and blood stasis.Lack of understanding of the theory of hidden wind stagnation and lodge phlegm.1.4 Conclusions: There were gender differences asthmatic children,and most were induced by respiratory tract infection,those who had allergic diseases(especially allergic rhinitis,eczema)more prone to morbidity,the syndrome of hidden wind stagnation and lodge phlegm is 72.4% in the distribution of asthma syndrome,and it proved that " hidden wind stagnation and lodge phlegm " is the key pathogenesis of asthma in children.2 Experimental Study 2.1 Objective: Through animal experiments,we try to find that the improvement of the infiltration of inflammatory cells in lung tissue of asthmatic model rats,the level of VEGF in serum,bronchoalveolar lavage fluid and the expression of VEGF protein and m RNA in lung tissue.And by so doing,explore the new theory of “hidden wind stagnation and lodge phlegm” pathogenesis and the action target of Soufeng Yuchuan decoction,to confirm the new pathogenesis of "hidden wind stasis Lodge phlegm" on asthma which will provide the theoretical foundation for its clinical application in the future.2.2 Methods: Randomly divide the rats into 6 groups: normal control,model of asthma,dexamethasone intervention and Soufeng Yuchuan decoction small dose,middle dose and high dose,there are 10 in each group.Establish the urgent rat model of asthma by intraperitoneal injection of egg albumen sensitization and atomization inspiring.By means of enzyme linked immunoabsordent assay(ELISA)we measured the value of VEGF from serum and bronchoalveolar lavage fluid(BALF),in order to observe changes of the lung’s morphological coloration technique of HE had been adopted,to detect the exploression of VEGF protein by immunohistochemistry(IHC),and measure the m RNA through Reverse transcription polymer method of polymerase chain reaction(RT-PCR).2.3 Results: After excitation,the general condition of Model Group deteriorate,shortness of breath,perioral cyanosis,dull hair,body weight decreased significantly,the treatment group was better than that of the asthma model group;Compared with the normal control group,there was a large number of inflammatory cells infiltration in the lung tissue of asthmatic model group,airway epithelial structure disorder and lumen stenosis,Compared with the model group,the treatment group was better,and the inflammatory cell infiltration in the high and middle dose group were significantly reduced,the arrangement of airway epithelial cells was regular and lumen stenosis symptoms improved significantly.The concentration of VEGF in asthma model rats serum and BALF significantly increased,each group of Soufeng Yuchuan Decoction and dexamethasone group can reduce significantly,at the same time it can reduce the expression of VEGF protein and m RNA in lung tissue,compared with the dexamethasone group,there has no significant difference among the middle and high dose group.(P>0.05),the results showed that both the groups of Soufeng Yuchuan Decoction and the dexamethasone group had an inhibitory effect on VEGF,and the most significant effect was found in the high,middle dose group and dexamethasone group.2.4 Conclusions: ⑴VEGF was over-expressed in the rats model of asthma,and involved in airway remodeling;⑵Soufeng Yuchuan Decoction can improve airway remodeling by regulating the level of VEGF and expression,the effect of middle and high dose group is better;⑶The results show the effectivement of " hidden wind stagnation and lodge phlegm " pathogenesis in the treatment of asthma. |
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