Clinical Study On Treatment Of Idiopathic Pulmonary Fibrosis With Shizaotang And Its Effect On Expression Of COL Ⅰ And FN

Objective:To investigate the clinical efficacy of Shizaotang in the treatment of IPF,and to investigate the effect of Shizaotang on Col I and FN expression in rat models through animal experiments,and to explore the anti-fibrosis mechanism of shizao decoction.Methods:Methods:Clinical observation:48 cases of IPF patients were randomly divided into control group and treatment group,with 24 patients in each group.The control group was treated with acetylcysteine(Fluimucil),and the treatment group was treated with Shizaowan on the basis of the treatment in the control group.The treatment course was observed for 8 weeks,and the changes of the total score of TCM symptoms and the score of dyspnea scale were observed before and after.Animal experiment:96 male SPF-grade SD rats were selected and the rat pulmonary fibrosis model was established by endotracheal intubation with bleomycin.The rat models were interfered with pirfenidone,Shizaotang,low,medium,high dose,and normal saline respectively,and the blank control group was set up.The rats were sacrificed on the 14th and 28th days after the model establishment.The right lung was taken and the pathological changes of the lung tissue were observed under light microscope.The left lung was taken and the expressions of COL Ⅰ and FN were determined by ELISA.Results:1.Clinical observation:After 8 weeks of treatment,the scores of TCM symptoms in patients were significantly lower in the treatment group than in the control group(P<0.05).Comparison of dyspnea scale score:the score of the treatment group was lower than that of the control group,with a significant difference(P<0.05).2.Animal experiment:On the 14th and 28th days after modeling,there was a significant difference in the concentration of COL Ⅰ between the groups,with the lowest concentration in the blank group and the higher concentration in the model group than in the low,medium and high dose groups of Shizaotang and the pirfenidone group(P<0.05).Among them,the concentration in the high-dose group of Shizaotang was lower than that in the pirfenidone group and the low-dose and medium-dose group of Shizaotang,with a significant difference(P<0.05).There was no significant difference in the concentration between the low-dose and medium-dose Shizaotang group and the pirfenidone group(P>0.05).These results suggest that Shizaotang can inhibit the expression of COL Ⅰ in IPF rat lung tissue.14 days after building detection FN concentration,concentration of blank group,model group the highest concentrations,with statistical significance(P<0.05),low dose group of FN Shizaotang concentration higher than pirfenidone group and Shizaotang low,medium and high dose group(P<0.05),Shizaotang medium-dose group with pirfenidone group FN concentration has no obvious difference(P>0.05),but were higher than high dose groups of Shizaotang(P<0.05).On the 28th day,the concentration was the lowest in the blank group and the highest in the model group,which was statistically significant(P<0.05).There was no significant difference in the concentration of FN between the pirfenidone group and the low and medium dose groups of Shizaotang(P>0.05),which was higher than that of the high dose group of Shizaotang(P<0.05).This indicated that Shizaotang could inhibit the expression of FN in IPF rat lung tissue.Conclusion:Shizaotang can alleviate the clinical symptoms of IPF patients and improve their dyspnea.The anti-fibrosis mechanism of Shizaotang decoction may be related to the inhibition of COL Ⅰ and FN expression in animal experiments.