Effects Of Different Doses Of Huangqi In Buyang Huanwu Decoction On TGF-β1,VEGF And PEDF In Rats With Pulmonary Fibrosis And Clinical Study

Objective: Pulmonary fibrosis is the final stage of many interstitial lung diseases.Buyang Huanwu decoction is a classic prescription in Yi Lin Gai Cuo.It has been used in the treatment of pulmonary fibrosis in recent years,but the dosage of Huangqi is controversial.In this study,the animal experimental part studies the effects of different doses of Astragalus in Buyang Huanwu decoction on TGF-β1,VEGF,PEDF,etc.in rats with pulmonary fibrosis,in order to explore the best dose of Astragalus in the Buyang Huanwu decoction for the treatment of pulmonary fibrosis;In the clinical part,Buyang Huanwu decoction with the most suitable dosage was selected to explore the clinical efficacy and safety of Buyang Huanwu decoction in the treatment of idiopathic pulmonary fibrosis.Methods: 36 SD rats were randomly divided into 6 groups: blank group,model group,pifenidone group(162mg/kg),Buyang Huanwu decoction group(7.56g/kg),Buyang Huanwu decoction group(10.26g/kg)and Buyang Huanwu decoction group(15.66g/kg).Serum TGF-β1,VEGF,PEDF and PDGF were detected by ELISA method.The levels of TGF-β1 and Smad3 protein in lung tissue were detected by Western blot,and the levels of TGF-β1 mRNA and VEGFmRNA were detected by q PCR.Clinical part: patients with idiopathic pulmonary fibrosis who met the inclusion and exclusion criteria were randomly divided into two groups.The control group was treated with pirfenidone capsule and the experimental group was treated with pifenidone combined with Buyang Huanwu decoction(Huangqi 60g).The effect was observed after12 weeks of treatment.Results: in the experimental part,Buyang Huanwu decoction(Huangqi30g)could significantly down-regulate the levels of serum VEGF,PDGF,TGF-β1,Smad3 and TGF-β1mRNA in rats,but had no obvious effect on the expression of lung VEGFmRNA and serum TGF-β1 and PEDF.Compared with Buyang Huanwu decoction(Huangqi 30g),Buyang Huanwu decoction(Huangqi 60g)and Buyang Huanwu decoction(Huangqi 120g)could significantly down-regulate the levels of serum TGF-β1,VEGF and PDGF,up-regulate PEDF,and down-regulate the levels of TGF-β1,Smad3 and TGF-β1mRNA and VEGFmRNA in lung tissue of pulmonary fibrosis rats,but there was no significant difference between the two groups.Clinical part: after treatment with Buyang Huanwu decoction(Huangqi 60g),DLCO%,FVC,6MWT,TCM syndrome score,total SGRQ score and total effective rate of treatment in the control group were significantly better than those in the control group,and the incidence of adverse reactions in the control group could be reduced.Conclusion: Buyang Huanwu decoction can exert the greatest therapeutic effect on pulmonary fibrosis when the dosage of Huangqi is 60 g and 120 g,and its mechanism may be related to TGF-β1,VEGF,PEDF and other factors.Huangqi(60g)can improve the symptoms of patients with idiopathic pulmonary fibrosis,delay the decline of pulmonary function and activity endurance,and reduce the side effects of western medicine.