Retrospective Analysis And Experimental Study On Treatment Of Chronic Obstructive Pulmonary Disease With Chinese Medicine Granules

Objective1 Retrospectively analyze the clinical effects and differences of traditional Chinese medicine formula granules and decoction pieces in the treatment of chronic obstructive pulmonary disease,and evaluate the effectiveness,safety and economic indicators of the two.2 Comparison of the effect and mechanism of Chinese medicine granules and decoction on COPD model rats,so as to provide experimental basis and basis for clinical application of traditional Chinese medicine granule.Methods1 Clinical TrialDesign a COPD clinical retrospective questionnaire to collect COPD patients in our hospital from January 2016 to December 2020.According to the different types of Chinese medicines,the cases were divided into granule group and decoction piece group.The general situation,hospitalization days,hospitalization expenses,TCM syndromes,composition of traditional Chinese medicine,Chinese and Western medicine treatment and related therapeutic indexes of the two groups were observed,and the clinical therapeutic effects of the two kinds of traditional Chinese medicine formulations were analyzed and compared2 Experimental Research32 SD rats were randomly divided into 4 groups:normal group,model group,experimental group（Liuwei Buqi granule group）and control group（Liuwei Buqi decoction group）,with 8 rats in each group.Except for normal group,the other 3groups were established COPD model of lung qi deficiency by passive smoking combined with intratracheal instillation of LPS.From the 15th day of modeling,rats in the normal group and the model group were given normal saline 10ml/kg·d.The experimental group and the control group were given Liuwei Buqi granules and Liuwei Buqi decoction respectively,and the doses were both 0.5g/kg·d,once a day.All the above groups were given continuous administration for 14 days.After treatment,observe the general condition of each group of rats,pulmonary function,lung histopathological changes,and detect serum inflammatory cytokines expression of IL-1β,IL-6,IL-10,NF-κB.Results1 Clinical Trial1.1 General situationThe study included 306 cases,95 in granule group and 211 in decoction group.There was no significant difference in general situation of sex,age,course of disease,hospitalization days,smoking history and severity of disease between the two groups.1.2 Distribution of TCM Syndrome TypesPhlegm heat stagnation of lung syndrome,phlegm dampness accumulation of lung syndrome and phlegm stasis obstructing lung syndrome were the most common syndromes of COPD in the two groups,followed by phlegm turbidity obstructing lung syndrome,lung and kidney deficiency syndrome and lung qi deficiency syndrome.The distribution of TCM syndromes in the two groups was similar,and there was no significant difference.1.3 Rules of prescription administrationThe two groups of patients with high frequency of use were cough and asthma drugs,heat clearing and phlegm resolving drugs,Qi tonifying drugs,Yin tonifying drugs and dispersive wind cold drugs.The comparison of high frequency drug use between the two groups showed that P>0.05,and there was no significant difference between the two groups.The results of association rules showed that 7 and 6 of the top 10 drug groups with high support of two association rules and three association rules were the same.The commonly used drug pairs in granule group and decoction group were the combination of clearing away heat and resolving phlegm and relieving cough and asthma.1.4 Curative effect of TCM syndromesThe total effective rate of TCM syndrome in traditional Chinese medicine granules group was 87.37%,and that in decoction group was 88.18%.There was no significant difference between the two groups.1.5 Pulmonary function resultsCompared with before treatment,FEV₁,FVC and FEV₁/FVC indexes of pulmonary function in the two groups were improved after treatment with traditional Chinese medicine granules and decoction pieces,and the difference was statistically,and the improvement degree of pulmonary function in the two groups was similar,and there was no significant difference.1.6 Related inflammation indicatorsAfter treatment,there was no significant difference in WBC,NEU-P,EOS,LYM and CRP indexes between the two groups,while decoction was slightly better than formula granule in improving ESR index,the difference was statistically significant.1.7 Blood gas analysisAfter treatment,there was no significant difference in p H value between the two groups,and the detection values of PO₂,PCO₂and Sa O₂in the two groups were significantly improved compared with those before treatment.Although the difference of Sa O₂between the two groups was statistically significant,the results were within the normal range.1.8 Average cost of Chinese medicineThe average cost of Chinese medicine formula granules was 48.33%±21 yuan,and the average cost of traditional Chinese medicine decoction was 27.35 yuan±16（yuan）,the formula granule was significantly higher than the traditional Chinese medicine Pieces（about 20 yuan）,the difference between the two groups was statistically significant.1.9 Safety evaluationThis study showed that after oral administration of traditional Chinese medicine granules and decoction pieces,the two groups of patients had no obvious abnormalities in routine urine and stool,coagulation function,liver and kidney function,and no adverse reactions occurred during hospitalization.2 Experimental Research2.1 Pulmonary functionCompared with the model group,the pulmonary function parameter FEV_0.3,FVC,FEV_0.3/FVC levels of rats in the Liuwei Buqi granules group and the decoction group were significantly increased,and the difference was statistically different;the Liuwei Buqi granules group and the decoction group increased significantly.There was no significant difference between them.2.2 Lung tissue pathologyCompared with the model group,the Liuwei Buqi granule group and the decoction group have reduced lung tissue damage,reduced airway inflammatory cell infiltration,reduced mucosal damage,reduced smooth muscle layer and basement membrane thickening,and reduced alveolar space slightly damaged.2.3 Serum inflammatory factorsCompared with the model group,the levels of IL-1β,IL-6 and NF-κB in the Liuwei Buqi granules group and the decoction group significantly decreased,and the IL-10 increased significantly;There is no significant difference between the Liuwei Buqi granules group and the decoction group.Conclusion1 Based on the retrospective analysis of clinical cases and the verification of animal experimental mechanisms,studies on the treatment of COPD with traditional Chinese medicine formula granules and decoctions have shown that traditional Chinese medicine has a definite effect in the treatment of COPD.2 The formula granules and the decoction pieces decoction have the same effect in improving the lung function,inflammation and hypoxia state of COPD patients.There is no significant difference between the two.Because the granules are portable and convenient,the patients are easier to accept,and they are worthy of clinical application in Chinese medicine.3 Chinese medicine formula granules and decoction pieces decoction have obvious improvement effects on lung tissue pathological damage,pulmonary function,and chronic airway inflammation in COPD rats,laying an experimental basis for the clinical promotion and application of Chinese medicine formula granules.