| Objective1.Clinical research: Data mining technology was applied to mine and analyze the tutor’s TCM prescriptions for the treatment of idiopathic pulmonary fibrosis(IPF),summarize the medication rules of dispatching prescription,explore the pathogenesis,treatment and treatment of IPF,provide reference for the clinical treatment of IPF in the future,and provide medication ideas and basis for the next basic experimental research.2.Experimental study: A bleomycin-induced pulmonary fibrosis rat model was used as the research object to explore the anti-pulmonary fibrosis mechanism of Astragalus combined with Epimedium,in order to provide medication basis for clinical treatment of IPF.Methods1.Clinical research: The clinical data of IPF patients treated by the tutor from June 2017 to June 2020 were collected by retrospective study of outpatient cases.A database was established by Microsoft Excel software,which included basic information such as name,gender,age and prescription medication information.Statistical description was conducted to analyze common Chinese medicines and common drugs.With the help of SPSS 21.0 and SPSS Modeler 18.0 statistical software,cluster analysis,association rules and other methods were used to mine the core prescription and core compatibility of tutor’s treatment of IPF,and the results were analyzed,summarized and summarized in combination with tutor’s experience in clinical treatment of IPF.2.Experimental study: 36 rats were randomly divided into blank group,model group,pirfenidone group,low,medium and high dose Chinese medicine(Astragalus-Epimedium)groups,with 6 rats in each group.Except the blank group,the other groups were given bleomycin intravenously to induce pulmonary fibrosis model of rats.The rats were killed 28 days later by intragastric administration of corresponding drugs.Lung tissues were weighed and lung coefficient was calculated.The content of hydroxyproline(HYP)in lung tissue was determined by alkaline hydrolysation.HE staining and Masson staining were used to observe the degree of alveolitis and fibrosis in lung tissues.The expression of core protein of NF-κB signaling pathway in lung tissues was detected by Western Blot.The expression of epithelial-mesenchymal transformation(EMT)related proteinsα-SMA,COL-1 and E-CAD m RNA were detected by fluorescence quantitative PCR.The contents of TGF-β1,IL-1β and TNF-α in serum were measured by ELISA,and the results were statistically analyzed by SPSS statistical software.Results1.Clinical study: A total of 89 cases were included in this study,including 64 males and 25 females.Male patients were more than female patients.The mean age of the patients was 67.54±8.34 years,among which2 patients were under 50 years old and the rest were over 50 years old,accounting for 97.75% of the patients.According to the statistics of the frequency of Traditional Chinese medicine,herba epimedii and Astragalus were the most frequently used,ranking first and second.The high-frequency drugs were classified,and it was concluded that the most commonly used drugs were tonifying drugs.In the application of tonifying drugs,qi drugs and Yang drugs were the core,followed by phlegm-reducing,cough relieving and asthmatic drugs,heat-clearing drugs,water permeating and dampness drugs,wind-chill drugs,blood circulation and stasis removing drugs,etc.Through cluster analysis,common clinical drugs can be divided into two categories,one is mainly tonifying drugs,the other is mainly removing pathogenic drugs;A total of 13 pairs of related drugs were obtained through association analysis,among which Astragalus-Epimedium was the most commonly used combination drug for the treatment of IPF.2.Experimental study: Compared with blank group,lung coefficient and HYP content in model group were increased(P<0.01).HE staining and Masson staining of lung tissue showed alveolitis,fibrosis and collagen deposition in different degrees,indicating successful modeling.Compared with model group,the protein expression of NF-κB,P-NF-κB and P-I κB α in pirfenidone group and low,medium and high dose Chinese medicine groups were down-regulated and the protein expression of IκB α was increased.The expression of α-SMA and COL-1 m RNA was down-regulated and the expression of E-CAD m RNA was increased.Decreased the content of TGF-β1in serum,the differences were statistically significant(P < 0.05).Compared with model group,the expressions of TNF-α and IL-1 β in pirfenidone group,medium and high dose Chinese medicine groups were also decreased,the difference was statistically significant(P<0.05),while the expressions of TNF-α and IL-1β in low dose Chinese medicine group were decreased,but the difference was not statistically significant(P>0.05).Conclusion1.Clinical studies have found that the incidence of IPF is mainly in elderly men,with qi deficiency and Yang decline as the core.In clinical practice,emphasis is paid to the application of tonifying drugs,especially the use of warming and Yang drugs,among which astragalus and Epimedium are the strongest associated drugs of warming and Yang method.2.Astragalus combined with Epimedium can reduce inflammatory infiltration and collagen deposition in lung tissue to a certain extent,and delay the progression of pulmonary fibrosis.The mechanism may be related to its anti-fibrosis effect by inhibiting the NF-κB signaling pathway,and then inhibiting the expression of inflammatory factors and pro-fibrotic factors as well as the EMT process. |
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