Xu Yanling 's Experience And Experimental Study On Treatment Of COPD From Kidney And Excavation Based On Discipline And Discrimination

Purpose:Summarize the thoughts of professor Yanling Xu about chronic obstructive pulmonary disease(COPD) syndrome differentiation and treatment of academic.Material and method:Tutor academic thoughts on COPD are influenced by the understanding of TCM viscera-state doctrine and combine traditional Chinese and western medicine. This paper elaborates tutor to gas ideological understanding, combine traditional Chinese and western medicine Zang-Xiang doctrine should be in clinical curative effect in order to further raises about characteristics and treatment of COPD pathogenesis, treatment.Results:1. Chronic obstructive pulmonary disease with virtual, the basic pathogenesis of factors,partial failure of Yin and Yang, disorder of qi activity, phlegm retention v, system mechanism with two lung kidney empty is given priority to, and thus leads to the symptoms of cough,phlegm, asthma group. With five Zang-organs and pathogenesis of lungs kidney deficiency as the core, outstanding about kidney empty place in understanding and treating diseases.2. The principle of Chronic obstructive pulmonary disease treatment to cure this disease are seek medical treatment, combined the centralizer exorcism, sober and pathogenesis.3. Treatment of chronic obstructive pulmonary disease characteristics include: key to treat virtual, lung spleen and kidney, with emphasis on kidney; Fill gas first, Xuan homology, SOP manage lung qi activity; Pathogenesis, ideas are gradually plan, remove is for; Compound method of achieving, medicine in the turn, the law on one side.Conclusion:1. Mentor to gas viscera-state theory concept learning, the combination to understanding disease, to treat is embodied in the gas first, value for the upright.2. Combine traditional Chinese and western medicine clinical research should still in order to solve the clinical practical problems, improve the clinical curative effect for primary purpose,in determining the effective can be below the premise of experimental study of the mechanism. Chinese and western medicine should be combined disease and highlight the features and advantages of Chinese medicine cure the disease.3. Chronic obstructive pulmonary disease with virtual, for the virtual nature, kidney empty in the disease process and treatment are important.Purpose:To observe the TGF-β1/Smads signal transduction pathway in the development of COPD, and to explore the partial mechanism of Xuchuanfangin the treatment of COPD.Material and method:60 SPF male Wistar rats were randomly divided into control group, model group, aminophylline group, low dose of xuchuanfang group, medium dose of xuchuanfang group and high dose of xuchuanfang group, 10 rats in each group. The rat model of COPD was replicated by instillation of lipopolysaccharide through air tube combined with continuoussmoking. Observe the general condition of rats; HE stainingwas used to observe the pathological changes of lung tissue of rats; IL-1β、IL-8、IL-6 levels of lung tissue were detected by enzyme-linked immunosorbent assay(ELISA); the expression levels of TNF-α、NF-κB oflung tissue were detected by immunohistochemical method; The TGF-β1 level of lung tissue was detected by immunofluorescence method;the expression levels ofp-Smad2、p-Smad3 and Smad7 were detected by Western-blot method;the expression levels of TNF-α、NF-κB、TGF-β1、Smad2、Smad3、Smad7 m RNA were detected by RT-PCR.Results:1. The rats were showed cough, increasing respiratory frequency, dispirited, pale yellow and withered hairs, weight loss, skin relaxation and such phenomena in the model group gradually.The rats in the other groups were taking a turn for the better with different degrees, especially aminophylline group and high dose of Xuchuanfang group.2. It could be seen uniformalveolar, moderatethickness of alveolar and no inflammatory cells infiltration in the control group. However, it could be seen thickening alveolar wall, uneven alveolar and a large number of inflammatory cellsinfiltrations in the model group. In the treatment group, the pathological changes of lung tissue were eased with different degrees in the treatment groups, especially aminophylline group and high dose of Xuchuanfang group.3. The levels of IL-1β、IL-8、IL-6 of lung alveolar irrigation lotion weresignificantly increased in other groups than control group(P < 0.01); the levels of IL-1β、IL-8、IL-6 weresignificantly decreased in the treatment groups than model group(P < 0.01 or 0.05); the levels of IL-1β、IL-8、IL-6 were significantly increased in low dose of Xuchuanfang group than aminophylline group(P < 0.01 or 0.05), the level of IL-6 were significantly increased in medium dose of Xuchuanfang group than aminophylline group(P < 0.01 or 0.05).4. The expressions of TNF-α、NF-κB proteins of lung tissue were in a very low level,occasionally positive expression cells in the control group. And TNF-α、NF-κB proteins showed strong positive expression in model group. According to average optical density,the expression levels of TNF-αand NF-κB were the highest in the model group, but down regulated in the treatment groups, the low dose of Xuchuanfang group had no significant difference compared with the model group, there were no significant difference among aminophylline group and high, medium dose of Xuchuanfang groups.5. The TGF-β1 protein showed low expression level in the control group with little green fluorescence positive cells. The TGF-β1 protein showed strong expression level in the model group with a large amount green fluorescence positive cells In model group, and the TGF-β1protein expression was down regulated in the treatment groups except low dose of Xuchuanfanggroup, there were no significant difference among aminophylline group and high,medium dose of Xuchuanfang groups.6. The p-Smad2 and p-smad3 expression levels were lower and Smad7 was in higher expression level in control group than model group(P < 0.01); The p-Smad2 and p-smad3 expression levels were lower and Smad7 expression was higher in aminophylline, high and medium dose of Xuchuanfang groups than model group(P < 0.01 or 0.05); there was no significant difference between aminophylline group and high dose of Xuchuanfang group.7. The expression levels of TNF-α、NF-κB、TGF-β1 m RNA were significantly decreased in control and treatment groups than model group(P < 0.01); there was no significant difference between aminophylline group and high dose of Xuchuanfang group.8. The expression levels of Smad2, Smad3 m RNA were lower and Smad7 m RNA were higher in control and treatment groups than model group(P < 0.01); there was no significant difference between aminophylline group and high dose of Xuchuanfang group.Conclusion:1. TGF-β1/Smad signal transduction pathway is related to the pathological changes of COPD.2. Xuchuanfang can treat COPD through inhibiting inflammatory factors, inhibiting the phosphorylation of Smad proteins, regulating the expression level of Smadm RNA to regulate the TGF-β1/Smad signal transduction pathway.Purpose:To explore contemporary evidence on chronic obstructive pulmonary disease element of traditional Chinese medicine syndrome differentiation and drug laws.Material and method:By Liaoning Chinese medicine university Chinese hownet database in the library electronic journal database(CNKI), WANFANGDATA,Weipuzhongwen sci-tech journal database(VIP) in chronic obstructive pulmonary disease,COPD" for the title or keywords retrieval, for the first time to" Chinese medicine ", "Chinese medicine", "clinical" as a title or keywords for the secondary retrieval. Included into the standard literature, literature of syndrome after entry Excel spreadsheet name, name of drug specification, forensics syndrome elements. Using SPSS19.0, SPSSClement12.0 to analyze data.Results:1. Factor analysis results: a total of extract, the disease is a class 3, cumulative frequency10434 times, followed by lung(50.99%), renal(34.54%) and spleen(14.47%). Six types of syndrome factors were extracted disease, cumulative frequency 7711 times, including virtual syndrome factor 5541 times, followed by qi deficiency(64.30%), Yin deficiency(4.05%),Yang deficiency(3.51%). Solid syndrome factor, 2170 times(15.41%), followed by blood stasis phlegm obstruction(11.88%), drugs(0.86%). There were four kinds of disease syndrome factor combination, the total frequency 8145 times, followed by document element(qi deficiency, Yang deficiency, Yin deficiency, 83.02%), double syndrome factor(qi deficiency, phlegm, qi deficiency and blood stasis, blood stasis, poison, blood stasis and phlegm obstruction, 10.31%), 3 card element(qi deficiency, blood stasis and phlegm obstruction, 5.70%), four syndrome factor(qi deficiency, Yin deficiency and blood stasis +phlegm obstruction, 0.97%). Four kind of disease syndrome factor combination according to the factors combination, virtual combination, solid combination is analyzed, followed by virtual combination(83.02%), the factors combination(13.98%), solid(3.00%). To contain more than one kind of disease of syndrome factor combination analysis of association rules,set support 30% or higher, the confidence level 80% or higher, concluded four association rules, qi deficiency respectively to phlegm obstruction and blood stasis, blood stasis, phlegm obstruction of qi deficiency, blood stasis and phlegm obstruction, deficiency and phlegm obstruction.2. Drug use analysis results: altogether collected 161 kinds of drugs, medication, 2335 times in more than 13% of drug use frequency, a total of 36, accounting for 22.37% of the total number of drugs, the 36 flavor drug medication total frequency of 1667 times, 71.39% of the total. Excess or insufficiency of 16 classes involved drugs, drug use frequency is highest,tonify deficiency, phlegm cough antiasthmatic, huoxue quyu medicine, medicine, and qi,nourish the medicine 6 drugs cumulative frequency of 80.55%. Mend a virtual medicine mainly concentrated in the Yang, qi, Yin tonic. Based on association rules, set support degree is 15% or higher, the confidence level is 80% or higher, to correlation analysis of 161 flavor drug, drug combinations in the 2 groups. Set support 10% or higher, the confidence level is80% or more, get 32 combinations of three ingredients. Set support 10% or higher, the confidence level is 80% or higher, received 42 three ingredients group. To cluster analysis of161 flavor drug, poly three categories:(1) atractylodes, poria cocos, dried tangerine or orange peel, pinellia, codonopsis, radix ophiopogonis, ginseng, Chinese yam, schisandra fruit,astragalus root, malaytea scurfpea fruit;(2) the salvia miltiorrhiza, lumbricus;(3) the peach kernel, angelica, Perilla seed, almond, white mulberry. Poly(five types:(1) the atractylodes,poria cocos, dried tangerine or orange peel, pinellia, dangshen;(2) the dwarf lilyturf, ginseng,Chinese yam, fructus schisandrae, radix astragali, malaytea scurfpea fruit;(3) the salvia miltiorrhiza, lumbricus;(4) peach kernel, angelica,(5) the Perilla seed, almond, white mulberry.Conclusion:1. COPD plateau disease syndrome factor for lung, kidney, spleen, a single virtual venereal sex syndrome factor and virtual sex syndrome factor combination frequency greater than the actual sexual syndrome factor and its combination, prove essential for COPD, "virtual" can be a programmatic Qi brought other syndrome elements. Qi deficiency in pathological products such as phlegm turbidity and blood stasis, has a key role in the formation of COPD disease for a long time, as an image of blood stasis, factors. 2. In drug test certificate, can be found that the treatment of COPD stabilization focus on the characteristics of the stability of this deficiency disease, mainly to notify deficiency of treatment should pay equal attention to benefit the lung and spleen qi and kidney Yin and Yang. Pharmaceutical analysis result confirms the COPD total belong to this virtual to real,factors, the stability is given priority to with qi deficiency, lung spleen kidney damage, the real include phlegm retention, blood stasis. Treatment is given priority to with the centralizer,and eliminating phlegm and activating blood and(or) clear heat, spleen, etc.