Assessment Of Diagnostic Value Of IOS Detection Technique And Molecular Biological Detection Technique In Patients With CVA And Of Type Of Symptom With CVA

Asthma is one of the most common aetiologies of chronic cough. Cough-variant asthma is considered as an asthma subset. In a subgroup of asthmatics, cough may be the predominant or sole symptom. This condition is referred to as cough variant asthma (CVA). The diagnosis of CVA often presents a challenge since physical examination and spirometric tests may be normal. In this project, we examined the changes of bronchial responsiveness and FEV1 in bronchial relaxation test, type of syndrome and polymorphism of human beta2-adrenergic receptor gene in CVA patients. We try to provide more information to the new diagnosis and treatment strategy of CVA.To observe the objective evidences diagnosing CVA, Maximal expiratory flow-volume curve function testing and impulse oscillation (IOS) testing were completed in bronchial relaxation test. FEV1 and bronchial responsiveness were analyzed in bronchial relaxation test among CVA group and health group and asthma group and non-productive cough group. Bronchial hyperresponsiveness depression and increased FEV1 were found in bronchial relaxation test in asthma group. Moreover, there are significant differences than those of three groups(P<0.01). For CVA, hyperresponsiveness of upper airway (included R20 and R35) was more significantly depressed than that of non-productive cough group and health group(P< 0.01). However, increased FEV1 doesn't clinical significance in CVA group (improvement rate < 15%). For non-productive cough group, bronchial hyperresponsiveness of upper airway wasn't changed in bronchial relaxation test. Up to 68.4% of patients with CVA have associated increased eosinophils (EOS>5%) in peripheral blood. For type of syndrome analysis, we found that the type of pathogenic wind and qi-stagnation was major type of syndrome in CVA group (69.23%). These results suggest that IOS examination in bronchial relaxation test may be regarded as one of routine measures to filtrating pute non-productive cough and CVA.To investigate the association between 16 locus alleles ofβ2-AR genetic polymorphism and CVA, We analyzedβ02-AR genetic polymorphisms by allele specific polymerase chain reaction (AS-PCR) test among health group, asthma group and CVA group. Results showed that the frequency of genotypeβ₂ - AR 16 loci in CVA group: Arg/ Arg was5.26%, Arg/Gly was89.48%, Gly/Gly was5.26%, which was no statistical difference compared with asthma group and healthy control (P > 0.05). There was no significant difference in the allele frequency of CVA compared with asthma control and healthy control group (P > 0.05). These results suggest thatβ2-AR 16 locus genetic polymorphism is not correlated with CVA and asthma.We studied the curative effect using method of nourishing Yin and dispelling wind in treatment of laryngeal cough (type of yin-deficiency and wind-dryness) to explore the key role of differentiation of symptoms and signs for classification of syndrome to CVA. Fifty objects who suffered from laryngeal cough were selected. Thirty in treatment group being given Xuan mai cough instant granule and twenty in control group being given J i zhi syrup. We observed the change of clinical symptoms and airway responsiveness indexes. Results showed that clinical heal rate, notable effective rate, effective rate and inefficiency rate in treatment group respectively were 3.3%, 53.3%, 40%, 3.4% and meanwhile 0%, 5%, 35% and 60% in control group. Data analysis indicated that the curative effect of treatment group significantly higher than that of control group. Leading symptoms, Clinical heal rate, notable effective rate and effective rate were all better than those in control group. Furthermore, indexes of Zrs, R5, R20 and R35 were remarkable reduced in treatment group and the efficacy was better than control group. These results suggest that the method of nourishing Yin and dispelling wind can remarkable relieve a cough. It apparently reduced bronchial hyperresponsiveness. Traditional Chinese Medicine and material medica can play the key role by determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs in the diagnosis and treatment of CVA.Our data reported here indicated that impulse oscillation (IOS) testing in bronchial relaxation test may be regarded as one of objective measures in preliminary diagnosis of CVA. Meanwhile, there is an assisting role combining type of symptom in treatment of CVA. The relation between genetic polymorphism and CVA, such as the correlation between genetic polymorphism and CVA and between genetic polymorphism and the curative in CVA, still remains to be explored after enlarging sample size.