Lung And Spleen As The Core Of The Whole Heart And Viscera, A Study On The Immune Regulation Of Chronic Persistent Bronchial Asthma Based On Syndrome Differentiation

ObjectiveBased on the research results of the traditional Chinese medicine intervention program for the chronic duration of bronchial asthma(CDBA),the well-controlled rate of WRFG(Wen run formula group)is 75.44%,which is significantly better than the well-controlled rate of RSDG(Routine syndrome differentiation group)of 48.33%.This study further used molecular biology research to prove that the traditional Chinese medicine intervention thinking that Syndrome differentiation of viscera with lung and spleen as the core "fully reflects the advantages and characteristics of traditional Chinese medicine in the treatment of CDBA.To construct a biological basis for CDBA immunoregulation based on "Syndrome differentiation of viscera with lung and spleen as the core ".MethodsThis research work is mainly based on the subject-CDBA TCM(traditional Chinese medicine)intervention program,respectively in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine,and China Academy of Chinese Medical Sciences,Xiyuan Hospital and other four research centers have carried out clinical practical randomized controlled superior-effect design studies in the same period,multi-center,randomized,controlled,and triple-blind.A series of prescriptions based on the principle of "wenrun xinjin peiben"(referred to as Wenrun Formula)formed under the guiding ideology of "Syndrome differentiation of viscera with lung and spleen as the core" is a traditional Chinese medicine intervention plan.A total of 128 cases meeting the requirements of the study were enrolled,and the included cases were randomly divided into Wenrun Formula Group(WRFG)and Routine Syndrome Differentiation Group(RSDG).In order to further observe the distribution characteristics of serum immunoglobulin and interleukin lineage before treatment,and the trend of serum immunoglobulin and interleukin lineage change after treatment.A second screening was carried out on the enrolled patients who met the requirements.At the same time,recruit healthy people as a healthy control group(HG),and collect the subjects' serum samples.ELISA competitive detection method was used to detect serum samples,and to carry out the immunoregulation study of adjusting the serum immunoglobulin and serum interleukin levels in the treatment of CDBA with "Syndrome differentiation of viscera with lung and spleen as the core".Results1 Cases information analysisIn this study,based on the current number of serum cases in each group,combined with the inclusion and exclusion criteria,24 cases of WRFG,14 cases of RSDG,and 14 cases of HG were determined to be included.In the comparison of TCM single symptom and sign score and total TCM symptom and sign score before treatment between WRFG and RSDG groups,only waist and knee soreness 1(1,2)(WRFG)and 0(0,1)(RSDG)had significant statistical differences.There was no significant difference in other single TCM symptoms and signs and the total score of TCM symptoms and signs;there was no significant difference in the total scores of TCM single symptoms and signs after treatment between the WRFG and RSDG groups;patients in the WRFG group In the comparison of the scores of individual symptoms and signs of TCM before and after treatment and the total scores of TCM symptoms and signs,Wheezing,fatigue,dry mouth,palpitation,dizziness,chilly limbs,waist and knee soreness,cough,cough nature,expectoration,total score have statistically significant differences.Other individual symptoms and signs of TCM have a downward trend,but there is no significant statistical difference;in RSDG group,there were significant differences in the scores of TCM symptoms and signs before and after treatment,such as shortness of breath,fatigue,dry mouth,chilly limbs,cough,cough nature,total score.Compared with RSDG,WRFG had lower scores in wheezing,bitter mouth,dry mouth,palpitation,numbness,abdominal distension,thirst,irregular stool,frequent nocturia,dizziness,soreness of waist and knee,and total score of TCM.There was no significant difference in FEV1%FVC and PEF%between WRFG and RSDG before and after treatment.2 Serum immunoglobulin2.1 Comparison between groups before treatmentWRFG serum IgA and IgG levels are lower than RSDG and HG,with statistical differences.The serum IgE level of WRFG was not statistically different from RSDG,and was lower than that of HG,with statistical differences.RSDG serum IgA,IgG,IgE levels were not statistically different from HG.2.2 Comparison between groups after treatmentThe serum IgA and IgG levels of WRFG were not significantly different from those of RSDG and HG.The serum IgE level of WRFG is higher than RSDG,with statistical difference,but not statistically different from HG.RSDG serum IgA,IgG,IgE levels were not statistically different from HG.3 Serum pro-inflammatory interleukins3.1 Comparison between groups before treatmentWRFG serum IL-1?,IL-2,IL-5,IL-7,IL-8,IL-13,IL-20,IL-25,IL-36y levels were lower than RSDG and HG,with statistical differences.WRFG serum levels of IL-3,IL-4,IL-6,IL-9 IL-33,were not statistically different than RSDG,and lower than HG,with statistical differences.RSDG serum IL-1?,IL-7,IL-8,IL-9,IL-13,IL-20,IL-25,IL-33,IL-36y levels were not statistically different from HG.RSDG serum IL-2,IL-3,IL-4,IL-5,IL-6,and levels were lower than HG,with statistical differences.3.2 Comparison between groups after treatmentWRFG serum IL-1?,IL-4,IL-5,IL-6,IL-7,IL-9,IL-33,IL-36? levels were not statistically different from RSDG,but lower than HG,with statistical differences.WRFG serum IL-2,IL-3,IL-8,IL-13,IL-20,IL-25 levels were not statistically different than RSDG and HG.RSDG serum IL-1?,IL-3,IL-7,IL-8,IL-13,IL-20,IL-33 levels were not statistically different from HG.RSDG serum IL-2,IL-4,IL-5,IL-6,IL-9,IL-25,IL-36? levels were lower than HG,with statistical differences.4 Serum anti-inflammatory interleukin4.1 Comparison between groups before treatmentWRFG serum IL-10,IL-21,IL-27,IL-28A,IL-35,and levels are lower than RSDG and HG,with statistical differences;serum IL-29 level of WRFG is lower than that of RSDG,with statistical difference,and no statistical difference compared with HG;serum IL-12 and IL-37 levels are higher than RSDG No statistical difference,lower than HG,with statistical difference.RSDG serum IL-10,IL-12,IL-21,IL-27,IL-28A,IL-29,IL-35,IL-37 levels were not statistically different than HG.4.2 Comparison between groups after treatmentWRFG serum IL-10,IL-12,IL-21 levels were not statistically different than RSDG,and lower than HG,with statistical differences;WRFG serum IL-27,IL-29,IL-35,and IL-37 levels were higher than RSDG There is no statistical difference between HG and HG;WRFG serum IL-28A level is lower than RSDG,with statistical difference,and there is no statistical difference compared with HG.RSDG serum IL-10,IL-12,IL-21,IL-27,IL-28A,IL-29,IL-35,IL-37 levels were not statistically different from HG.Conclusion1 The WRFG group has obvious advantages in improving wheezing,coughing,uncomfortable sputtum expectoration,fatigue,dry mouth,palpitations,dizziness,waist and knee weakness,total score and other systemic symptoms and signs in asthma patients.It embodies the advantages and characteristics of WRFG "Syndrome differentiation of viscera with lung and spleen as the core",and the overall diagnosis and treatment of CDBA.2 After WRFG treatment,the levels of serum immunoglobulin,serum pro-inflammatory and anti-inflammatory interleukins increased and were close to the levels of healthy people.It may be possible that the Wenrun formula reduced the basic pathological damage of chronic airway inflammation in asthma patients,and caused local airway inflammation in asthma patients.The increased tolerance to higher serum pro-inflammatory interleukin levels improves the airway's immune defense and repair capabilities against injury factors.3 There are many kinds of immune cells and cell components involved in the pathological changes of chronic airway inflammation in the CDBA.Inflammation and immunity participate in the micro pathological changes of the macro performance of the disease.On the contrary,the imbalance of inflammation and immune regulation in different micro levels affects the evolution of TCM asthma pathogenesis in macro level.There is a key common law of pathogenesis in CDBA,which is "lung and spleen as the core,multiple viscera deficiency"Based on a comprehensive and objective understanding of the relationship between viscera and pathogenesis of chronic persistent bronchial asthma,the holistic concept of traditional Chinese medicine and viscera syndrome differentiation is inherited,developed and applied.The holistic concept of "lung and spleen as the core" is emphasized to reveal the pathogenesis of asthma.