Clinical Observation On Treatment Of Bronchiectasis With Spleen - Qingfei Decoction (Spleen Deficiency Syndrome)

1. Research backgroundBronchiectasis is a common chronic lung structural disease. Most of the patients with chronic cough, sputum, clinical and repeated pulmonary infection is the main performance,a few people only presentation of hemoptysis and chest pain. The late stage of the disease may be associated with dyspnea. Bronchiectasis often causing acute exacerbation happening which due to the infection,in the exacerbation time,cough and sputum volume increased significantly,like yellow green purulent sputum,dyspnea increased,different degree high fever and hemoptysis,all of these was the performance of acute period. There is no fever and hemoptysis after the acute exacerbation. The general manifestation is chronic cough, white phlegm. Accompanied by shortness of breath, fatigue, anorexia, anemia and other symptoms, Which were lesser and shortter. Bronchiectasis is persistent airway morphology change.Recurrent pulmonary infection,chronic airway inflammation and lung function were decreased seriously affect the life quality of patients. Repeated hospitalization, antibiotics and other drugs used for a long time, increase the economic burden of patients and society. At present, the exact incidence of bronchiectasis,etiology and pathological mechanism is unclear, compared with other diseases of the respiratory system, the guidelines,relevant test and research data is relatively scarce. The treatment of bronchiectasis is lack of evidence-based guidance,the long-term repeated use of antibiotics and chest physical therapy is the common treatment methods.The repeated use of antibiotics, leading to the emergence of drug-resistant bacteria issues continue to produce and treatment difficulties etc. At the time of remission the methods of prevention and treatment mainly physical treatment,other treatment methods were in the preliminary study stage. In patients with bronchiectasis,addition to the infection factors,there is a close relationship in immune dysfunction, disease severity and acute episodes of infection. Therefore,regulation of immune dysfunction in patients,enhancement of immunity,may be an important and meaningful intervention measures which can improvement life quality of the patients and prevent acute attack.2. Clinical studyObjectiveThrough the observation of Bupi Qingfei decoction in the treatment of chronic, bronchiectasis curative effect of during remission efficacy and the change of immune index, summary and analysis Bupi Qingfei decoction which immune function the effects of patients with bronchial dilation.MethodThis study selected in Xiyuan Hospital from 2014.8 to 2015.3 in the outpatient and inpatient pulmonary disease chronic bronchiectasis remission patients as the research object, depend on the random number table, the patients were randomly divided into 2 groups. Two groups were given anti infection,and other routine western medicine and physical therapy,on the basis of this,experience group treat by Buqi Qingfei decoction.Take the medicine daily a agent,do it for continuous 30 days. Treat the treatment of stage(15 days),and the treatment of late(30 days)as the evaluation point of curative effect,collect FEV1 and the immune index of samples before treatment and 30 days. Statistics the frequency of acute attack and the times of hospitalization,which will the evaluation of long-term efficacy of patients. Data were statistically analyzed using SPSS 20. software.Result:(1)The baseline compared:Totail collected of 62 cases,31 people in experimental group,31 people in control group. The test group loss 1 cases,The control group 1 cases excluded and 1 cases lost. The final statistical analysis is 59 cases,30 people in experimental group,29 people in control group. The experimental group include male 9 cases,female 21 cases, the average age is 57 years old, the average duration isl5years. The control group includes male 8 cases, female 21 cases, the average age is 60 years old, the average course of disease was 11 years. Statistics of two groups of patients respectively gender,age, course of disease,the score before treatment, FEV1, immunoglobulin (IgA、IgG、IgM、IgE), T lymphocyte subsets (CD4+、CD8+、CD4+/CD8+) and other related indexes. As the result, both of two group’s P less then 0.05,no statistical significance between them.Based on a comprehensive analysis of two groups of baseline, they were balanced and comparable.(2)Baseline comparison:Two groups of traditional chinese medicineTCM syndrome integral, FEV1, FEV1/FVC, PEF,IgA,IgG, IgM,IgE,CD4+%,CD4+T,CD4+/CD8+,all of these were no significant difference before treatment.(3)The treatment effect:The experimental group total effective rate was 93.3%,the control group the total effective rate was 79.3%.The difference was statistically significant (P<0.05).(4)Pulmonary function:After treatment,comparisoned the FEV1,FEV1/FVC、PEF within groups and between two groups,differences were not statistically significant,P>0.05.(5) The aspect of Immune globulin:IgG of the experimental group after treatment is increased than before treatment(P<0.05). The IgG was no statistically significant difference in control group before and after treatment (P>0.05). The two groups were no difference in IgA, IgM and IgE, between before and after treatment (P>0.05). There was no significant difference in IgA, IgG, IgM, IgE, after treatment between the two groups (P>0.05). Compare the difference of the two groups before and after treatment, each index was no significant difference (P >0.05).(6)The aspect of T lymphocytes:The number of test group CD4+% and CD4+T cells were increased after treatment than before treatment (P<0.05). The number of CD4-% and CD4+ T cells in control group after treatment was lower than before the treatment (P<0.05). The number of CD4-% and CD4+T cells, in experimental group were higher than control group(P<0.05). The difference of two groups between before and after the treatment,the number of CD4-% and CD4+T cells in experimental group was higher than that in control group(P<0.05). The number of CD8-% in the experimental group after treatment was lower than it before the treatment(P <0.05). There was no statistically significant difference in CD8-% of the control group before and after treatment (P>0.05). There was no statistically significant difference before and after treatment in the two groups in CD8+T cells (P>0.05). No statistically significant difference between two groups in the number of CD8+% and CD8+T cells after treatment (P>0.05). The CD8+% between the two groups before and after treatment in experimental group was lower than that in control group (P<0.05). The number of CD8-T cells was no significant difference in two groups between before and after treatment (P>0.05). The CD4-/CD8+ of the experimental group after treatment increased than before treatment (P<0.05). The control group’s CD4+/CD8+ after treatment was lower than it before the treatment (P<0.05). Two groups’ CD4+/CD8+ after treatment in experimental group was higher than control group (P<0.05). The difference in CD4+/CD8+ between the two groups before and after treatment in experimental group was higher than that in control group (P<0.05).Conclusion:1.Bupi Qingfei decoction combined phlegm and postural drainage therapy were effectived in treatment of bronchiectasis disease, and obviously is better than pure phlegm and postural drainage therapy.2. Bupi Qingf ei Decoction combined with phlegm and postural drainage therapy has no obvious effect of improving on pulmonary function indexes.3. Bupi Qingfei Decoction has certain regulation effect on immune function, mainly reduce the increase in the CD8+,CD4+,regulation the ratio of both,maybe have a relevant with the increase of IgG.