Clinical And Experimental Study On The Treatment Of Feixiantong In Patients With Idiopathic Pulmonary Fibrosis

Pulmonary fibrosis (PF) is the final pathology outcomes of interstitial lung disease, which mainly manifestate diffuse alveolar inflammation, structural disorder of alveolar units and pulmonary fibrosis .Idiopathic pulmonary fibrosis (idiopathic pulmonary fibrosis, IPF) have serious harm, whose rate of death and incidence have gradually increased. After onset of symptoms, the survival is 4 to 6 years (5 year survival rate is 30% to 50%), with the same cancer, looking for new and effective treatments have become pressing needs.The subject intended to base on the soup of Xuanfuhua from"Golden Chamber", adding up Yiqiyangyin and Endometriosis Chinese medicine, which constitutes the soup of Feixiantong. For pulmonary fibrosis patients, through the observation of its impact in clinical symptoms, quality of life and activities endurance, we evaluate the clinical efficacy and safety and explore the establishment of model of interstitial pulmonary fibrosis with Qi and Blood stagnation, providing an animal model of disease and syndrome for the TCM treatment of the disease. We also explore mechanisms of pulmonary fibrosis rats, which accep the treatment of Feixiantong.Clinical ResearchObjective:Through observing the integrated scoring, lung function, lung HRCT, arterial blood gas analysis, quality of life questionnaire,6-minute walk test and other methods to evaluate clinical efficacy, quality of life and endurance activities of Feixiantong for IPF patients.Methods:50 cases selected were randomly divided into two group, the treatment group(receive Feixiantong) and the control group (receive NAC) in the research of 3 months. Then analyzed the integrated effect scores, symptoms changes, lung function, lung HRCT, arterial blood gas analysis, quality of life and 6-minute walk test before and after the treatment. Established a database and analysis data with SPSS13.0. Results:There was no significant difference in the integrated effects between the treatment group and the control group, but the treatment group provivided greater improvement in cough, weak and dry mouth. There is no effective improvement both the treatment group and the control group in lungHRCT and lung function. There is also no significant difference between the two groups. The treatment group play better than the control group in improving the quality and endurance activities of the IPF patients'life.Conclusion:The patients with IPF may benefit from the treatment of the decoction of Feixiantong in short of breath, cough, weak, chest tightness and dry mouth. It was better than NAC in improving the quality of life and endurance activities.Experimental studyObjective:to establish the rat model of Qi and Blood stagnation, for an animal model of disease and syndrome; Determinate of rat IFN-γ,IL-4, pulmonary function, blood coagulation and other indicators, for the possible mechanisms of pulmonary fibrosis rats.Methods:84 healthy male SD rats, of which 12 rats were randomly selected intratracheal injection of normal saline as normal control group, the remaining 72 intratracheal bleomycin injection resulted in pulmonary fibrosis model of rat. After 7 days, randomly selected 10 as a simple model of IPF from the survival of rats, and made the remaining rats swimming for 14 days inducing the model of Qi deficiency and blood stasis, the survival rats were randomly divided into 5 groups, named IPF+ Qi deficiency and blood stasis model group (abbreviated as Qi deficiency and Blood Stasis IPF group), Feixiantong (high dose)+Qi deficiency and Blood Stasis IPF group, Feixiantong(equal dose)+Qi deficiency and Blood Stasis IPF group, Hormone +Qi deficiency and Blood Stasis IPF group, NAC + Qi deficiency and Blood Stasis IPF group.28 days after, administrated done, the normal group and model group were distilled water for 2ml daily, and the remaining treated groups were given daily about 2ml drug solution for consecutive 28 days.56 days after surgery, rats were forced to do pulmonary function test, determination of FVC,FEV0.3,FEV0.3/FVC%,Cdyn, after pulmonary function test, abdominal aortic blood extracted, determination IL-4,IFN-γand blood clotting, after arterial blood extracted, rapidly removed the lung, observed the lung tissue appearance with naked eye, selected left lower lung from the rat for biopsy, for HE staining to observe morphological changes.Results:(1) pulmonary fibrosis model was successfully established. (2) IL-4 levels:Compared with the normal group, the levels of IL-4 in model groups (IPF groups and Qi deficiency and Blood Stasis IPF group) was significantly higher; the treated groups except NAC were lighter than the model groups. (3) IFN-γtest results: Compared with the normal group, the levels of IFN-y in model groups was significantly lower. the treated groups were lighter than the model groups, and showed significant difference, between the treated groups showed no significant difference. (4) coagulation test results::between the model groups and normal group, there was significant difference; the treated groups in coagulation had improved compared with model groups, but there was no significant differences among the groups. (5) pulmonary function indicators:the order of FVC levels in each group was the normal group, hige dose of Chinese medicine, hormone group, equal dose of Chinese medicine, NAC group, IPF group, Qi deficiency and Blood Stasis IPF group. Compared with the normal group, the model groups were lower, but there was no statistical significance; the model groups were lower than the normal group in FEV0.3 level, but there was no statistical significance; there was the same significance between FEV0.3 and FEV0.3/FVC levels; Compared with the normal group, the levels of Cydn in model groups (IPF groups and Qi deficiency and Blood Stasis IPF group) was significantly lower.Between the treated groups and model groups, there was significant difference, but among treated groups.Conclusion:Feixiantong could shift the Thl/Th2 imbalance in pulmonary fibrosis possibly through increasing IFN-γand reducing IL-4 to shorten the expression of fibrosis; Feixiantong could improve Cdyn for the model rats and the effects were better than hormone rats; between the IPF group and Qi deficiency and Blood Stasis IPF group, there was no significant difference, whther the model of Qi deficiency and Blood Stasis fited more needto be further in-depth study.