Lungs And The Cough Treatment Of Cough Variant Asthma Clinical And Experimental Research

1.BackgroundCough variant asthma is known as a special type of asthma.Cough is the only or the main clinical manifestations.There is also has airway hyperresponsiveness(AHR). Mainly for the irritating dry cough,night cough for its important characteristics. Catching cold,cold air,dust,fumes,such as likely to cause or aggravate coughing.If there is no timely and effective treatment,some patients may develop into typical asthma.Epidemiological data show that about 5%-6%of bronchial asthma in patients with asthma symptoms before the typical performance for a few stubborn cough, and 28%of asthma symptoms as the only cough only.Its cause is not entirely clear, both studies from different perspectives of their pathogenesis are discussed that with the high sensitivity of the airway,airway neural regulation,inflammation, immunology and genetics and the environment,infectious factors.Regarding the treatment of bronchiectasis mainly in Western glucocorticoid-based agents.Writing in the traditional Chinese medicine,there is no cough variant asthma and fully corresponds to the disease,from the occurrence of the disease,the development of clinical symptoms shown by the characteristics of analysis,many doctors belong mostly to "cough","Asthma Disease" "asthma syndrome","whooping cough", "swallow-induced cough" and other aspects of different diseases.Chinese medicine treatment use syndrome differentiation theory,the overall treatment,with well efficacy,side effects and other advantages,can significantly improve symptoms in patients with CVA.Hyperactivity of this study was based on the feireyinxu,used with RunFeiKechuan Fang of QingRe RunFei,HuaTanZhiKe Kechuan treatment of CVA, to make good results.In order to further RunFeiKechuan Fang of the clinical efficacy for an objective evaluation,this paper from both clinical and animal experimental study to explore its therapeutic mechanism of CVA.2.clnical studyObjective:By observing two groups of patients before and after treatment to improve the individual symptoms,airway reactivity,T cell subsets,cytokines,such as indicators of the changes of "Deficiency Hyperactivity type" CVA occurred in the role of the development process.Methods:Cough variant asthma diagnostic criteria of Western medicine and TCM for vaginal injuries Hyperactivity of CVA in patients with evidence of 55 cases,were randomly divided into traditional Chinese medicine treatment group(observation group) 27 cases,Western medicine treatment group(control group) 28 cases, Application of the treatment group RunFeiKeChuan capsule,the application of the control group theprocaterol hydrochloride,within 14 days of treatment,symptoms and signs before and after the determination of score,provocation test PD20-FEV1, CD4/CD8,IL-2,IL-6,TNF-αand so on.SPSS13.0 and the results of the use of statistical software for statistical analysis.Results:The integrated effect of the disease,significant rate-control group was 66.67%,total effective rate was 88.89%,control group,control a significant rate of 57.14%,total effective rate was 71.43%.Score after treatment both groups showed steady improvements in the control group and significantly higher than the total effective rate.Observation of patients after treatment of the individual symptoms in cough frequency,cough extent,dyspnea,expectoration,pharyngeal itching,throat and so on have significant improvement in the control group in improving the frequency of cough,cough degree of dyspnea obvious aspects of efficacy,the treatment group compared group in cough frequency,cough extent throat are obviously better than the control group.Significant control in the individual symptoms and total effective rate, the observation group were significantly higher than that.Observation group and the control group the level of PD20-FEV1 after treatment have improved,and the observation group than the control group.IL-2,TNF-αlevel of the observation group and control group after treatment than before treatment to improve,IL-2 to improve the level of the observation group than the control group,CD4/CD8,IL-6 levels observed only after treatment than before treatment to improve.Inter- group comparison before and after treatment there was no significant difference (P＞0.05).Conclusion:The RunFeiKechuan Fang improve cough in patients with CVA Deficiency Hyperactivity of clinical symptoms,reduce the responsiveness of high gas and improve the immune disorders in CVA and cytokine levels of access to good effect.3.experimental studyObjective:To copy the guinea pig model of CVA,CVA model and explore the guinea pig asthmatic model of guinea pig airway responsiveness between the pathological changes in lavage fluid,such as the similarities and differences;and to explore intervention RunFeiKechuan Fang prescription CVA model in guinea pigs airway responsiveness and changes in cytokine levels.Methods:the general level of health of male guinea pigs(200±20 grams) 50,were randomly divided into 5 groups:normal control group,asthma model group,CVA model group,CVA hormone group,CVA Chinese Medicines group.Keeping the normal one week after the beginning of the experiment.In addition to the normal control group,the remaining section of each group in guinea pigs by intramuscular injection 1 day per 4%OVA solution 0.5ml,while intraperitoneal injection of 2%AL (OH) 3 gel 0.2ml.The 14th day,CVA with three groups of guinea pigs were nebulized 1%OVA solution to attack up to 2min,next time,made the model of cough variant asthma.Asthma model group for the attack time 5min,guinea significant shortness of breath,and even abdominal breathing,convulsions,asthma model made.The 14th day later,CVA hormone group and the CVA Chinese Medicines group administration of traditional Chinese medicine for 14 days.The first 29 days,the cough frequency to stimulate animal lung function tests,bronchoalveolar lavage fluid eosinophil count measured executed tissues of guinea pig tracheal dedicated histopathological examination,abdominal aortic blood serum for the determination of cytokine levels.Results:Determination of cough frequency,the normal control group,the least number of cough,asthma model group,slightly higher than the normal control group, but the two groups was not significant P＞0.05,Three groups the number of CVA cough was significantly higher than the normal control group P＜0.05,CVA model group in which the number of cough was significantly higher than the other two groups.Histopathological sections from the observation of the trachea,bronchial wall of the normal control group and around a clear organizational structure,no inflammatory cell infiltration,bronchial asthma model group and the surrounding epithelial tissue damage off there,surrounded by a large number of inflammatory cell infiltration can be seen,eosinophil visible;CVA model group,inflammatory cells, eosinophil infiltration in model group than to reduce asthma;CVA hormone group of inflammatory cells,eosinophil infiltration in model group than to reduce CVA than asthma model group.CVA Chinese Medicines group of inflammatory cells,eosinophil infiltration CVA model group than the reduced model than the asthma group.Lavage fluid from guinea pigs in eosinophil count observed,compared with normal control group,asthma model group,the eosinophil count was significantly increased,CVA count lower than the asthma model group,model group,but higher than the normal control group.Methacholine challenge test total inspiratory airway resistance(RL) measured in the two previous administration when RL did not significantly increase the level of the third dose(10min),RL the level of the remaining four groups than the normal control group increased,the fourth dose(15min),RL the level of the remaining four groups than the normal control group was significantly increased, including asthma model group increased most significantly,P＜0.01.Lung compliance(Cdyn) measured in the first administration of(st),only the asthma model group than normal control group significant improvement in compliance,the second administration(5min),only the Chinese Medicines group was significantly higher than normal controls compliance group,the third dose(10min),CVA hormone group, CVA compliance is higher than the Chinese Medicines CVA model group,the fourth dose(15min),asthma model group,CVA hormone group,CVA compliance is higher than the normal Chinese Medicines group,CVA hormone group,CVA Chinese group than the CVA model group compliance.Determination of cytokines,IL-1 levels between groups showed no significant difference;IL-2 levels measured in comparison with normal control group,asthma model group and significantly improved CVA model group,CVA among the three groups compared to normal control group and CVA model of traditional Chinese medicine group than in CVA group significant difference.Determination of IL-6 levels,in addition to CVA model group,the other group and the normal control group are significant differences;IL-8 levels measured in levels of asthma model group was significantly higher than not only the normal control group,but also higher than the three groups of CVA,CVA model alone and the group has significant difference between groups.Determination of TNF-αlevel in comparison with normal control group,asthma,there are significant differences in the model group.Conclusion:CVA model of guinea pig airway responsiveness in pathological changes in the areas of lavage fluid were lower than the level measured in guinea pig asthma model,and higher than the normal control group.Prescription RunFeiKechuan Fang CVA model of intervention in the reduction of guinea pig airway resistance and improve the efficacy of pulmonary obvious aspects of compliance,cytokine levels and hormone changes in the traditional Chinese medicine for the effect of the indicators are not identical,RunFei Kechuan Fang for airway inflammation have a role to improve.