The Clinical Research Of Liujunzi Decoction In The Treatment Of Chronic Obstructive Pulmonary Disease Patients In Plateau Period With Lung Spleen Deficiency Type

Objective:By a randomized controlled method, and observing the clinical symptoms, lung function, sputum HDACs activity and cytokine changes before and after treatment of chronic obstructive pulmonary disease (COPD) patients in remission period with lung spleen deficiency type, which confirmed that Liujunzi decoction of clinical efficacy, improving lung function, reducing airway inflammation, and restoring HDACs activity. From COPD core disease machine of HDACs function and endogenous anti-inflammatory system, explore the mechanism of action of Liujunzi decoction to treat COPD and the impact of endogenous anti-inflammatory mechanisms in COPD.Methods:According to strict inclusion criteria and exclusion criteria in the subject design, with randomized controlled clinical trial design method, select70cases of chronic obstructive pulmonary disease patients with lung spleen deficiency type, which is divided into using simple western medicine (control group) and Liujunzi decoction combined with Western symptomatic treatment (treatment group),35cases in each group. Among them, the average age of the control group is58.63±4.53years old, giving the inhalation therapy of salmeterol and fluticasone propionate (Seretide50/250); the average age of the treatment group is58.54±5.37years old, giving the oral Liujunzi decoction combined with the inhalation therapy of Seretide50/250; the treating times of two groups are3months. After three months of treatment, Observed the clinical symptoms (including cough, sputum, wheezing, shortness of breath), lung function (FEV1, FEV1/FVC), sputum HDACs activity and the changes of TNF-a and IL-8of the two groups of patients before and after treatment.Results:(1) Comprehensive clinical efficacy comparison:the total effective rate of the clinical effects of the control group was85.71%, the total effective rate of the clinical effects of the treatment group was88.57%, the total efficiency of the treatment group is higher than the control group. Statistically, compared with the clinical efficacy of the treatment group and the control group, there were no significant difference (P>0.05).(2) Assessment of lung function results:Key Indicators with lung function of improving FEV1and FEV1/FVC, Comparison between groups showed no significant difference(P>0.05). Compared two groups of patients before and after treatment group showed a significant difference (P<0.05), in FEV1and FEV1/FVC improvement.(3) Determination of sputum HDAC activity:HDAC activity between the treatment group and the control group showed no significant difference (P>0.05); compared the two groups of HDAC activity before and after treatment group showed a significant difference (P<0.05).(4) Determination of the cytokines IL-8and TNF-a: the cytokines IL-8and TNF-a levels of the two groups before treatment showed no significant difference (P>0.05); the cytokine IL-8and TNF-a levels of the two groups after treatment was significantly lower than before treatment (P<0.05).Conclusions:Liujunzi decoction can significantly improve the clinical symptoms and lung function of COPD patients with lung spleen deficiency type, improve sputum HDAC activity, and reduce the cytokines IL-8and TNF-a levels, indicating Liujunzi decoction treatment of COPD patients with lung spleen deficiency type from HDAC function and mechanism of endogenous anti-inflammatory system.