| 1 Clinical research1.1 Objective To study the distribution of TCM Syndromes of chronic obstructive pulmonary disease, and to provide a basis for TCM syndrome differentiation and treatment of chronic obstructive pulmonary disease. Investigation of TCM syndromes in 188 patients with stable chronic obstructive pulmonary disease.1.2 Methods Combine with clinical experience, and develop chronic obstructive pulmonary disease in stable period of TCM syndromes and syndrome type questionnaire according to the research and epidemiological investigation of chronic obstructive pulmonary disease in stable period of TCM Syndromes, combine with CAT scale,using statistical software, analysis the data of 188 patients with stable chronic obstructive pulmonary disease,to find the relationship between age, gender, region, smoking status, occupation,acute increase incentives and syndromes, summary of chronic obstructive pulmonary disease in stable period of TCM syndrome distribution rules.1.3 Results188 cases of chronic obstructive pulmonary disease in stable period patients, male,107 cases, accounting for 56.91% of the total number, female 81 cases, accounting for43.09% of the total number, the syndrome differentiation of TCM, and 23 cases of lung qi deficiency syndrome(12.2%), 72 cases of lung and spleen qi deficiency syndrome(38.3%), 48 cases of lung and kidney qi deficiency(25.5%), 45 cases of lung and kidney qi yin deficiency(23.9%).1.4 Conclusion TCM syndrome investigation found: lung spleen qi deficiency is a common syndrome type of chronic obstructive pulmonary disease.2 Experimental study2.1 Objective To study the mechanism of Yifei Jianpi Prescription to treat chronic obstructive pulmonary disease model rats of two deficiency of lung and spleen, and to provide experimental basis for clinical application.2.2 Methods112 healthy male SD rats only according to the random number table method were divided into 7 groups, blank control group, model control group, Yifei Jianpi low dose group, Yifei Jianpi medium dose group, Yifei Jianpi high dose group, dexamethasone group and ambroxol group, with 16 rats in each group. Except the blank control group,the other 6 groups were exposed to tobacco smoke and intratracheal instillation of lipopolysaccharide(LPS) and Senna gavage multi factor combined modeling, the modeling phase, a total of 49 days, each group after the establishment of the model to be appropriate medical treatment for 6 consecutive weeks. HE staining was used to observe the groups of rat lung, bronchial pathological changes; AB-PAS staining in each group rat bronchial goblet cells and mucus observation secretion; ELISA detected in rat serum and BALF IL-8, IL-10, IL-17 and TNF-? and MCP-1, MMP-9, leptin and CRP content; blood chemical examination(liver and kidney function, etc.) to monitoring drug safety.2.3 Results2.3.1 Effect of Yifei Jianpi on pathological morphology of rats Compared with the blank control group, model control group rat bronchial and lung tissue were chronic obstructive pulmonary disease pathological changes; and model compared to the control group, Yifei Jianpi high, medium and low dose group,dexamethasone group and ambroxol group pathological changes are mitigated, the Yifei Jianpi high dose group and dexamethasone group was decreased significantly. Ab-pas staining showed that in the model control group rat bronchial visible a large number of goblet cell hyperplasia; Yifei Jianpi high dose group, dexamethasone group and ambroxol group were visible a few goblet cell hyperplasia, and compared to the model control group, the number of goblet cells decreased.2.3.2 The effect of Yifei Jianpi on rat' IL-8, IL-10, IL-17, TNF-, MCP-1, MMP-9,Leptin and CRP in serum Compared with the blank control group, the content of IL-17, TNF-?, MCP-1, MMP-9, CRP, Leptin and IL-8 in the model control group was significantly higher than that in the control group(P<0.01). The content of IL-10 in model control group was significantly lower than that in control group(P<0.01). Yifei Jianpi high, medium and low dose group, dexamethasone group and ambroxol group IL-8, IL-17 and TNF-? and MCP-1, MMP-9 and CRP in compared with the model control group were reduced to varying degrees, of which Yifei Jianpi Decoction high dose group, dexamethasone group and ambroxol group compared with the model control group was significantly decreased(P<0.01). Yifei Jianpi high, medium and low dose group, dexamethasone group and ambroxol group IL-10 were significantly higher than those in the model control group(P<0.01). MMP-9 in dexamethasone group were significantly lower than the ambroxol group(P<0.01). Yifei Jianpi high, medium and low dose group and ambroxol group Leptin was significantly lower than that of model group(P<0.01). The content of Leptin in dexamethasone group was higher than that in blank control group(P<0.01) and model control group(P<0.05).2.3.3 The effect of Yifei Jianpi on rat' IL-8, IL-10, IL-17, TNF-, MCP-1, MMP-9,Leptin and CRP in BALF Compared with the blank control group, the content of IL-17, TNF-?, MCP-1, MMP-9, CRP, Leptin and IL-8 in the model control group was significantly higher than that in the control group(P<0.01). The content of IL-10 in model control group was significantly lower than that in control group(P<0.01). Yifei Jianpi high, medium and low dose group, dexamethasone group and ambroxol group IL-8, IL-17 and TNF-? and MCP-1, MMP-9 and CRP in compared with the model control group were reduced to varying degrees, of which Yifei Jianpi Decoction high dose group, dexamethasone group and ambroxol group compared with the model control group was significantly decreased(P<0.01). Yifei Jianpi high, medium and low dose group, dexamethasone group and ambroxol group IL-10 were significantly higher than those in the model control group(P<0.01). MMP-9 in dexamethasone group were significantly lower than the ambroxol group(P<0.01). Yifei Jianpi high, medium and low dose group and ambroxol group Leptin was significantly lower than that of model group(P<0.01).2.3.4 Drug safety Compared with the blank control group, Yifei Jianpi high, medium and low dose group, dexamethasone group and ambroxol group rats liver and kidney function showed no obvious abnormalities.2.4 Conclusion Yifei Jianpi Prescription may reducing the chronic obstructive pulmonary disease,lung and spleen deficiency model rats IL-8, IL-17 and TNF-? and MCP-1, MMP-9, leptin and CRP levels in the serum and BALF, and elevated IL-10 levels in the serum and BALF, reduce airway inflammation, improve airway remodeling; Yifei Jianpi Prescription is safe and effective. |
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