Clinical Observation And Experimental Research On Treatment Of Bronchial Asthma(Cold Asthma Syndrome) With Mashaopingchuan Decoction

Objective:To evaluate the clinical effect of Mashaopingchuan decoction in the treatment of acute stage of acute episode of bronchial asthma?cold asthma syndrome?and itsinfluence on serum inflammatory factors such as IL-6,IL-8,IL-13,TNF-?and INF-?,to provide them basic clinical treatment of bronchial asthma with TCM.Through the effect of Mashaopingchuan decoction on pathological changes in lung tissue,serum inflammatory factors,and autophagy-related genes and protein expression in lung tissue of rats with bronchial asthma?cold asthma syndrome?,the mechanism of treatment of asthma with Mashaopingchuan decoction was explored.Methods:From January 2018 to December 2019,60 patients with an acute episode of bronchialasthma?cold asthma syndrome?from the respiratory clinic of Anhui Hospital of traditional Chinese medicine were randomly divided into the control group and observation group with 30 cases each,and 15 normal people were selected as the normal group.The control group was treated with Budesonide formotero powder inhaler,and the treatment group was treated with Mashaopingchuan decoction and Budesonide formotero powder inhaler for seven days.The general condition,TCM syndrome characteristics,lung function,ACQ-7 score,and Marks-AQLQ score of asthma patients in the two groups were observed and recorded.ELISA detected the serum levels of IL-6,IL-8,IL-13,TNF-?and INF-?.SD rats were randomly divided into normal group,model group,low dose group ofMashaopingchuan decoction?3.69 g/kg?,medium-dose group of Mashaopingchuan decoction?7.38 g/kg?,high dose group of Mashaopingchuan decoction?14.76 g/kg?,Guilongkechuanning group?0.405 g/kg?and dexamethasone group?0.405 g/kg?.To establish the model of bronchial asthma?cold asthma syndrome?,Aluminum hydroxide?Al₂?OH?₃?gel and ovalbumin were used to induce allergic asthma in rats.And the rats were given cold stimulation at the same time.And then the drug was intervened forthree weeks.Bronchial.HE and PAS staining were used to observe the pathological changes of lung tissue and the secretion of airway mucus;transmission electronmicroscopy was used to observe the expression of autophagic vesicles in lung tissue;IF was used to detect the expression of Beclin1,LC3B protein in lung tissue;ELISA was used identify the contents of IL-6,IL-8,IL-13,TNF-?and INF-?in serum;RT-q PCR was used to detect the transcription of Beclin1 m RNA,ATG 3 m RNA,ATG5 m RNA.Western blot was used to identify the expression of Beclin1,LC3-?/LC3-?,ATG3,ATG5 protein in lung tissue of rats.Results:1 Clinical trial?1?The influence on the efficacy of TCM syndromes in patientsIn the control group,2 cases were controlled clinically,12 cases were markedly effective,16 cases were effective,0 case was ineffective,the total effective rate was100.00%.In the treatment group,5 cases were controlled clinically,17 cases were markedly effective,8 cases were effective,0 case was ineffective,the total effective rate was 100%.After treatment,the curative effect of TCM syndromes in the treatment group was obviously better than that in the control group?P<0.05?.?2?The effects on TCM syndromes of patientsCompared with before treatment,The improvement of TCM syndromes in the control group and the treatment group was significant?P<0.01?.In the control group and the treatment group,the improvement of wheezing,phlegm in the throat,lung wheezing,chest tightness,expectoration,cough,chilly limbs,shortness of breath and tongue coating were significant?P<0.01?,and the effect of the treatment group on the improvement of phlegm in the throat,expectoration,cough,chilly limbs of asthmatic patients was obviously better than that of the control group?P<0.05?.There was no obvious difference in the improvement of wheezing,lung wheezing,chest tightness,shortness of breath,and tongue coating between the two groups.?P>0.05?.?3?The Effect on ACQ-7 score of patientsCompared with before treatment,the growth of ACQ-7 score of asthmatic patients in the control group and the treatment group was significant?P<0.01?,and there was no obvious difference between the treatment group and the control group?P>0.05?.?4?The effect on Marks-AQLQ score of patientsCompared with before treatment,the improvement of Marks-AQLQ scores in the control group and the treatment group was significant?P<0.01?.There was no obvious difference in Marks-AQLQ scores between the treatment group and the control group?P>0.05?.?5?The Effect on pulmonary function of patientsCompared with before treatment,the improvement of FVC,FEV₁,FEV₁/FVC%,PEF in the control group and the treatment group was significant?P<0.01?,and the advancement of FEV₁ in the treatment group was obviously better than that in the control group?P<0.05?,and the improvement of FEV₁/FVC%and PEF is significant?P<0.01?.There was no obvious difference in the improvement of FVC in the two groups?P>0.05?.?6?The effect on serum inflammatory factors in patientsCompared with the normal group,the serum levels of IL-6,IL-8,IL-13,TNF-?in asthmatic patients were significantly higher,and the serum levels of INF-?were significantly lower?P<0.01?.Compared with the pre-treatment group,the control group and the treatment group can significantly reduce the serum IL-6,IL-8,IL-13,TNF-?content and significantly increase the serum INF-?content?P<0.01?.However,there are still some differences with the normal control group.The improvement of IL-6,IL-8,TNF-?,INF-?in the treatment group was significantly better than that in the control group?P<0.05?,and the improvement of IL-13 in the treatment group was significantly better than that in the control group?P<0.01?.2 Animal experimentCompared with the model group,the thickening of the airway wall,smooth muscle layer and basement membrane in the high dose group of Mashaopingchuan decoction was significantly reduced,and the inflammatory cell infiltration of the tracheal wall was significantly reduced?P<0.01?,and shows specific concentration dependence.Compared with the control group,the expression of autophagic vesicles in the model group was significantly higher than that in the control group,and the expression of autophagic vesicles in the lung tissue of the rats in Mashaopingchuan decoction treatment groups decreased according to the concentration.Compared with the model group,the fluorescence expression of Beclin1,LC3B protein in the lung tissue of rats in the high dose group of Mashaopingchuan decoction decreased significantly?P<0.01?,and shows a specific concentration dependence.Compared with the model group,the contents of IL-6,IL-8,IL-13,and TNF-?in the serum of the high dose group of Mashaopingchuan decoction decreased significantly?P<0.01?,and the content of INF-?in the serum of rats increased significantly and showed a certain concentration dependence.Compared with the model group,the expression of Beclin1 m RNA,ATG3 m RNA,ATG5 m RNA and Beclin1,LC3-?/LC3-?,ATG3,ATG5 protein in the lung tissue of rats in the high dose group of Mashaopingchuan decoction decreased significantly?P<0.01?,and showed a certain concentration dependence.Conclusion:Machaopingchuan decoction combined with Symbiotox and Symbiotox can effectively improve TCM syndrome characteristics,lung function,ACQ-7 score,Marks-AQLQ score,and serum inflammatory factor content in patients with acute episode of bronchial asthma?cold asthma syndrome?,to play a role in treating asthma,but the combined effect is better than that of Symbiotob inhalation treatment alone,and clinical observation shows that the effect is faster.Machaopingchuan decoction can effectively improve airway inflammation and airway remodeling in asthmatic rats.Its mechanism may be related to the down-regulation of autophagy-related genes and proteins in lung tissue,the down-regulation of serum pro-inflammatory factors IL-6,IL-8,IL-13,TNF-?,and the up-regulation of anti-inflammatory factor INF-?.