| Objective:In this study,a prospective randomized controlled design was used to observe the changes of clinical symptoms,immunity and inflammation in the treatment of chronic obstructive pulmonary disease(COPD)in the western medicine control group and the Chinese and Western medicine treatment group during the acute aggravation period of COPD,and the syndrome differentiation of phlegm heat damming lung syndrome(TCM)in the process of treatment,so as to objectively evaluate the efficacy and safety of Western medicine conventional treatment+Qingjin Huatan Decoction,and the COPD in the acute aggravation period(COPD)Lung patients,to provide a more effective,safe,standardized treatment program of integrated traditional Chinese and Western medicine,but also for the clinical treatment of chronic obstructive pulmonary disease in the acute aggravation stage(phlegm heat syndrome)to provide more evidence-based medical basis.Method:The prospective randomized controlled study method was adopted.According to the inclusion criteria of the study design,the patients were selected from September 2018 to January 2020 in the respiratory department of Zhuhai branch of Guangdong Hospital of traditional Chinese medicine,and were divided into western medicine control group and Western medicine treatment group according to whether the patients used Qingjin Huatan Decoction.The western medicine group was given routine treatment,while the Chinese and Western medicine group was given Qingjin Huatan Decoction in the treatment plan of the western medicine group.The effectiveness and safety of the two groups before and after treatment were objectively evaluated,including the control and improvement of clinical symptoms,quality of life,lung function and the changes of related immunology and inflammatory reaction indexes.Meanwhile,the occurrence and detailed treatment process of adverse reactions were recorded,Data collected from the study were analyzed statistically.Result:1.Baseline situation:In this study,66 clinical patients were collected,including 33 in the western medicine group,33 in the western medicine group,and 6 in the process of the experiment.All of the cases dropped out without sticking to the medication,3 in the western medicine treatment group and 3 in the western medicine control group.There were 19 males and 11 females in the western medicine group,with the maximum age of 80 and the minimum age of 46.There were 20 males and 10 females in the western medicine group,with the maximum age of 80 and the minimum age of 54.After the treatment,14 patients refused to complete the blood index test,and 46 patients finally agreed to complete the blood index test,including 24 patients in the traditional Chinese and Western medicine group and 22 patients in the western medicine group.There was no significant difference in age,gender and pulmonary function between the two groups(P>0.05).2.Liver and kidney function:there was no significant difference in alt,AST and Cr between the two groups before,after and after treatment(P>0.05).3.Cat and MMRC scores:there was no significant difference between the two groups before and after treatment,before and after treatment,and before and after treatment(P>0.05).4.Clinical symptom control:the difference of CRF scores between the two groups before and after treatment was statistically significant(P<0.05).There were significant differences between the two groups(P<0.05).There was a significant difference in the improvement of the symptom scores in the western medicine group(P<0.05),but there was no significant difference in the western medicine group(P>0.05).Compared with the western medicine group,the scores of expectoration,wheezing,self perspiration,wheezing and other symptoms and the total scores in the western medicine group decreased significantly(P<0.05).In terms of the score and total score of symptoms such as expectoration,wheezing,spontaneous sweating,wheezing,the difference between the two groups before and after treatment was statistically significant(P<0.05).5.In terms of inflammation indexes,there were significant differences in serum IL-8,NE,TNF,NF-kB absorbance and TLR4 mRNA expression between the two groups before and after treatment(P<0.05).There was no significant difference between the two groups before treatment(P>0.05).There was no significant difference in serum IL-8,TNF concentration and NF-kB absorbance between the two groups(P>0.05),but there was significant difference in NE concentration and TLR4 mRNA expression between the two groups(P<0.05).There was significant difference in NE concentration and TLR4 mRNA expression between the two groups(P<0.05).In terms of NE concentration and TLR4 mRNA expression,the difference between the two groups before and after treatment was statistically significant(P<0.05).6.In terms of immune index,there was no significant difference in Thl7 and Treg cell ratio between the two groups before treatment(P>0.05).There was significant difference in Treg and Th17 percentage of peripheral blood between Chinese and Western medicine group and Western medicine group(P<0.05).There was no significant difference in Treg percentage between the two groups after treatment(P>0.05),but there was significant difference in the improvement of Th17 percentage between the Chinese and Western medicine group and the western medicine group(P<0.05).In terms of Th17 percentage,the difference between the two groups before and after treatment was statistically significant(P<0.05).7.Effective rate:there was no significant difference between the two groups before and after treatment(P>0.05).But in the aspect of control rate,the group of traditional Chinese and Western medicine is better than the group of Western medicine.8.Adverse reactions:no obvious adverse reactions were found during the treatment.Conclusion:1.In the aspect of symptom control,the effect of Qingjin Huatan Decoction on the basis of Western medicine is more obvious than that of Western medicine alone,especially in the improvement of panting,expectoration,wheezing,spontaneous sweating and other symptoms.2.Qingjin Huatan Decoction may intervene inflammatory reaction and relieve clinical symptoms through TLR4-MyD88/trif-nf-K B signaling pathway.3.Th17 may be the target of Qingjin Huatan Decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease(syndrome of phlegm heat blocking lung). |
