Based On "The Lungs And The Large Intestine Are The Same Between The Outside And The Inside",the Mechanism Of The Therapeutic Effect Of Qingjin Huatan Decoction On AECOPD Is Analyzed By Studying The Changes Of Intestinal Flora

Objective:Based on the traditional Chinese medicine theory of"the lung and the large intestine are in harmony with the outside and inside",this study is to study the clinical efficacy of the classic Qingjin Huatan Decoction on patients with AECOPD（Phlegm-heat choking lung type）and the mechanism of intestinal flora changes.Methods:This study is a single-blind,randomized parallel controlled clinical study.A total of 60 patients with AECOPD（Phlegm-heat choking lung type）from the Department of Respiratory and Critical Care Medicine of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine were enrolled.They were randomly divided into a control group and a treatment group with 30 cases in each group.The control group was given conventional Western medicine comprehensive treatment.On this basis,the treatment group took Chinese medicine compound Qingjin Huatan Decoction.After 2 weeks of treatment,observe and compare the scores of the severity of TCM clinical symptoms,white blood cell count（WBC）,neutrophil percentage（Neut%）,C-reactive protein（CRP）,forced expiratory volume in the first second/forced vital capacity（FEV₁/FVC）,forced expiratory volume in the first second as a percentage of predicted value（FEV₁%Pred）,oxygen partial pressure（Pa O₂）,carbon dioxide partial pressure（Pa CO₂）indicators and changes in intestinal flora.Another 30 healthy volunteers who came to the hospital for physical examination during the same period were collected to observe the changes in intestinal flora in the healthy group,and jointly analyzed the effect of Qingjin Huatan Decoction on（Phlegm-heat choking lung type）AECOPD The patient’s treatment effect and the change of intestinal flora.Results:（1）After 2 weeks of treatment,the total effective rate in the treatment group was 86.67%,and the total effective rate in the control group was79.31%.The treatment group was better than the control group in improving the four clinical symptoms of cough,expectoration,wheezing,and abdominal distension（P<0.05）,and there was no significant difference from the control group in terms of wheezing and fever（P>0.05）.（2）After treatment,both the treatment group and the control group were able to reduce the WBC,Neut%,and CRP levels of the patients（P<0.05）;comparison between the groups,the WBC and CRP index levels of the treatment group were better than those of the control group（P<0.05）,but the decrease in Neut%index was not significantly different from that of the control group（P>0.05）.（3）After treatment,both the treatment group and the control group can improve the patients’FEV₁/FVC,FEV₁%Pred,Pa O₂,and Pa CO₂levels（P<0.05）;the improvement effect of the treatment group is better than the control group（P<0.05）.（4）Sequencing results of intestinal flora:OTU cluster analysis result Venn diagram shows that there are a total of 153 OTUs among the five groups.The number of OTUs in each group is 1185 in the Health group,1122 in the Con B group,697 in the Con A group,1203 in the Treat B group,611 in Treat A group.The analysis of bacterial composition showed that Firmicutes,Bacteroidetes,Proteobacteria and Actinobacteria were the dominant strains at the level of each group of phyla.The total number of bacteria is more than90%.At the same time,compared with the healthy group,the Firmicutes abundance value of the treatment group increased significantly after 2 weeks of treatment;at the genus level,compared with the healthy group,the treatment group was treated for 2 weeks of Lactobacillus abundance value increased significantly;Al Pha diversity analysis results showed that compared with the healthy group,the Chao1 index and Shannon index of the control group and the treatment group after 2 weeks of treatment were both lower than before treatment（P<0.05）;Bate NMDS The results of diversity analysis showed that the intestinal flora structure of the treatment group after 2 weeks of treatment was closer to that of the healthy group.Conclusion:（1）Compared with pure Western medicine treatment,the combination of Qingjin Huatan Decoction can improve the clinical efficacy of AECOPD patients（Phlegm-heat choking lung type）by alleviating clinical symptoms,reducing inflammation,improving lung function,correcting hypoxia and carbon dioxide retention.（2）Compared with simple western medicine treatment,the combination of Qingjin Huatan Decoction can increase the abundance of intestinal Firmicutes and Lactobacillus probiotics in patients with AECOPD（Phlegm-heat choking lung type）.It is speculated that Qingjin Huatan Decoction may affect the intestinal flora Potential mechanism.