| Purpose:1.Clinical observation on acute pharyngitis to verify the efficacy of Zheng’s laryngology Blowing Medicine No.2 formula on acute pharyngitis.2.To investigate the possible mechanism of Zheng’s laryngology Blowing Medicine No.2 formula for the treatment of acute pharyngitis through animal experimental studies on acute pharyngitis.Methods:1.Clinical observation: a total of 60 cases eligible for acute pharyngitis in the ENT outpatient clinic of Anhui Provincial Hospital of Traditional Chinese Medicine2018.10-2021.01 were collected,and the patients were divided equally into 3 groups of20 each by the randomized data table method according to the numbering of the order in which they were seen.During the treatment,the experimental group was terminated in 1case due to sudden acute appendicitis requiring surgery,the control group was excluded in 2 cases because they were worried about the ineffectiveness of Chinese medicine and added antibiotics on their own,and the negative control group was excluded in 1 case due to poor compliance and failure to adhere to the medication,making a total of 4 cases.There were 19 cases in the experimental group,18 cases in the control group and19 cases in the negative control group.The experimental group used Zheng’s laryngology Blowing Medicine No.2 formula for pharyngeal cavity administration,combined with Zizheng Dihuang Tang for oral administration.The control group used Bing Bor San pharyngeal cavity administration combined with Zi Zheng Di Huang Tang orally.Negative control group: oral administration of Zi Zheng Di Huang Tang alone.Primary and secondary symptoms and signs were collected from patients in each group before and after treatment and scores were recorded.Patients in each group were asked about their satisfaction with this treatment after the whole treatment and the time of drug onset was recorded.2.Animal experiment: 55 healthy SD rats,10 rats were randomly selected as blank group by random sampling method,the remaining rats were constructed as acute pharyngitis model,and were divided into experimental group,control group,negative control group and model group by random number table method.The experimental group used Zheng’s laryngology Blowing Medicine No.2 formula for pharyngeal cavity administration combined with Zi Zheng Di Huang Tang gavage;the control group used Bing Bor San for pharyngeal cavity administration combined with Zi Zheng Di Huang Tang gavage.The negative control group was gavaged with Zizhengdihuang Tang alone;the model group and the blank group were treated with no intervention.The general condition of the rats was recorded during the treatment;after the treatment,the oral mucosa of the rats was taken and HE stained to evaluate the pathological changes of the rat pharyngeal mucosa;the blood of the rat’s abdominal aorta was taken and the levels of TNF-α,IL-I and IL-6 in the serum were measured;the mucosa of the rat’s pharynx was taken to determine the expression levels of JAK2 and STAT3 proteins in the rat’s oral mucosa.Results:1.Clinical observations:(1)Through clinical observation,patients with acute pharyngitis in the experimental group,the control group and the negative control group all achieved different degrees of efficacy;the healing rate and total effective rate of the experimental group were statistically significant compared with the other two groups(The healing rates of the experimental group,control group and negative control group were: 89.47%,83.33%,68.42%,respectively,by SNK test,q=3.93 for the experimental group compared with the control group;q=5.45 for the experimental group compared with the negative control group;q=3.23 for the control group compared with the negative control group,p<0.05,all differences were statistically significant;the total effective rates were The total effective rate was 94.73%,89.47% and 84.21% respectively,one-way ANOVA test,F=6.20,P<0.05,the difference was statistically significant).(2)The difference between the three groups was not statistically significant(P=0.05)before treatment;the difference between the three groups was statistically significant(P=0.05)before and after treatment;the difference between the three groups was not statistically significant(X2=-1.478,P=0.139>0.05)for the improvement of "pain in the extremities" among the secondary symptoms.There was no statistically significant difference in the improvement of "pain in the extremities" among the three groups(X2=-1.478,P=0.139>0.05).2.Experimental animal studies:(1)The rat model of acute pharyngitis was effective in the experimental,control and negative control groups compared to the model group by animal experimental studies.(2)Effect of Zheng’s laryngology Blow 2 on serum IL-1,IL-6 and TNF-α in rats with acute pharyngitis:Compared with the blank group,serum IL-1,IL-6 and TNF-α concentrations were significantly higher in the model group of rats with acute pharyngitis,and the differences were all statistically significant(IL-1 comparison,t=3.529,P<0.01;IL-6comparison,t=2.529,P<0.05;TNF-α comparison,t=3.823,P<0.01);Compared with the model group,serum IL-1 concentrations were reduced in the experimental,control and negative control rats(P was less than 0.05 by SNK test for comparison between the three groups,and the difference was statistically significant);Compared with the model group,serum IL-6 concentrations were reduced in the experimental,control and negative control rats(P was less than 0.05 by SNK test for comparison between the three groups,and the difference was statistically significant);Compared with the model group,serum TNF-α concentrations were reduced in the experimental,control and negative control rats(P was less than 0.05 by SNK test for comparison between the three groups,and the difference was statistically significant)(3)Effect of Zheng’s throat medicine No.2 on JAK2 and STAT3 protein in pharyngeal mucosa of rats with acute pharyngitis:Compared with the blank group,the protein levels of JAK2 and STAT3 in pharyngeal mucosa of model group were increased in different degrees,and the differences were statistically significant(P < 0.05);Compared with the model group,the protein levels of JAK2 and STAT3 in pharyngeal mucosa of rats in treatment group 1,treatment group 2 and treatment group 3 were decreased(P < 0.05 by SNK test)。(4)Histopathological observations on the pharynx of rats in each group showed that the mucosal structure of the model group was disorganized,with congestion and haemorrhage and heavy inflammatory cell infiltration,while the inflammatory cell infiltration and congestion and oedema in the lamina propria of the pharynx of rats in the experimental group,control group and negative control group all showed different degrees of improvement,and the improvement in the pharynx of the experimental group was the most obvious.Conclusion:Combined with clinical observation and animal experimental studies,Zheng’s laryngology Blowing Medicine No.2 Formula is effective in the treatment of acute pharyngitis,and its possible mechanism of action is to inhibit the JAK/STAT signalling pathway of the inflammatory response,thereby regulating the inflammatory response. |
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