| Objectives:1.Exploring the distribution of TCM Syndrome Types bronchiolitis obliterans(BO) in children to provide evidence for clinical syndrome differentiation and treatment.2. Exploring the infuence of Wenfei-decoction on the expression of CCSP, PPAR, TGF-β1/Smad3 in lung of BO rats.Methods:1.Clinical research: A questionnaire of children with BO was made to collect diagnostic information of TCM in 117 children in BO.Establishing an information database of TCM syndrome, using SPSS17.0 factor analysis to perform the statistics. 2.Experimental study: BO of lung asthenia cold syndrome model was established with rats.The Wistar rats were randomly divided to normal group(normal saline 2ml·d-1), model group(normal saline 2ml·d-1), TCM low dose group(3.145mg·kg-1·d-1),medium dose group(6.29mg·kg-1·d-1),high dose group(12.58mg·kg-1·d-1),western medicine group(dexamethasone0.08mg·kg-1·d-1 +montelukast sodium1.07 mg·kg-1·d-1).Rats in each group were given gavage for 2 weeks to observe the rats general conditions,the changes of pulmonary function.IFN-γ levels in bronchoalveolar lavage fluid was detected by ELISA. The expression of CCSP, PPARγ was detected by immunohistochemistry method.The expression in rat lung tissue TGF-β1, Smad3 and α-SMA was detected by western blot. RT-PCR method was used to detect the expression of CCSP, PPAR, TGF-β1, Smad3, α-SMA and mRNA in rat lung tissue.Results:1.Clinical research:(1)The sex ratio of boys:girls was about 3:1 in children with BO.87(74.4%) of cases were under 3 years of age. The age of high incidence of BO was infants and young children.(2)The main pathogens of infection were adenovirus, mycoplasma pneumoniae, measles virus, fungi.(3)The main clinical syndromes were phlegmheat obstructing lung syndrome, syndrome of exogenous disease due to yang deficiency, lung asthenia cold syndrome,lung qi deficiency syndrome,yin deficiency and lung heat syndrome,lung-spleen qi deficiency syndrome.Phlegm heat obstructing the lung in children was more common in males and mycoplasma pneumoniae infection.The condition of this syndrome was in a improved trend. Syndrome of exogenous disease due to Yang deficiency in children was more common in virus infection, especially adenovirus infection, highly correlated to pulmonary emphysema, bronchial dilation is. The course was longer and the condition was recurrent. Children in lung asthenia cold syndrome first wheezed in six months after birth and was more common in mixed infection after.This syndrome was highly correlated with ICU days, severe history of pneumonia, mechanical ventilation days.The course was usually more than 2 years,and the condition was exacerbation.Lung qi deficiency syndrome were closely related to ICU hospitalization days,the duration of mechanical ventilation and adenovirus infection sicker. Yin deficiency and lung heat syndrome were more common with mixed infection, mycoplasma was one of the most common pathogens.Lung and spleen qi deficiency syndrome in children were less than 1 year old and more common in adenovirus infection.CT showed pulmonary emphysema and atelectasis.Yang exogenous syndrome and qi deficiency syndrome were closely related with adenovirus infection,bronchiectasis,bronchial wall thickening,emphysema, severe pneumonia,mechanical ventilation days and ICU days,and was difficult to treat in clinic.(4)BO in children with infective stage showed phlegm heat obstructing the lung syndrome and yang exterior syndrome. In the stable phase of the disease,children showed lung deficiency cold syndrome,deficiency of lung qi weak syndrome,lung yin deficiency heat syndrome, lung and spleen qi deficiency.2.Experimental study: Wenfei decoction low dose group had no obvious effect on the model rats, the medium and high dose groups could significantly improve the general conditions of rats, significantly improve rat lung compliance(P<0.05), improve IFN-γ levels in bronchoalveolar lavage fluid in model rats(P<0.05),downregulate level of TGF-β1,Smad3,a-SMA(P < 0.05), upregulate CCSP and PPARγ(P < 0.05) from both gene and protein expression.The effect was better than Western Medicine(P<0.05) in improving the weight,lung compliance, upregulating of CCSP,PPARγ and downregulating the expression of a-SMA in rats.Conclusion: 1.(1)Clinical research:The main clinical syndromes were phlegmheat obstructing lung syndrome, syndrome of exogenous disease due to yang deficiency, lung asthenia cold syndrome,lung qi deficiency syndrome,yin deficiency and lung heat syndrome,lung and spleen qi deficiency syndrome.(2) BO in children with infective stage showed phlegm heat obstructing the lung syndrome and yang exterior syndrome. In the stable phase of the disease,children showed lung deficiency cold syndrome, deficiency of lung qi weak syndrome, lung yin deficiency heat syndrome, lung and spleen qi deficiency syndrome.2.Experimental study:Wenfei-decoction medium and high dose groups can significantly improve the general conditions of rats, significantly improve pulmonary function of the ratsimprove IFN–γ level in bronchoalveolar lavage fluid of model rats upregulate CCSP, PPARγ, downregulate the expression of TGF-β1, Smad3 and a-SMA expression from both gene and protein level. |
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