Study On The Clinical Efficacy Evaluation And Mechanism Of Zhuyang Bufei Chubi Decoction In The Treatment Of Interstitial Lung Disease(Fei Bi )

1 Meta-analysis of clinical efficacy of Zhu yang tong bi method in interstitial pulmonary diseasesObjective:Interstitial lung disease is delayed over time,because of the invasion of wind evil,fire evil,cold evil,dampness evil,which leads to the formation of lung qi occlusion,pulmonary collateral obstruction,and poor movement of qi and blood.Many clinical doctors have achieved a good curative effect in treating lung bi.At present,there are many clinical studies on the treatment of interstitial lung diseases,many scholars by using Zhu yang tong bi theory of interstitial lung disease harvest good effect,through the literature search found that there are many articles from this theory of interstitial lung disease this kind of disease,but in view of Zhu yang tong bi method treatment of interstitial lung disease in a series of clinical reports,lack of system evaluation.In this study,we conducted a comprehensive search of the published literature in the database,and applied Meta analysis to comprehensively analyze the RCT of human patients with interstitial lung disease,so as to provide a scientific basis for the treatment of interstitial lung disease.Methods:First of all,the retrieval plan should be formulated,which should be formulated according to the principles in the Cochrane system evaluation manual,and fixed subject words and free words should be formulated.Through free words and subject words,CNKI,Wanfang and VIP electronic database until November 2023,and different databases will adopt different retrieval formulas.The main object of clinical research is limited to human beings,and all animal experiments and cell experiments should be excluded.The research process includes literature screening and elimination,and data extraction,which requires 2-3 evaluators to cooperate and discuss according to the acceptance and arrangement standards.After data extraction,the risk of offset was reported,and the risk of bias assessment map,forest map and sensitivity analysis were made.Results:After in-depth reading of the literature and screening,19 articles were finally included in the study.According to statistics,a total of 1383 patients were included in the 19articles,divided into 2 groups,namely,the control group and the treatment group,with 694patients in the treatment group and 689 patients in the control group.Adverse reactions are not discussed in all the literature,indicating that the method has good safety in treating interstitial lung disease,and there are no reports of liver and kidney function injury.Statistics found that the treatment of interstitial lung disease by Zhu yang tongbi method can significantly improve the clinical symptoms of TCM,blood gas analysis,lung function,St.George’s respiratory questionnaire,etc.Conclusion:The clinical effect of traditional Chinese medicine that combines the method for patients with interstitial lung disease is good,with no obvious side effects and good safety.It can improve the clinical symptoms of traditional Chinese medicine,optimize the physical and chemical examination results,and it is recommended to promote it in clinical practice.2 A retrospective analysis of 163 cases of interstitial lung diseaseObjective:To take the opportunity of the treatment of pulmonary bi,Based on the pathogenesis of lung and kidney deficiency and cold,phlegm and blood stasis obstruction,through the study of Zhuyang Bufei Chubi Decoction,to explore the clinical efficacy of Professor Wang Tan,and to provide theoretical support and scientific basis for the clinical application of Zhuyang Bufei Chubi Decoction.Methods:According to the inclusion criteria and exclusion criteria,163 patients of pulmonary bi were selected from January 2019 to the inpatient department of the Department of Chinese Medicine of Changchun University of Chinese Medicine in December 2022 and met the inclusion criteria.The clinical symptoms and physical and chemical examination of interstitial lung diseases before and after taking Zhuyang Bufei Chubi Decoction were analyzed after data processing,and the efficacy of Zhuyang Bufei Chubi Decoction was verified combined with the data comparison.Results:After 2 months of treatment,cough,phlegm,wheezing,chills,chest tightness,shortness,fatigue,insomnia,joint pain and other symptoms all improved.Statistics showed that the P values of the above symptoms were<0.05,and the difference between groups was statistically significant.For palpitations and lower extremity edema,P value is>0.05,the difference between groups is not statistically significant,so the policy of taking Zhuyang Bufei Chubi Decoction did not significantly improve palpitations and lower extremity edema;in blood routine,the percentage of white blood cells,eosinophils,neutrophil count,neutrophil percentage,and CRP improvement P value is less than 0.05,further explained that taking Zhuyang Bufei Chubi Decoction can effectively improve the blood routine index;Pa O₂,the main indicator of blood gas analysis₂reach Pa CO₂,P<0.001.It is suggested that Pa O₂can be improved by taking Zhuyang Bufei Chubi Decoction and conventional basic treatment、Pa CO_2.Thus,helping the patient to open the airway and gradually restore ventilation function.By Wilcoxon signed rank test,the median of DLco and FEV 1%was P<0.001,indicating that lung ventilation function and diffusion function can be improved by Zhuyang Bufei Chubi Decoction and conventional basic treatmentConclusion:Zhuyang Bufei Chubi Decoction can effectively improve the clinical symptoms,blood routine,lung function and other indicators,and verify the clinical efficacy of Zhuyang Bufei Chubi Decoction,which can prevent the progression of the disease to some extent,and there is no obvious adverse reactions,which is recommended to be widely used in clinical practice.3 Bioinformatics analysis and experimental study of interstitial lung disease regulation network and pulmonary prescription in the treatment of interstitial lung diseaseObjective:Using the technology of bioinformatics,find the alternate difference genes and ways through data analysis,find potential biomarkers in the process of interstitial lung disease,explore the intrinsic regulation network of interstitial lung disease and through enzyme-linked immunization to Zhuyang Bufei Chubi Decoction verified genetic differences after the treatment of interstitial lung disease,to provide the experimental basis for the diagnosis and treatment of interstitial lung disease in the future.Methods:Firstly,GEO was used to select the datasets related to interstitial lung disease.After data analysis and processing,the important pathogenic genes of interstitial lung disease were identified:TNF-α,TGF-β,FOS,IL-6,KLF 4,BDNF and IGF 1.Secondly,blood samples were collected before and after taking medicine for patients taking Zhuyang Bufei Chubi Decoction.After collection,the samples were uniformly centrifuged and the supernatant was taken for use.Finally,enzyme-linked immunoassay（ELISA）was used to test the expression of TNF-α,TGF-β,FOS,IL-6,KLF 4,BDNF and IGF 1 in patient serum samples to verify the regulatory effect of Zhuyang Bufei Chubi Decoction on the above gene expression,so as to explore the potential mechanism of Zhuyang Bufei Chubi Decoction in the treatment of interstitial lung disease.Results:Bioinformatics analysis identified TNF-α,TGF-β,and IL-6 as inflammatory factors.therefore,We used ELISA to verify the effect of Zhuyang Bufei Chubi Decoction on the expression of TNF-α,TGF-β,FOS,IL-6,KLF 4,BDNF and IGF 1.The results showed that Zhuyang Bufei Chubi Decoction significantly inhibited the expression of TNF-α,TGF-β,FOS,IL-6,KLF 4,BDNF,IGF 1 in serum samples.To confirm the intrinsic mechanism of Zhuyang Bufei Chubi Decoction in the treatment of interstitial lung disease.This chapter partly confirms the potential mechanism of action in the treatment of interstitial lung diseases.Through the regulation of the above factors or can achieve efficacy.Conclusion:This chapter uses bioinformatics methods to mine the main biological pathways and markers of ILD,and constructs the regulatory network of interstitial lung disease,which provides a direction for the diagnosis and treatment of biological pathways and biomarkers related to interstitial lung disease.It can reduce the expression of TNF-α,TGF-β,FOS,IL-6,KLF 4,BDNF,and IGF 1,suggesting that these genes may be potential therapeutic targets of BAit in the treatment of interstitial lung diseases.4 Exploration of the utility substance and action mechanism of interstitial lung disease in the treatment of serum metabolomicsObjective:Through non-targeted metabolomics,the metabolic pathways and differential metabolites were detected before and after treatment in healthy people and ILD patients,and the metabolic pathways and potential biomarkers in the treatment of disease and Zhuyang Bufei Chubi Decoction were found,so as to provide new biological targets for the diagnosis and treatment of interstitial lung disease.Methods:Serum samples of ILD patients and healthy controls were analyzed by liquid chromatography-mass spectrometry（LC-MS）to obtain differential metabolites,metabolic profiles and related data.Positive and negative ion flow chart and orthogonal least squares-discriminant analysis（OPLS-DA）were used to determine the pre-and post-treatment metabolites,and the potential biomarkers were found by the S-plot of OPLS-DA and the variable weight value VIP>1.ROC curve analysis of differential metabolites was performed using SPSS 26.0 software to analyze the differential diagnostic value and identify novel biomarkers with differential diagnostic significance.Differmetabolic pathway enrichment analysis based on KEGG database to identify the main metabolic pathway.The correlation between the core metabolic differentials and the above six serum assays were analyzed.Results:Through the difference of LC-MC and OPLC-DA ion peak intensity of 40serum samples,there were different metabolites between the groups,the quality assessment of OPLS-DA model was well,and the data analysis was reliable.There were 875,64,862and 20 differential metabolites in the ILD groups before and healthy controls,before and after,and healthy controls,respectively.Correlations between differential metabolites between groups.There is a significant difference between human metabolites before and after the treatment of Zhuyang Bufei Chubi Decoction（P<0.05）.Zhuyang Bufei Chubi Decoction can regulate the abnormal changes of some metabolites.According to KEGG enrichment analysis,the relevant metabolic pathways in ILD disease mainly include serotonergic synapses,tryptophan,glycerol metabolism pathways,cancer pathways,and fat digestion and absorption.The most relevant metabolic pathways are the serotonergic synaptic pathway and the tryptophan metabolism pathway.The treatment of ILD by Zhuyang Bufei Chubi Decoction is mainly by affecting the sphingolipid signaling pathway and glycerophospholipid metabolism pathway.After serum metabolomics study,there are18 kinds of metabolites can be used as potential biological markers for the treatment of interstitial lung disease,mainly belonging to ketones,free fatty acids,amines,esters,sugars,heterocyclic compounds,small peptides,benzene and its derivatives,organic acids and their derivatives,terpenoids,nucleotides and their metabolites,and other classes.Conclusion:There were differences in serum metabolites between the groups.According to KEGG enrichment analysis,the most related metabolic pathways in ILD are the serotonergic synapse pathway and tryptophan metabolism pathway;the treatment of ILD with Zhuyang Bufei Chubi Decoction is mainly by affecting the sphingolipid signaling pathway and glycerophospholipid metabolism pathway.It may play A role in the treatment of interstitial lung diseases by regulating Acacia acetyl,ethyl linolate,sulfonamide,14,14,15,15-tetradeuterium-N-（2-hydroxyethyl）hexadecamide,raccoside A,maloside,hydroxycitric acid,o-benzyl-1-serine,M2 dihydroxylated metabolites,and adenine.