Professor CUI Hong - Sheng 's Experience In The Treatment Of SDA And The Pathological Changes Of Bronchial Lung Tissue In Rats

In recent years, the nature of the bronchus asthma airway allergic inflammation in the gradually in-depth research, inhaled corticosteroids as a first-line drugs in the treatment of bronchial asthma in western medicine, by reducing the airway inflammation, relieve asthma symptoms, in the control of asthma plays a vital role, but there is still a small number of patients in the clinical sensitivity to glucocorticoid is bad, need a large number of oral hormone for a long time, formation of hormone dependence, when reduce the dosage of hormone or withdrawal will appear repeatedly in delay or worse, cause the asthma attack or his condition deteriorated again, this type of bronchial asthma is the steroid-dependent asthma (steroid-dependent asthma, SDA), SDA as a kind of difficult to treat asthmatic disease, put many clinical doctors in the difficulty of don’t know how to treat.Through the study of outpatient follow tutor professor Hongsheng Cui Copy party in the third affiliated hospital of Beijing university of Chinese medical, summarize tutor for diseases including SDA experience in treating bronchial asthma. Tutor clinical bian xiao disease based on the"and"thought, when clinical follow"to a","and"total principle, from the perspective of zang-fu syndrome differentiation and treatment, in order to seek the right in the prevention and treatment of bronchial asthma in the equilibrium state.Objective:clinical part through the study of outpatient with architect, sum up the experiences of tutor in the treatment of bronchial asthma and thought of traditional Chinese medicine clinical treating bronchial asthma with guiding significance; Experimental research on simulating clinical patients with SDA process of hormone pullback in reshaping the airways of the asthma rat hormone intervention model, the model rats in the pullback in bronchial lung tissue were studied at different times of the hormones, then observe the airway tube weeks inflammatory cells infiltration and bronchial mucosal hyperplasia Masson trichromatic dyeing observation lung fibrosis and airway epithelial cells were observed under electron microscope and mitochondrial ultrastructure changes.Methods:150 SPF SD male rats, according to a random table, divided into normal control group, and airway remodeling, dexamethasone intervention group, Mick to shu and three sequential group, each group 30. With egg albumen sensitization and stimulate the airway remodeling group get airway remodeling of asthma model, each time the atomization before with intraperitoneal injection of dexamethasone intervention and dexamethasone intervention group. Mick to shu and three sequential group, general Mick to shu and three sequential group prior to the excitation with budesonide atomization, Chinese traditional medicine three sequential party prior to the withdrawal, and pulled back to three lavage execration second side. Normal control group sensitization and excitation are replaced with normal saline.Result and conclusion:Clinical aspects, three sequential method can effectively shut down SDA in patients with oral dosage of hormone, relieve asthma symptoms improve the patient’s lung function, improve the quality of life in patients with asthma, reducing patients dependency of hormone. Its mechanism may be through regulating Th1/Th2 subsets imbalance inhibition of IL-4,5,il-thereby inhibit airway inflammation and restore the function of HPA axis, reduce airway hyperresponsiveness, improve pulmonary ventilation function, so as to reduce patients of hormone dependence, and three sequential method is expected to be an effective alternative to hormone therapy of traditional Chinese SDA treatment.Experiment aspects:1. Rats macroscopic characterization and behavioral changes:(1) macro Characterization and abnormal changes of mental, emotional and behavior such as:dexamethasone intervention group after neutralization pulled hair color fading, diet, depressed, mainland incontinence, weight loss and other symptoms, psychiatric, symptoms, the abnormal change of mood, behavior situation, such as irritable resisting arrest, or clothing v compliance, or terrified, or limb jitter symptoms, such as three sequential group was obviously improved, similar to general Mick to shu group;(2) in the rat asthma symptoms and signs:after neutralization pulled, dexamethasone intervention group breathing, shortness of breath, abdominal muscle contraction, serious respiratory rhythm of slow or irregular and sometimes choke to cough, sneeze, or even smell and wheezing sound, basic control three sequential group respiratory symptoms, respiratory symptoms and Mick to shu group is controlled, but there are different degrees of limb skin cold, nose and mouth, claws, the tail light purple purple, like crowded together nuzzles, decreased activity, such as disease, these symptoms improved significantly in group three sequential.2. bronchial lung tissue morphological changes:① then HE lung tissue staining:normal control group(Z group) has no obvious inflammatory cell infiltration. Groups of sensitization, asthma rat lung tissue HE staining shows different degree of bronchial mucosal epithelium goblet cells increased, wall smooth muscle hyperplasia, tube weeks lymphocytes scattered and focal flake infiltration, wide alveolar septa, lymphocytes mainly inflammatory cells infiltration, inflammation significantly reduce three sequential group, bronchial mucosal epithelium rare goblet cells, epithelial hyperplasia of mild, no obvious secretions in the cavity, the wall smooth muscle hyperplasia, lymphocyte infiltration pipe weeks have scattered, alveolar walls are inflammatory cells infiltrating lymphocytes;② then Masson trichromatic dyeing airway remodeling group collagen sex interstitial connective tissue of pulmonary fibrosis collagen deposition in great quantities, hormone pullback in dexamethasone group, also appeared in the process of collagen deposition and three sequential group and Mick to shu, compared with more than two groups decreased significantly;③ under electron microscope:airway remodeling of airway cilia fall off, obviously not neat, goblet cells and mitochondria increased, shut down during and after the dexamethasone group hormone and airway remodeling group of close, and three sequential group and Mick to shu in the process of the group can obviously improve the hormone pullback in airway cilia fall off;④ the bronchial wall thickness:hormone shut down before, during and after general Mick to shu and three sequential group compared with airway remodeling group, significantly reduce bronchial wall thickness(group P<0.01),compared with dexamethasone group, hormone before shut down at Mick to shu and three sequential group no difference(P>0.05), a hormone in the pullback in bronchial wall thickness decrease(P< 0.05),significantly reduced hormone shut down after the bronchial wall thickness(P<0.01); Bronchial smooth muscle thickness; hormone shut down before each group no significant difference(P=0.476> 0.05), hormone shut down process, Mick to shu group and three sequential group compared with airway remodeling group, bronchial smooth muscle thickness reduction for each group(P<0.05), hormone after shut down, Mick to shu group and three sequential group compared with airway remodeling group, each team will significantly reduce the thickness of the bronchial smooth muscle(P< 0.01), compared with dexamethasone group, hormone before shut down at Mick to shu and three sequential group no difference(P>0.05), hormone shut down to reduce the thickness of bronchial smooth muscle(P.<0.05), significantly reducing hormone after the pullback in bronchial smooth muscle thickness(P<0.01);Bronchial smooth muscle cell nucleus numberp:hormone shut down before,during and after general Mick to shu and three sequential group compared with airway remodeling group, each team will significantly reduce the number of bronchial smooth muscle cell nucleus(P<0.01), compared with dexamethasone group, hormone before shut down at Mick to shu group and three sequential smooth muscle cell nucleus reduced(P<0.05), smooth muscle cell nucleus hormone shut down during and after several significant decrease(P<0.01).Three sequential method can obviously relieve asthma model rats to bronchial lung tissue pathology morphological inflammatory change, suppression of SDA airway remodeling.