The Clinical Expeirence Research Of Professor Yang Ming-hui On Treating Bronchial Hyperresponsiveness Cough

Objective:To summarize the academic thought and clinical experience on treating bronchial hyperresponsiveness cough of professor Yang Ming-hui. To observe the clinical effect of Zi Yin Qing Re Gu Ben therapy in treatment of cough variant asthma(CAV) and to explore its mechanism.Method:To study professor Yang's academic thinking and clinical experience on treating bronchial hyperresponsiveness cough, explain bronchial hyperresponsiveness cough's pathogenesis and the principle of treatment in detail.70 CVA patients were randomly divided into control group and treatment group, the 34 patients (1 dropped out) in the treatment group were treated with Chinese herbs of Zi Yin Qing Re Gu Ben therapy, and the 34 patients (1 dropped out) in the control group were treated with theophylline sustained-release capsules, 100mg,1 per 12 hours, treatment course lasted for 4 weeks. The symptoms change of cough, throat itching, expectoration and shortness of breath were observed in patients before and after treatment. Infrared thermal images of bronchial of both groups were examined and the results compared after receiving the treatment. At the same time, The changes of peripheral blood of y-interferon (IFN-y), interleukin-4 (IL-4), Interleukin-5 ((IL-5)IL-5 were detected before and after treatment in both groups.Results:It was proved that yin deficiency and internal heat is the necessary factor of bronchial hyperesponsiveness cough, qi-yin deficiency of lung and kidney is the internal conditions of its occurrence. Four weeks after taking the medicine, the improvement of patients'symptoms, including cough, throat itching and expectoration in the treatment group were more obvious than that in the control group (P＜0.05). Difference in temperature of the bronchial mucosa tissue decreased remarkably in the treatment group (P<0.05). The cough effective rates were 91.2% in treatment group and 79.4% in control group (P＜0.05). The TCM syndrome total effective rates were 85.3%in treatment group and 70.6%in control group (P<0.05). After treatment, the level of IFN-y in serum was significantly higher than before treatment in the treatment group (P<0.05), there was not remarkable difference in the control group(P>0.05);2the level of IL-4,IL-5 in serum was significantly lower than that before treatment in the two groups (P<0.05). After treatment, the level of IFN-γ,IL-4,IL-5 in serum were significant differences between two groups (P< 0.05.Conclusion:Qi-yin deficiency of lung and kidney, Nourishing Yin and Clear Heat is the fundamental pathogenesis of bronchial hyperresponsiveness cough. Invigorating Kidney and Lung, Nourishing Yin and Clear Heat, Dispersal and descent Lung-qi, Eliminating phlegm and relieving blood-stasis are the methods of treatment. The treatment of CVA with Zi Yin Qing Re Gu Ben therapy can relieve the clinical symptoms obviously, modulate the immune balance, reduce the levels of inflammatory cytokines. The present study indicated that this therapy has the dominant of control chronic airway inflammation, reduce bronchial hyperresponsiveness. This may be one of the mechanisms to achieve good effect with CVA.