The Effect Of Tanreqing Injection Combined With Bronchoalveolar Lavage On Neutrophi Elastase And MUC5AC In CAP (Community-acquired Pneumonia) With Phlegm-heat Blocking The Lung Type

Objective:To study the effect of Tanreqing injection combined with bronchoalveolar lavage(BAL)on neutrophi elastase and MUC5AC in CAP(Community-acquired Pneumonia)with phlegm-heat blocking the lung type,and preliminarily explore the mechanism of Tanreqing injection in CAP patient.MethodsThis study was carried out in the respiratory inpatient of Guangdong Hospital of TCM between July 2016 and July January.59 cases were included according to the inclusion criteria and were randomly divided into 2 groups:the treatment group and control group.One case in the treatment group fall off in the observation process,and the shedding rate was 1.69%.In this 1 week study,control group was given routine western medicine,while the treatment group was given additional Tanreqing Injection and BAL.All patients' changes of sputum neutrophi elastase(NE)and MUC5AC,traditional Chinese medicine(TCM)symptoms score,clinical pulmonary infection score(CPIS),blood White blood cell count(WBC)count,neutrophil percentage(N%)and C-reactive protein(CRP)was observed.The correlation between NE and MUC5AC was analysed.Results1.The baseline conditions:There were 28 cases in the treatment group and 30 cases in the control group.The differences of the two groups' age,gender and merger diseases have no statistical s ignificance(P>0.05);and severity of illnessand of the two groups was at the same level,indicating the good comparability of materials.2.The changes of sputum NE and MUC5AC:Decrease of NE and MU,C5AC was observed in both groups(P<0.05),and the treatment group had a greater descend range(P<0.05).Positive correlation between NE and MUC5AC was found.3.The changes of WBC,N%,CRP,CPIS and TCM symptoms score:There were statistical significance within groups before and after treatment for WBC,N%,CRP,CPIS and TCM symptoms score(P<0.05),but not N%(P>0.05).There were statistical significance between groups after treatment for WBC,CRP and TCM symptoms score(P<0.05),but not N%and CRP(P>0.05).However,the degree of deviation of WBC between groups after treatment showed few clinical significance.4.The therapeutic effect comparison:The treatment group has a total effective rate of 100%,while the control group's rate was 86.7%,which showed a better therapeutic effect of the treatment group than its counterpart(P<0.05).5.Safety evaluation:There were 2 cases of adverse events in the process of the entire study.One patient in the treatment group show slightly elevated at level of Aspartate transaminase(AST)and Alanine aminotransferase(ALT)in the 6 th day of the process,and they fall back to normal range without any pertinency treatment.One patient in the control group showed a hearing in the 2 th day of the process after BAL,and this symptoms disappeared in the same day after being given Golden throat atomization liquid by aerosol inhalation.Conclusion1.The comprehensive treatment combining Tanreqing injection with BAL based on western medicine treatment can reduce sputum NE and MUC5AC of CAP patients.2.Sputum NE and MUC5AC of CAP patients is positivly correlated.Reducing MUC5AC and NE may be one of the action pathways for Tanreqing Injection combined with bronchoalveolar lavagein treating CAP patients.3.Both routine western medicine therapy and the comprehensive treatment combining Tanreqing injection with BAL based on western medicine treatment have a good clinical efficacy in patients with CAP.4.Comparing with routine western medicine therapy,the comprehensive treatment combining Tanreqing injection with BAL based on western medicine treatment is safety,and it can better reduce inflammatory reaction and the symptoms of CAP patients.