| Chronic obstructive pulmonary disease(COPD),referred to as COPD,is a relatively common chronic respiratory disease.Its high morbidity,high economic burden,low penetration rate of corresponding diagnostic equipment,low population awareness,and low compliance caused by the need for long-term medication make COPD one of the more difficult preventable and curable chronic diseases.At present,modern medical treatment of COPD mainly relies on bronchodilators,glucocorticoids,relieve cough,resolve phlegm,relieve asthma and other symptomatic drugs,which have a certain effect on delaying the decline of lung function and reducing the number of acute exacerbations,but long-term use of these drugs causes high economic burden and problems such as adverse reactions and complications cannot be ignored.Traditional Chinese medicine has a wealth of treatment methods for COPD since ancient times,and more and more modern studies have confirmed that traditional Chinese medicine is not only effective in treating COPD,but also has a high degree of safety and patient acceptance.The thinking advantage of TCM syndrome differentiation and treatment makes Chinese herbal medicine have great vitality for the treatment of chronic diseases.In recent years,researchers have paid more attention to the study of the mechanism of action of traditional Chinese medicine in the treatment of COPD.Airway remodeling is the core pathological process that is generally believed to cause COPD airflow limitation,its typical clinical symptoms,and the progressive decline of lung function.Transforming growth factor-β1(TGF-β1)and vascular endothelial growth factor(VEGF)are generally considered to be a cytokine related to COPD airway remodeling.Studying the effect of traditional Chinese medicine on airway remodeling factors is one of the important propositions involved in further understanding the mechanism of traditional Chinese medicine in treating COPD and promoting the treatment of COPD.Objective:To observe the effects of Bushen Peiyuan Capsule on the serum airway remodeling factors TGF-β1 and VEGF in patients with chronic obstructive pulmonary disease with kidney-yang deficiency syndrome and its clinical effects,in order to add more evidence-based medicine for the clinical use of Bushen Peiyuan Capsule in the treatment of COPD.Methods:Using a randomized controlled clinical trial method,60 subjects who met the inclusion criteria were divided into observation group and control group according to the stratified block randomization method.The control group was given conventional western medicine basic treatment,and the observation group was given Bushen Peiyuan capsule combined with western medicine conventional basic treatment.The treatment course is 3 months to observe the changes of serum TGF-β1,VEGF and TCM syndrome scores before and after treatment,and explore the effect of Bushen Peiyuan Capsule on COPD airway remodeling and clinical efficacy.Result:1.Baseline comparison of subjects:56 effective cases were finally included in the statistics,28 were in the observation group,and 28 were in the control group.The two groups of subjects had no significant differences in age,gender,smoking and GOLD classification distribution,and they were comparable.2.Comparison of main efficacy indicators:The comparison of serum TGF-β1 and VEGF levels between the two groups before treatment showed no significant difference and was comparable.Before and after treatment,the serum TGF-β1 levels of the observation group and the control group after treatment were significantly lower than their pre-treatment levels(P<0.05);the serum VEGF levels of the observation group after treatment were significantly lower than the pre-treatment levels(P<0.05),while the serum VEGF level after treatment in the control group was lower than the level before treatment,but there was no significant difference(P>0.05).Comparing the two groups,the serum TGF-β1 and VEGF levels of the observation group after treatment were significantly lower than those of the control group(P<0.05).3.Comparison of secondary efficacy indicators:The observation group combined with the patent drug Bushen Peiyuan Capsule has significantly improved the degree of improvement in TCM syndromes than the control group with conventional basic western medicine.Among them,the scores of cough,expectoration,shortness of breath,cold limbs,dizziness and tinnitus,urination frequency in the observation group after treatment were significantly lower than those in the control group(P<0.05).The integral difference of cold limbs and urination frequency before and after treatment was significantly higher than that of the control group(P<0.05).Conclusion:Bushen Peiyuan Capsule can significantly reduce serum TGF-β1 and VEGF levels in patients with kidney-yang deficiency syndrome in stable COPD,thereby delaying the airway remodeling process of COPD,and has a good clinical effect,and has a good promotion potential value. |
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