The Investigation Of TCM Syndrome In Patients Of AECOPD And The Research Based On The Mechanism Of Th17/Treg Cell Imbalance Effect Of Intervention In COPD Model Rats

1 Purpose1.1 Clinical research: Collect and study the case data of patients with AECOPD,and summarize the distribution of TCM syndrome in AECOPD patients.1.2 Experimental study: Through the intervention of COPD model rats by using Shenqi Huatan recipe(SQHTF),observed the changes of general condition and lung tissue morphology,and detected the expression of TGF-β 1,IL-6,IL-10,IL-17,Foxp 3,ROR γ t and calculating Th17 / Treg cell ratio to study the effect of rats on the intervention mechanism of Th17 / Treg cell imbalance in COPD model rats.2 Method2.1 Clinical study:In this study,clinical case data of patients with AECOPD in the outpatient department and inpatient department of the First Affiliated Hospital of Anhui University of Chinese Medicine were collected to summarize the distribution rule of TCM syndromes.2.2 Experimental study:After a week of adaptive breeding,60 SPF rats were randomly divided into blank group(10)and mold making group(50).In the model group,lipopolysaccharide(LPS)was injected into the trachea on day 1 and day 14 at the beginning of the experiment,and the rats were passively exposed to cigarette smoke on days 2-13 and 15-60 to construct COPD model rats.After the modeling,the rats in the modeling group were randomly assigned to COPD model group(10 rats)and treatment group(SQHTF low-dose,medium-dose,high-dose groups and Jinshuibao group(10 rats each).The rats in the treatment group were treated with drugs 28 days later.The lung tissues of rats were stained with HE and the pathological changes were observed.The levels of Foxp3 and RORγt were detected by Western Blot.The expressions of IL-6,IL-10,IL-17 and TGF-β1 in rat serum were detected by ELISA.The proportion of Th17/Treg cells was measured and calculated by flow cytometry.3 Results3.1 Clinical study3.1.1 Basic Information:Among the 120 AECOPD patients,the male to female ratio was about 3:1,the mean age was(62.95 ± 9.15)years,and the mean course of disease was(7.64±5.48)years.A history of smoking accounted for 61.67%.3.1.2 Results of TCM syndrome: The top three TCM syndrome types of 120 AECOPD patients were sputum turbidity obstruction syndrome(30.83%),sputum heat obstruction syndrome(26.67%),and sputum stasis obstruction syndrome(17.50%).3.2 Experimental study3.2.1 HE Staining:The lung tissue structure outline was complete and clear,with smooth lumen,moderate thickness,no obvious inflammatory cell infiltration and bleeding exudation,and no obvious thickening of the alveolar septum.In the model group,there were significant small airway stenosis,alveolar septal rupture,vesicle cavity fusion,and obvious inflammatory cell infiltration,consistent with the pathological changes of COPD.Compared with the model group,lung tissue damage was reduced in the treated group.3.2.2 IL-6,IL-10,IL-17 and TGF-β1 expression: IL-10 expression decreased significantly lower in model group,and IL-10 expression increased in serum of treated rats(P<0.01);in contrast,IL-6,IL-17 and TGF-β1 decreased in blank group(P<0.01).3.2.3 Foxp3 and RORγt protein expression: Compared with the blank group,RORγt protein was decreased in the model group and treatment group,while RORγt protein and Foxp3 protein were increased in the treatment group.3.2.4 Th17/Treg Cell ratio: Compared with the blank group,the proportion of Th17/Treg cells increased significantly in the model group;compared with the model group,the treatment group was reduced.4 Conclusion4.1 Clinical study:120 cases of patients with AECOPD,TCM syndromes survey showed that the number of diagnosed syndromes in the patients was syndrome of phlegm turbidity obstructing lung > syndrome of phlegm heat obstructing lung >syndrome of phlegm stasis interlocking > syndrome of external cold and internal drink > syndrome of wind cold striking lung > syndrome of phlegm Mengshen expiating.4.2 Experimental study:SQHTF can improve the pulmonary lesions of COPD model rats,reduce the expression of IL-6,IL-17 and TGF-β1 in serum,increase the content of IL-10,promote Foxp3,inhibit the transcription of RORγt protein,and reduce the proportion of Th17/Treg cells in COPD model rats.It can reduce inflammation and regulate immunity.