| Severe Atypical Respiratory syndrome (SARS), caused by a new coronary virus, is a respiratory infectious disease characterized by quick onset, fast spread and high mortality. SARS, once widespread in 32 countries and regions, has caused huge economic losses to human kind. It has been successfully been brought under control, but man still faces the challenge of its possible variant and its attack on human kind.Influenza is a common disease with a high incidence and mortality. People including medical professionals pay little attention to it. In the 20th century, there were 4 influenza attacks globally, which claimed thousands of lives, surpassing the total casualty figure in the First and Second World Wars.Avian Influenza has been in the avian for more than 100 years. The victims can be all kinds of domestic birds or wilds birds. A small number of mammary animals can also be affected. We didn' t find the first human case affected with avian influenza virus until in May 1997, in Hong Kong. So far we have found 3 serotypes, i. e, H5N1, H9N2 and H7N7 which can get people ill. All of them belong to Type A influenza virus. 50% of people with H5N1 will lead to pneumonia, the mortality being 30%, which is more severe than SARS. Now China has found several cases of deaths caused by avian influenza. It is fortunate that there is no proof that avian influenza can spread between humans beings. If a high pathologenicity virus such as H5N1 can acquire the ability to spread between man and man, the severity of the consequence will be no less serious than the threat posed by SARS.SARS coronary virus, avian influenza virus and influenza virus have something in common: they are viruses that invade the human body through respiratory tract to cause respiratory infection and general infection. Facedwith the common challenge that more and more cases of respiratory virus infection, increasing severity of contagion, more seriousness of illness, it is essential for medical workers in China and the western countries to find effective prevention and treatment methods to reduce the harm caused by respiratory virus infection.1. Literature studySARS is caused by the infection of a variant coronary virus (SARS-CoV). CoV is a single plus strand RNA virus with a capid. It falls into the family of coronary virus, coronary virus genus. In the process of the onset of SARS, SARS-CoV virus is not the decisive factor. It is the imbalance in immune function caused by the invasion of SARS-CoV that is the main element of the onset. The target organs of SARS-CoV are the lungs and the immune system. On one hand, it can trigger the body' s immune response to fight against SARS-CoV;On the other hand, it can cause the host' s immune suppression and immune damage. It is connected with the following factors: (1) human body' s non-atopic immune cell response;(2) the immune imbalance of T cell;(3) overreaction of immune response and autoimmune response;(4) the participation of cell factor such as TNF-a ? IL-2> IL-6 and cell apoptosisInfluenza virus belongs to orthomyxovirus family and is a single minus RNA virus divided into segments. According to the antigenicity of nucleoprotein and stromatin and the difference in the genetic characteristics, influenza virus can be classified as Type A, Type B and Type C. The same type can be divided into several subtypes according to the difference in antigenicity in hemagglutinin (HA) and neuraminic acid enzyme (NA). The antigenicity of HA in Type A influenza virus has 15 subtypes (HI—H15), HI—H3 relative to human influenza virus. The antigenicity of NA has 9 subtypes (Nl—N9), only Nl and N2 peculiar to human beings. Type A influenza virus that attacks avians is called avian influenza virus (AIV). Bird disease caused by H5 AND H7 subtype toxic strains (with H5N1 and H7N7 as the example) is called high pathogenicity avian influenza. By studying the infectious mechanism through which influenza virus attacks, it is found that in the pathological change the production of antigen processing cells and CD4\ CD8+T cells and related cell factors in the respiratory tract plays an important role. After the infection, monocytes, phagocytes and white cells are stimulated to release three kinds of cell factors: chemotactic factor (such as IP-10), inflammatoryfactor (such as IL-6> IL-18), TNF-a , which further triggers the accumulation of immune cell. This results in the regulatory imbalance of cell factors. High pathologenicity AIV overcomes the genus barrier. After infecting humans in the respiratory tract, it can replicate itself and spread in the body. This not only causes direct tissue and cell damage, but also causes the immune system in the body to produce pathological immune response, thus indirectly causing pathological trauma in the tissue and cell. So one common pathological mechanism in the three respiratory viuses is that they can lead to the imbalance in the body' s immune function.Traditional Chinese Medicine thinks that SARS belongs to the category of "warm disease. " It is due to experiencing "the evil of the epidemic and the poison of the season. " The pathologenesis is closely related to "humidity, heat, poison, stasis and feebleness. " My academic adviser Professor Peng Shengquan thinks that this disease can be diagnosed as "wind warm. " It is because of wind, together with heat and humidity. The pathologenesis is that the miasma blocks channels and collaterals. As a result the lungs can not perform the function of descending and liquefying and disseminating and circulating. The change is from the surface to the inside. Clinical diagnosis can be classified as 8 discriminative types: miasma invading the defence of the lungs;miasma blocking Shaoyang;humid heat frustrated in tormogen;evil heat overfilling in the lungs;the heat of the lungs moving to the intestines;heat entering the nourishing blood;human resistance to disease being enfeebled;Yin is harmed in later stages. The overall curative principle is that we should bear the pathologenesis in mind. We can disperse wind out of the way of heat or saturate humidity below heat. Clinically Kangliyin as the main therapy to treat SARS has been used and has achieved good results. 38 cases are under clinical observance. It takes 5 days for them to reduce fever and the average number of days in hospital is 18. This is obviously better than western medicine treatment Influenza is caused by unhealthy environmental influence and the pathologenesis is because patients suffer from the miasma of the season. The imbalance of Ying and Wei leads poison to go inside and heat fill the lungs. The changing regularity of Wei, Qi, Ying and blood can be identified. In treatment, it is important to recognize the surface and inner part as well as interior and exterior. If the miasma hasn' t entered the body, the priority should be to disperse heat and drain the surface;if the miasmahas entered the body, the priority should be to disperse heat, get rid of poison, get the miasma out of the body. 2. Experimental Research1) Experimental Model and MethodThis experiment takes mouse virus pneumonia caused by influenza virus dropping into the nose as the model and uses anti-immoderate drinking decoction to carry out experiments inside and outside the mice' s body. Among the indexes selected are lung index, death protection rate, life-lengthening rate. IL-2n IL-6^ IFN- Y -. TNF-ck T cell subgroup, phagocytosis index a etc. The mice are randomly divided into normal control group;model control group, positive medicine control group (virus azole group), the group on high dose of anti-immoder.ate drinking and the group on low dose of anti-immoderate drinking. There are 10 mice in each group. Under slight anesthesia caused by ether, the mice are infected by dropping influenza virus into the nose. Before the day the virus attacks medicine is given, which lasts 4 days. Then measures of relevant indexes are made.2) Experiment Results(1) The effect of Kangliyin on Mouse Pneumonia Caused by FMI Strain of Type A Influenza VirusThe results indicate that anti-immoderate drinking can reduce the lung index value of the mice with influenza virus pneumonia and has a protective effect on mice with Type A influenza virus. What is more, it can significantly reduce the degree of their pathological change. But outside the body non-toxic concentration of anti-immoderate drinking has no suppressing effect on Type A influenza virus.(2) The effect of Kangliyin on the IL-2^ IL-6> TNF-ck IFN- Yof the mice with influenza virus pneumonia.The results indicate the level of IL-2 and IFN- y in the plasma has decreased while the level of IL-6 -. TNF-a has markedly risen. This is an indication that the virus infection leads to imbalance of the immune function. After Kangliyin treatment, the level of IL-2 and IFN- Y in the plasma has markedly risen, which shows that this medicine can promote the production of IL-2 and IFN- y. The two kinds of cell factors can strengthen the function of CTL, and set natural killer cell (NK) in motion. The mutual reaction of NK cell, IFN-Y and IL-2 can form an immune network, strengthen the anti-virusand immune regulatory effect. The results also show that after Kangliyin treatment, the level of IL-6 -. TNF-a in the plasma obviously decreased, which has a significant effect in reduce the harm to body immune pathology, because IL-6 n TNF-a are inflammatory factors and they are important elements in causing immune pathological harm. By preventing the overproduction of TNF-a, the harm done to the organs can be lessened or eliminated. It is reported that in the mouse model infected by adenovirus, high titration of TNF-ck IL-K IL-6 has been detected both in the infiltrating stage of the lung of the mouse and in the plasma, indicating that cell factor plays an important role in the process of inflammation.(3) The effect of anti-immoderate drinking on the subgroup in the T lymphatic cell of the mouse infected with influenza virus pneumoniaThe results indicate that after the mouse has been infected by influenza virus, there has been a reduction in the level of CD3+ n CD4\ CD47CD8* while there is a rise in CD8+, both of which are the manifestation of T cell immune suppression. This can be seen as the temporary cell immune defect caused by influenza virus infection and show that cell immunity has taken part in the complete process of the infection of influenza virus. After the Kangliyin treatment, CD3+ ^ CD4\ CD4+/CD8+ rises and CD8+drops, which indicates that Kangliyin has the function of regulating cell immunity. It is likely that it has a protective effect in influenza virus infection thus checking the development of the disease, and promoting the improvement of pathological change. Besides, results indicate that Kangliyin can improve the phagocytosis of the mouse' s mononuclear phagocyte.This experiment indicates outside the body, Kangliyin has not suppressant effect on influenza virus, but inside the body experiments show Kangliyin has a good curative effect on the influenza virus pneumonia. This shows that Kangliyin takes effect not through direct suppression or killing influenza virus, but through the improvement or regulation of the cell immunity and body fluid immunity function of the mice infected with influenza virus. Because the pathological degree of the influenza virus pneumonia is lessened, the mice' s mortality is reduced. There is something in common in respiratory viruses when they cause disease, that is, they cause imbalance in the body' s immune response. It can be predicted that the mechanism of Kangliyin treating SARS may also lie in the ability to regulate the immune function of the body,and not take effect by directly suppressing or killing viruses. So there is great prospect and unique advantage in treating respiratory virus infectious disease by using Kangliyin. |
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