| Objective:According to the pathogenesis of pulmonary qi deficiency is the Ben of theScleroderma, phlegm retention and blood stasis is the Biao of the Scleroderma, formulatingthe the therapy method of treating by lung, Selecting the ancient prescription "Bufei soup"for addition and subtraction, We evaluated the TCM understanding of the pathogenesis ofthe Scleroderma. Also with the guidance of the Jinshi instructor, we selectedBufeiqiyu-granule decoction for clinical observation and the associated experimentalstudy, in order to evaluate the mechanism of Bufeiqiyu-granule decoction for the treatmentof the scleroderma and provide reliable experimental data and theoretical basis.Methods:1 Theory methods: use computer network, search literature in ancient or moderntimes,in china or abroad, analysis and compare.2 Experimental methods:①Using intradermal continuous injection to the back skin ofmice BLM (A255-70%) three weeks,after the success of replication sclerodermatous model,Chinese herb for some time, The mice were killed and skin pathology, observed thetreatment of experimental scleroderma of Bufeiqiyu-granule decoction on BLM-inbredmice.②Using intratracheal instillation of bleomycin in rats (BLM-A6) to replicate themodel of pulmonary fibrosis, after use Chinese herb for some time, killed the mice andexamed the rat lung on pathology examinations and other experiments forinspection,observed the treatment of Bufeiqiyu-granule decoction on the experimentalpulmonary fibrosis in rats.③Through the mutual relations between primaryPharmacodynamics and experiment Clinical function.3 Clinical research methods: this study used a randomized Parallel controlled clinicaltrial methods, the number of patient observed was 40 cases, divided the treatment groupand the control group,each group was 20,they were treated for 8 weeks,usedBufeiqiyu-granule decoction on the treatment group,one does daily, used Penicillamine0.125 on the control group,twice daily, gradually increased the volume to 0.75—1.25 oneday, evaluated the Chinese medicine syndromes integral, integralskin sclerosis, signs andsymptoms, the difference related to laboratory tests and adverse reactions of both groupsbefore and after the treatment.Results:1 Theoretical study results: On the basis of an extensive literature search, and based on the academic thinking of Jinshi instructor, We believe that the basic pathogenesis ofScleroderma is: pulmonary qi deficiency is the Ben of the Scleroderma, phlegm retentionand blood stasis is the Biao of the Scleroderma, treatment by strengthening vital qi andeliminating pathogenic factors, treatment by lung and replenishing and restoring pulmonaryQi aiming at the Ben of the Scleroderma, treatment by promoting blood circulation toremove phlegm retention and blood stasis aiming at the Biao of the Scleroderma.2 Experimental study results:(1) Hemorheology experiment of the blood stasis mice showed: Bufeiqiyu-granuledecoction can expand blood vessels and improve microcirculation, had the certain effects ofpromoting blood circulation.(2)The experiment of DTH reaction in mice induced by DNCB showed:Bufeiqiyu-granule decoction can regulate the abnormal cells immune function.(3) The experiment of IgM antibody production in mice showed: Bufeiqiyu-granuledecoction can reinforce the role of humoral immunity.(4) The experiment of monocyte-macrophage phagocytosis functions of the Kunmingmice showed: Bufeiqiyu-granule decoction can reinforce the role of monocyte-macrophagephagocytosis functions, so can enhance immune function.(5) The experiment of Bufeiqiyu-granule decoction on Serum MDA and MAOdynamic of rat model of pulmonary fibrosis showed: Bufeiqiyu-granule decoction canlower serum MDA and MAO vitality in rat model of pulmonary fibrosis.(6) The effectible experiment of Bufeiqiyu-granule decoction on MDA content andHydroxyproline content in rat model of pulmonary fibrosis tissue showed:Bufeiqiyu-granule decoction can lower MDA content and Hydroxyproline content in tissue.(7) Pathology results of Bufeiqiyu-granule decoction anti bleomycin-inducedpulmonary fibrosis showed: Bufeiqiyu-granule decoction had the certain effects of antibleomycin-induced lung fibrosis,low-dose group was better.(8)The effect of Bufeiqiyu-granule decoction to bleomycin-induced inbred strainBALB/C sclerodermatous rat model showed:①Bufeiqiyu-granule decoction can prevent thymic atrophy and can preventsclerodermatous splenomegaly.②The low dose of, middle dose of and large dose of Bufeiqingyu-granule group hadimproved bleomycin-induced sclerodermatous dermal thickening trend.③The middle dose of and large dose of Bufeiqingyu-granule group can reduce dermalaround the small blood vessels,and ease subsidiary structure of hair follicles and sweatglands in the reduction or deletion.so showed that Bufeiqiyu-granule decoction had thecertain effects of anti bleomycin-induced sclerodermatous rat model. 3 Clinical studyresults: 40 cases of sclerodermatous patients were randomized into the treatment group andthe control group, each group was 20 cases. Compare the effects of TCM Syndrome,theeffects of Bufeiqingyu-granule group 95%, 41.7% better than penicillamine group, ranktest, T=7.02 P=0.008, a significant difference; The skin integral, tooth distance, fingersdistance, average grip strength,joint pressure pain index of two group compared with thosebefore treatment have improved, However, the treatment group better than the control group, These two groups showed significant differences (P＜0.05); the improvement inESR,MG of treatment group better than the control group, a significant difference(P＜0.05);Security Analysis showed: The treatment group found no adverse events and laboratoryabnormalities, five patients with abnormal taste, leukopenia, and abnormal liver functionwithdrew the test in the control group,so showed that Bufeiqingyu-granule group more safe.Conclusion:Bufeiqiyu-granule decoction improved clinical symptoms of the sclerodermatouspatients and more safe. Experimental studies have confirmed: Bufeiqiyu-granule decoctioncan promote blood circulation to remove blood stasis,improve microcirculation, regulateimmune function,anti-fibrosis,promote skin softening, clearly showed theBufeiqiyu-granule decoction has a number of ways to play the treatment of sclerodermafrom many areas. |
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