| BackgroundAllergic rhinitis(AR)is one of the most common diseases in the world.The disease is easy to recur,which not only reduces the quality of life of patients,but also increases the social medical economic burden.The incidence of AR is increasing year by year,the latest surveys show that the prevalence of AR in adults is about 1%?40%,5%?38%of asthmatic patients have AR,and 6%?85%of asthmatic patients have nasal symptoms.AR is not only related to asthma,but also a risk factor for the development of asthma.The treatment of AR can significantly improve asthma control,early and active treatment of AR may prevent the development of asthma.According to perfessor Zhang Shunan,the main etiology and pathogenesis of AR are deficiency of Yang and invasion of wind and cold,warming yang and dispersing cold are the main methods.In this study,data mining technology was used to analyze and study the drugs used by tutors in the treatment of AR,and to summarize the rules of drug use and the characteristics of diagnosis and treatment.In the past,the pathogenesis of AR was thought to be related to Th1/Th2 immune imbalance.With the deepening of research,it was found that the pure Thl/Th2 imbalance theory was not enough to explain the pathogenesis of AR.The discovery of Th17 and Treg cells has increased our understanding of the pathogenesis of AR.By using modern pharmacology,pathology,molecular biology and other methods,the animal experiment of lu'e Biyan formula was carried out.To study the effect of lu'e Biyan formula on Treg/Th17 cells and related cytokines in AR model rats,to explore the mechanism of lu'e Biyan formula in the treatment of AR.Clinical ResearchObjectiveUsing retrospective clinical research methods,213 cases of AR were analyzed.The clinical experience of treating AR by perfessor Zhang Shunan was summarized and the idea of differentiation and treatment and the experience of medication were inherited to provide reference for clinical treatment.MethodsFrom January 2018 to December 2019,the subjects were Allergic rhinitis patients who visited chief physician Zhang Shunan in China Japan Friendship Hospital from January 2018 to December 2019 were collected.The average age was 46.63 years.There were 140 females and 73 males,the ratio of males to females was 1:1.92.Among the 213 patients,131 were simple allergic rhinitis,42 were allergic rhinitis with chronic cough,40 were allergic rhinitis with bronchial asthmaUsing Excel 2010 to set up database,including basic information of patients and prescriptions of traditional Chinese Medicine.Using SPSS 18.0 and weka3.8.2 statistical software,using statistical methods such as frequency analysis,clustering analysis,association apriorl algorithm,etc.,data mining of drugs is carried out.By analyzing the correlation of drug taste,we can get the rule of drug combination.ResultsAmong the 213 selected cases,131 cases were simple AR,42 cases were AR with chronic cough,40 cases were AR with bronchial asthma.Based on the further analysis of 131 cases of simple AR,42 kinds of high-frequency drugs were used,mainly Xinwen,mostly in lung,spleen,liver and kidney meridians,with the highest frequency in tonifying and dispersing wind and cold.Apriori algorithm was used to mine drug association rules of 42 high-frequency drugs,and 7 commonly used dual drug pairs and 18 commonly used triple drug pairs were obtained.The cluster analysis of 42 high-frequency drugs was carried out by using the method of systematic cluster analysis,and 5 regular drugs and 5 combination of 3 drugs were finally obtained.ConclusionsProfessor Zhang Shunan thinks that the pathogenesis of AR is Yang deficiency and wind cold invasion,the treatment is to warm yang,clear the orifices,dispel wind and dispel cold.He emphasizes the treatment of both nose and lung,and pays attention to the "identity" of diseases.He is good at using the Scriptures in the clinical evidence,and there are many additions and subtractions.He is good at using all kinds of resuscitation drugs to make them have their own advantages.Experimental ResearchObjectiveIn this study,the effect of lu'e Biyan formula on Treg/Th17 cells and related cytokines in AR model rats was studied to explore the mechanism of lu'e Biyan formula in the treatment of AR.MethodsAfter 7 days of adaptive feeding,45 male SD rats were weighed and randomly divided into five groups:normal group,model group,western medicine group,low-dose Chinese medicine group and high-dose Chinese medicine group,with 9 rats in each group.In addition to the normal group,the establishment of allergic rhinitis model of SD rats in other groups is divided into two stages:basic sensitization and local sensitization.In the first two weeks of the model,0.3mg ovalbuinin(OVA)and 30mg Al(OH)3 were mixed in 1ml normal saline,and intraperitoneal injection was performed every other day.The blank group was injected with the same amount of normal saline.From the 15th day to the 21st day,the local sensitization stage was observed.50 ?l of 10%OVA solution was dripped into each nostril of rats every day,and the same amount of normal saline was dripped into the blank group.On the 22nd day of the experiment,rats were divided into groups.The drug was administered once a day,2ml/time,by gavage for 2 weeks.The specific administration was as follows:the blank group and model group were given normal saline,the western group was given 1 mg/kg loratadine,the low-dose Chinese medicine group was given 6.5g/kg lu'e Biyan formula,and the high-dose Chinese medicine group was given 13g/kg lu'e Biyan formula.The rats were given corresponding drug intervention respectively,and were killed after two weeks of continuous treatment.The serum and nasal mucosa of rats were taken,HE and PAS staining were performed on the nasal mucosa of rats to observe the pathological changes.The expression of IL-17 and IL-10 in the nasal mucosa of rats was measured by immunohistochemistry.The expression of Foxp3 and ROR yt mRNA was determined by RT-PCR.The concentrations of IL-17,IL-10 and TGF-?1 in rat serum were detennined by enzyme-linked immunosorbent assay(ELISA).ResultsCompared with the blank group,the nasal mucosa of the model group showed continuous interruption,structural destruction,cilia shedding,epithelial cells arranged in disorder,goblet cell proliferation,gland and blood vessels around the submucosa expanded and proliferated,and a large number of eosinophils and other inflammatory cells infiltrated.Compared with the model group,the pathological changes of nasal mucosa in the western medicine group,the low-dose Chinese medicine group and the high-dose Chinese medicine group were alleviated in varying degrees.Compared with the blank group,the contents of IL-10,Foxp3 mRNA,IL-10 and TGF-(31 in the model group were significantly reduced,while the ratios of IL-17,RORyt mRNA,RORyt mRNA/Foxp3 mRNA in the model group and the contents of IL-17 in the serum were significantly increased(p<0.05).After drug intervention,compared with the model group,the western medicine group,the low-dose Chinese medicine group and the high-dose Chinese medicine group showed that the levels of IL-10,Foxp3 mRNA,IL-10 and TGF-?1 in the rat nasal mucosa increased to different degrees,while the levels of RORyt mRNA,RORyt mRNA/Foxp3 mRNA and IL-17 in the rat nasal mucosa decreased to different degrees,with statistical significance(p<0.05).Compared with the model group,the expression of IL-17 in the nasal mucosa of the rats in the western medicine group and the high-dose Chinese medicine group was statistically significant(p<0.05),and there was no significant difference between the low-dose Chinese medicine group and the model group(p>0.05).ConclusionsLu'e Biyan formula can inhibit the differentiation of Th17 cells and the expression of related proinflammatory cytokines,and enhance the activity of Treg.Regulate the balance of Th17/Treg in vivo,so as to regulate the immune state of the body,and finally achieve the purpose of controlling the inflammatory response. |
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