The Clinical Effect Of Yiqi Wenyang Huoxue Therapy In The Treatment Of Idiopathic Pulmonary Fibrosis And Its Experimental Study On Regulating The Expression Of MiR-210-3P

Objective:On the basis of theoretical summary,the clinical effect of Yiqi Wenyang Huoxue therapy in the treatment of idiopathic pulmonary fibrosis was investigated through clinical study.Then the role of mi R-210-3p and angiogenesis related indicators in the pathogenesis of idiopathic pulmonary fibrosis was explored through experimental studies.Finally,the regulatory effects of Yiqi Wenyang Huoxue therapy on mi R-210-3p,VEGF and PEDF were investigated through experiments.Methods:Part I Theoretical Discussion: collect literature,discuss the pathogenesis of idiopathic pulmonary fibrosis from the theoretical aspect,and discuss the feasibility of treating idiopathic pulmonary fibrosis by Yiqi Wenyang Huoxue therapy.Part II Clinical Study: 60 patients with idiopathic pulmonary fibrosis were enrolled in a randomized controlled study and randomly divided into control group and experimental group,with 30 patients in each group.The control group was treated with pirfenidone,and the experimental group was treated with Jiawei Buyang Huanwu Decoction.Three months later,patients were compared in terms of symptoms,St.George’s scores,TLC,DLCO-SB,FVC,and 6-minute walking test.The treatment costs of patients were compared and adverse reactions were recorded.Part III Network Pharmacology and Bioinformatics Analysis:The active ingredients and related targets of Jiawei Buyang Huanwu Decoction were obtained through TCMSP database,and related targets of IPF were collected through CTD,Gene Card,Dis Ge NET,KEGG and other databases.After the intersection,Cytoscape software was used for network topology analysis.Obtain the protein interaction network diagram from the STRING database,and perform GO analysis and KEGG pathway enrichment analysis on the target.Use Target Scan7.2,mi RDB,mi RPath DB and star Base to predict the target of mi R-210-3P,and then perform GO analysis and KEGG pathway enrichment analysisPart IV Experimental StudyExperiment 1 Mi R-210-3p was used to investigate the expression of VEGF and PEDF in TGF-β1-induced MRC-5 cells.The experiment was divided into six groups: control group,model group,mi R-210-3p mimic group,mi R-210-3p mimic NC group,mi R-210-3inhibitor group,and mi R-210-3p inhibitor NC group.After 48 h of culture,the levels of mi R-210-3p 、 VEGFm RNA 、 PEDFm RNA 、 HIF-lαm RNA 、 PDGF-BBm RNA were detected by RT-PCR,and the expression of VEGF and PEDF were detected by Western blot.Experiment 2 The effects of Jiawei Buyang Huanwu Decoction on the expression of mi RNA-210-3p,VEGF and PEDF in TGF-β1-induced MRC-5 cells were investigated.The experiment was divided into control group,model group,Jiawei Bu Yang huanwu decoction and blank serum group.After 48 h of culture,the levels of mi R-210-3p,VEGFm RNA 、 PEDFm RNA 、 HIF-lα m RNA 、 PDGF-BBm RNA were detected by RT-PCR,and the expression of VEGF and PEDF were detected by Western blot.Results:After the first part of theoretical discussion,we found that Yiqi Wenyang Huoxue therapy is feasible for IPF.In the second part,the results showed symptom scores and St.George’s questionnaire scores were not improved after pirfenidone treatment.Jiawei Buyang Huawu Decoction can slightly improve the TCM syndrome score and St.George’s score.Both the pirfenidone group and the Jiawei Buyang Huawu Decoction group had a slight deterioration in TLC and 6-minute walking distance.However,compared with the pirfenidone group,the TLC and walking distance of patients in the TCM group decreased less.For DLCO-SB,FVC,arterial oxygen saturation and acute exacerbation,there was no significant difference between the two groups before and after treatment.The incidence of adverse drug reactions in the pirfenidone group was higher than that in the TCM group,and the drug cost in the pirfenidone group was much higher than that in the TCM group,indicating that TCM was superior to pirfenidone in terms of safety and treatment cost.The third part of the network pharmacology and bioinformatics analysis shows that the treatment of IPF by Jiawei Buyang Huanwu Decoction may be closely related to the angiogenesis mechanism.Experimental research results: Cell experiments show that mi R-210-3P can up-regulate the expression of VEGF,HIF-1α,PDGF-BB,and reduce the expression of PEDF.Jiawei Buyang Huanwu Decoction can reduce the expression of mi R-210-3P,and then interfere with the expression of angiogenesis factors such as VEGF,HIF-1α,PDGF-BB,PEDF,etc.Conclusion:According to the clinical experimental data,it can be found that after the application of Jiawei Buyang Huanwu Decoction in the treatment of IPF,the progress in the 6-minute walking distance,TLC and other indicators is slower than that of pirfenidone.The TCM syndrome score and St.George’s questionnaire score were slightly improved in the TCM group compared with before treatment.In general,pirfenidone is not better than traditional Chinese medicine in the treatment effect,but traditional Chinese medicine has more advantages in improving patients’ symptoms,improving the quality of life and slowing down the disease progression.In addition,compared with traditional Chinese medicine,pirfenidone has more adverse reaction results and the treatment cost is more expensive.From the part of experimental studies,we demonstrated that mi R-210-3p/VEGF/PEDF may be an important mechanism of pulmonary fibrosis,and it is by regulating mi R-210-3p /VEGF/PEDF that Jiawei Buyang Huanwu Decoction intervenes the progression of pulmonary fibrosis.Therefore,Yiqi Wenyang Huoxue therapy is an effective treatment for IPF,and Jiawei Buyang Huanwu Decoction has high clinical value and economic benefits in the treatment of IPF.