| ObjectivesThis thesis aims to conduct an experimental study on the clinical efficacy of Peitu Shengjin Recipe for intervening asthma and its effect on airway inflammation and intestinal flora in the asthmatic mice.It will explore the mechanism of TCM in preventing and treating asthma,providing an experimental basis for the prevention and treatment of asthma by Traditional Chinese Medicine.Methods1.Animal experimentsA total of sixty 3-week-old male mice were randomly divided into normal control group(Z),Shenling Baizu group(L),model control group(M),Yigong powder group(Y),Western medicine control group(X),and ginseng monomethyl group(D),with 10 mice in each group.The classical sensitized atomization was applied to induce asthmatic model,and the mice were drenched with cefoperazone and Candida albicans,which caused intestinal microflora disorder.Group Z and Group M were given normal saline.Group X were drenched with 0.4m L clostridium caseinate powder per mouse and 2m L budesonide +2m L normal saline for atomization for 15 min.Group L,Group Y,and Group D received0.2m L/20 g compound or monomer(Shenlingbaizhu Powder,Yigong Powder,and ginseng monomer)orally.Each group was administered once a day for 7 days.The mice were killed for sampling 24 hours after the experiment was completed.The general conditions of the mice were observed,together with the pathological sections of lung tissue and the changes of intestinal microflora after 16 Sr RNA sequencing.2.Clinical researchDuring the period from June 2020 to June 2021,60 children,diagnosed with asthma remission and lung-spleen deficiency syndrome in the First Affiliated Hospital of Guangzhou University of Chinese Medicine,were selected as the research objects.They were divided into the control group(30 cases)and the experimental group(30 cases),based on the random number table.The control group was given conventional western medicine basic treatment,while the experimental group was given conventional Western medicine basic treatment together with Traditional Chinese Medicine treatment(Shenling Baizhu Powder,1 dose per day,taken after meals for a month).The main therapeutic indexes included the frequency of asthma attacks and the symptom days of asthma attacks,while the secondary therapeutic indexes included related physical and chemical indexes(lung function indexes,serum immune indexes,serum leukocyte mediators,etc.)as well as the changes of cardiac enzymes in liver and kidney function during medication.Results1.Animal experiments(1)Before the experiments,the mice shared similar body weight.After the experiments,the body weight of the mice in Groups L,Y,and X was increased compared with those in Group M(P<0.05),and their general condition(including the asthmatic and physical)was improved.(2)Pathological sections of the lung tissues of the miceIn Group Z,there is no inflammatory cell infiltration in bronchus,no squamous metaplasia and exfoliation in the epithelial cells,no thickening observed in alveolar septa,and no macrophages in alveolar lumen.In Group M,chronic necrosis and inflammatory cell infiltration(mast cells and eosinophils)were observed surrounding bronchi.Squamous metaplasia was seen in epithelial cells,with occasional exfoliation.Alveolar septa were moderately thickened 3-5 times.In Group X,there is no obvious inflammatory cell infiltration in bronchus,and no squamous metaplasia nor abscission in epithelial cells.No thickening was observed in most areas of alveolar septa,only with mild thickening in some local parts.The condition of Group L remained the same as Group X.In Group Y,chronic necrosis and inflammatory cell infiltration were observed surrounding bronchi.Squamous metaplasia was seen in epithelial cells,without exfoliation.Some parts of alveolar septa were thickened from mild to moderate degree,while other parts were free from thickening.In Group D,there is no obvious inflammatory cell infiltration in bronchus.No squamous metaplasia nor exfoliation was found in the epithelial cells,and the alveolar septum was slightly thickened one to two times.The efficacy of Shenling Baizhu Powder for reducing inflammatory infiltration on the lung tissue in the asthmatic mice is more significant than Yigong Power and ginseng monomer,and its effect was similar to that of budesonide.(3)16Sr RNA sequencing results showed:In terms of phylum and genus differences,compared with Group Z,Group M had a decrease in Candidatus Saccharibacteria and Alloprevotellaan,and an increase in Actinobacteria.The difference is statistically significant(P<0.05).Compared with Group M,Group X had an increase in Proteobacteria,Verrucomicrobia,Actinobacteria,and Akkermansia.The Candidatus Saccharibacteria,Alloprevotella,and Saccharibacteria?genera-incertae?sedis were increased in Group L;while in Group Y,Clostridium Xl Vb was increased.Actinobacteria was decreased in Group D,but Alloprevotella and Prevotella were increased.All differences are statistically significant(P<0.05).In terms of Chao1 Index,Group M,L,and D were lower than Group Z,Group D was lower than Group L,and the differences were statistically significant(P<0.05).The Shannon Indexes of Group L and D were decreased compared with Group Z,and it has statistical significance(P<0.05).? diversity analysis: there was a significant difference in the species diversity in Group M,compared with Group Z(P< 0.05).Compared with Group D,there was no significant difference in the species diversity in Group X,L,and Y.2.Clinical research(1)A total of 60 cases were included in this study,including 35 males and 25 females.18 males and 12 females were in the experimental group,while17 males and 13 females in the control group.The average age of the experimental group was 5.97±1.00,and that of the control group was 5.90±1.16.There was no statistical significance in gender and age composition between the two groups(P>0.05).(2)Primary efficacy indicators: after treatment,there were 22 cases with significant effect,6 cases with positive effect and 2 cases with no effect,with a total effective rate of28 cases(93.33%)in the experimental group.In the control group,there were 14 cases with marked effect,8 cases with positive effect and 8 cases with non-effect,with a total effective rate of 22 cases(73.33%).The total effective rate in the experimental group was much higher than that in the control group,with statistical significance(P<0.05).Compared with the control group,the number of symptom days after treatment was markedly reduced in the experimental group,and the difference was statistically significant(P<0.05).In addition,the number of asthma attacks was also reduced in the experimental group in comparison with the control group but with no statistical significance(P>0.05).During the 3-month follow-up,the number of asthma attacks and symptom days in the experimental group were reduced compared with the control group,but the difference was not statistically significant(P>0.05).(3)Secondary efficacy indicators: the lung function of the experimental group was improved after treatment,and the immunoglobulin E and eosinophil were decreased.Compared with the control group,the differences were statistically significant(P<0.05).(4)Safety indicators: before and after treatment,there was no significant difference in liver and kidney function and myocardial enzymes index between the two groups(P>0.05).ConclusionPeitu Shengjin Recipe can improve the general condition of the asthmatic mice,reduce the inflammatory infiltration of lung tissue,and regulate the quantity balance of intestinal flora.The efficacy of Shenling Baizhu Powder is more obvious in reducing inflammatory infiltration than Yigong Powder and ginseng monomer.While Shenling Baizhu Powder and ginseng monomer are more effective in regulating the quantity balance of intestinal flora than Yigong powder,Yigong Powder can better regulate the richness and diversity of intestinal flora than Shenling Baizhu Powder and ginseng monomer.As the representative recipe of Peitu Shengjin Method,Shenling Baizhu Powder can reduce the number of immunoglobulin E and eosinophil,improving the lung function of the children who are in the stable period of asthma. |
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