| Part Ⅰ: Clinical Study of Sanju Kechuan Oral Liquid on Pulmonary Hypertension During Acute Attack of ChronicPulmonary Heart DiseasePurpose:To evaluate the therapeutic effect of Sanju Kechuan oral liquid on pulmonary hypertension during chronic pulmonary heart attack,and to provide valuable theoretical and clinical basis for Sanju Kechuan oral liquid to treat pulmonary hypertension during chronic pulmonary heart disease.Method:SPSS software was used to generate pseudo-random numbers,and the included subjects were divided into observation group and control group in a ratio of 1:1.The control group was given conventional treatment plus blank control scheme,and the observation group was given conventional treatment plus Sanju Kechuan oral liquid"scheme.After 14 days of treatment,pulmonary artery pressure,blood gas analysis,6-minute walking test,TCM syndrome score and other main therapeutic indexes,white blood cell count,whole blood C-reactive protein,proalbumin,K+,Na+ and other minor therapeutic indexes,as well as safety indexes,were observed in the two groups.The mortality of hospitalized patients was compared,and the survival subjects were followed up for 90 days.To evaluate the efficacy and safety of Sanju Kechuan oral liquid in treating pulmonary hypertension during acute attack of chronic pulmonary heart disease.Results:From July 01,2021 to December 31,2022,92 subjects were enrolled:1.Main therapeutic indicators: pulmonary artery pressure on the 7th day of treatment,the difference between the observation group and the control group was statistically significant(P < 0.05);On the 14 th day of treatment,there was no significant difference between the observation group and the control group.After treatment,the oxygen partial pressure in blood gas analysis was statistically significant between the observation group and the control group(P < 0.05),and the observation group was better than the control group.The partial pressure of carbon dioxide in blood gas analysis was statistically significant between the observation group and the control group(P < 0.05),and the observation group was better than the control group.In the 6-minute walking test,the difference between the observation group and the control group was statistically significant(P < 0.05),and the observation group was better than the control group.Clinical comprehensive efficacy(TCM syndrome score),observation group and control group,the difference is statistically significant(P < 0.05),observation group is better than the control group.2.Secondary efficacy index: white blood cell count,at the 7th day of treatment,the difference between the observation group and the control group was statistically significant(P < 0.05),at the 14 th day of treatment,the difference between the observation group and the control group was not statistically significant(P > 0.05);Whole blood C-reactive protein,at the 7th and 14 th day of treatment,the difference between the observation group and the control group was statistically significant(P <0.05);Electrolyte(K+,Na+),prealbumin and other indicators,the observation group compared with the control group,the differences were statistically significant(P < 0.05),the observation group was better than the control group.3.The readmission rate and mortality of subjects in the two groups after discharge were not statistically significant between the observation group and the control group(P > 0.05),and the observation group was not better than the control group.4.Safety indicators: The safety indicators of subjects in the two groups showed significant differences without statistical significance(P > 0.05),and the safety of observation group and control group was similar.Conclusion:Sanju Kechuan oral liquid combined with conventional Western medicine treatment and conventional Western medicine treatment can effectively improve the pulmonary artery pressure during the acute attack of pulmonary heart disease,Sanju Kechuan oral liquid combined with conventional Western medicine treatment of pulmonary hypertension is better than conventional Western medicine treatment.Part Ⅱ: To Investigate the Mechanism of Sanju KechuanOral Liquid Treating Pulmonary Hypertension in RatsBased on Rho A/NF-κB PathwayPurpose:By constructing a rat model of pulmonary hypertension,Sanju Kechuan oral liquid was used to intervene,and the pulmonary artery pressure,pulmonary vascular pathology and the expression of related proteins(Rho A,TLR-4,TNF-α,p65)of rats were observed,so as to explore the therapeutic effect of Sanju kechuan oral liquid and the mechanism of treating pulmonary hypertension.Method:Forty healthy male SD rats were randomly assigned to blank group(Con),model group(Mod),Sanju Kechuan oral liquid low-concentration group(Low)and Sanju Kechuan oral liquid high-concentration group(High),with 10 rats in each group.Except for Con group,all the other groups were given 60mg/kg monocrotaline by a one-time intraperitoneal injection to build a pulmonary hypertension model,while Con group was given 1.5ml solvent(without monocrotaline)in the same way.On the 15 th day of modeling,Low group and High group were given low concentration and high concentration Sanju Kechuan oral liquid intragastric administration,Con group and Mod group were given intragastric administration with 10ml/kg distilled water,and after intragastric administration on the 28 th day,the right ventricular pressure of rats in each group was measured,and then sacrificed for sampling.Detection methods: The right ventricular pressure was measured by the right ventricular direct catheter method instead of the pulmonary artery pressure,and the pathological condition of the pulmonary vascular tissue of rats was observed by HE staining.The expression levels of Rho A,TLR-4,TNF-α and p65 in lung tissues of rats in different groups were detected by Western blot.Results:Pulmonary artery pressure: Model group(Mod),Low concentration group(Low)and High concentration group(High)were significantly different from blank group(Con)(P < 0.01).Compared with the model group,the difference between Low concentration group(Low)and High concentration group(High)was statistically significant(P < 0.01).Pulmonary vascular pathology: Compared with Con group,the medium membrane in Mod group,Low group and High group was significantly thickened,and the difference was statistically significant(P < 0.01).Compared with Mod group,vascular wall area fraction and media thickness fraction in High and Low groups were significantly improved,with statistical significance(P < 0.01).Protein level:(1)Rho A: Compared with Mod group,the protein expression level of Rho A in Low concentration group(Low)and High concentration group(High)was decreased,and the difference was statistically significant(P < 0.05);compared with Low group and high group,the Rho A level in low group was decreased,and the difference was statistically significant(P < 0.05).(2)TLR-4: Compared with Mod group,the expression level of TLR-4 protein in Low and High groups was significantly decreased,and the difference was statistically significant(P < 0.05).According to the histogram of average optical density value of TLR-4 protein,the expression level of histone in High group was decreased compared with that in Low group,but the difference was not statistically significant(P > 0.05).(3)TNF: Compared with Mod group,the expression level of TNF protein in Low and High groups was decreased,and the difference was statistically significant(P < 0.05).Compared with Low group,the expression level of histone in High group was decreased,and the difference was statistically significant(P < 0.05).(4)p65: Compared with Mod group,the expression level of P65 protein in Low and High groups was decreased,and the differences were statistically significant(P < 0.05).According to the bar chart of average optical density of P65 protein,the expression level of histone in High group was lower than that in Low group,but the difference was not statistically significant(P > 0.05).Conclusion:Sanju Kechuan oral liquid can improve the pulmonary artery pressure in rats with pulmonary hypertension,which may be related to the inhibition of Rho A/NF-κB pathway to release inflammatory factors and vascular remodeling.part Ⅲ:The Summary of Professor Zhang Xiaoyun’sAcademic ThoughtPurpose:The academic thoughts of Professor Zhang Xiaoyun are summarized in order to provide academic experience for TCM treatment of pulmonary diseases.Method:Through learning from teachers,I collected Professor Zhang Xiaoyun’s prescription for the treatment of pulmonary diseases,recorded his clinical sayings,combined with his published papers and taking one of his diseases as an example,I made a brief summary of Professor Zhang Xiaoyun’s academic thoughts.Results:In diagnosis,attention should be paid to syndrome differentiation and disease differentiation;in treatment,the combination of Chinese and Western medicine should be emphasized;the prescription should be moderate;attention should be paid to the protection of the patient’s spleen and stomach;at the same time,attention should be paid to the smoothing of the patient’s mood;and patients should be instructed to pay attention to food and abstaining.Taking cough after infection as an example,the author briefly summarized the professor’s experience in treating pulmonary diseases.Conclusion:Professor Zhang emphasizes that traditional Chinese medicine should attach importance to the study of classics,and apply the knowledge into practice,organically combine syndrome differentiation and disease differentiation in clinical practice,attach importance to the regulation of patients’ spleen and stomach function,take medicine with light spirit and calm,at the same time,pay attention to the people-oriented,care for patients,give psychological guidance when necessary,do not forget to instruct patients to adjust their emotions,establish a positive attitude,and pay attention to food and abdication in nursing. |
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