Clinical And Experimental Study Of Run Fei Zhi Ke Therapy Methods On Cough Variant Asthma Treatment

1. BackgroundCough variant asthma is known as a special type of asthma. Cough is the only or the main clinical manifestations. There is also has airway hyperresponsiveness(AHR). Mainly for the irritating dry cough, night cough for its important characteristics. Catching cold, cold air, dust, fumes, such as likely to cause or aggravate coughing. If there is no timely and effective treatment, some patients may develop into typical asthma. Epidemiological data show that about 5%-6% of bronchial asthma in patients with asthma symptoms before the typical performance for a few stubborn cough, and 28% of asthma symptoms as the only cough only. Its cause is not entirely clear, both studies from different perspectives of their pathogenesis are discussed that with the high sensitivity of the airway, airway neural regulation, inflammation, immunology and genetics and the environment, infectious factors. Regarding the treatment of bronchiectasis mainly in Western glucocorticoid-based agents.Writing in the traditional Chinese medicine, there is no cough variant asthma and fully corresponds to the disease, from the occurrence of the disease, the development of clinical symptoms shown by the characteristics of analysis, many doctors belong mostly to "cough", "Longgoing cough" "heart cough"and other aspects of different diseases. Chinese medicine treatment use syndrome differentiation theory, the overall treatment, with well efficacy, side effects and other advantages, can significantly improve symptoms in patients with CVA. Hyperactivity of this study was based on the feireyinxu, used with RunFeiKechuan Fang of QingRe RunFei, HuaTanZhiKe Kechuan treatment of CVA, to make good results.In order to further RunFeiKechuan Fang of the clinical efficacy for an objective evaluation, this paper from both clinical and animal experimental study to explore its therapeutic mechanism of CVA.2. clnical studyObjective:By observing two groups of patients before and after treatment to improve the main individual symptoms, airway reactivity, cytokines, such as indicators of the changes of "Deficiency Hyperactivity type" CVA occurred in the role of the development process.Methods:Cough variant asthma diagnostic criteria of Western medicine and TCM for vaginal injuries Hyperactivity of CVA in patients with evidence of 60 cases, were randomly divided into traditional Chinese medicine treatment group (observation group) 30 cases, Western medicine treatment group (control group) 30 cases, Application of the treatment group RunFeiKeChuan capsule, the application of the control group theprocaterol hydrochloride, within 14 days of treatment, symptoms and signs before and after the determination of score, provocation test PD20-FEV1, IL-2, IL-6, TNF-αand so on. SPSS13.0 and the results of the use of statistical software for statistical analysis.Results:The integrated effect of the disease, significant rate-control group was 76.67%, total effective rate was 93.33%,control group, control a significant rate of 53.33%, total effective rate was 73.33%. Score after treatment both groups showed steady improvements in the control group and significantly higher than the total effective rate.Observation of patients after treatment of the main individual symptoms in cough frequency, cough extent and so on have significant improvement in the control group in improving the frequency of cough, cough degree of dyspnea obvious aspects of efficacy, the treatment group compared group in cough frequency, cough extent are obviously better than the control group. Significant control in the individual symptoms and total effective rate, the observation group were significantly higher than that. Observation group and the control group the level of PD20-FEV1 after treatment have improved, but no difference between the two groups. IL-2, IL-6,TNF-a level of the observation group and control group after treatment than before treatment to improve, IL-6 to improve the level of the observation group than the control group, IL-2, TNF-αlevels observed\no significant difference between the two groups.Conclusion:The RunFeiKechuan Fang improve cough in patients with CVA Deficiency Hyperactivity of clinical symptoms, reduce the responsiveness of high gas and control cytokine levels of access to good effect. 3. experimental studyObjective:To copy the guinea pig model of CVA, CVA model and explore the guinea pig asthmatic model of guinea pig airway responsiveness between the pathological changes,such as the similarities and differences; and to explore intervention RunFeiKechuan Fang prescription CVA model in guinea pigs airway responsiveness and changes in cytokine levels.Methods:the general level of health of male guinea pigs (200±20 grams) 84, were randomly divided into 7 groups:normal control group, asthma model group, CVA model group, CVA hormone group, CVA Procaterol Hydrochloride(PH) group,CVA Chinese Medicines high-dose group,CVA Chinese Medicines lowe-dose group. Keeping the normal one week after the beginning of the experiment. In addition to the normal control group, the remaining section of each group in guinea pigs by intramuscular injection 1 day per 4% OVA solution 0.5ml, while intraperitoneal injection of 2% AL (OH) 3 gel 0.2ml. The 14th day, CVA with three groups of guinea pigs were nebulized 1% OVA solution to attack up to 2min, next time, made the model of cough variant asthma. Asthma model group for the attack time 5min, guinea significant shortness of breath, and even abdominal breathing, convulsions, asthma model made. The 14th day later, CVA hormone group,CVA PH group and the CVA Chinese Medicines group administration of traditional Chinese medicine for 14 days. The first 29 days, the cough frequency to stimulate animal lung function tests, measured executed tissues of guinea pig tracheal dedicated histopathological examination, abdominal aortic blood serum for the determination of cytokine levels.Results:Determination of cough frequency, the normal control group, the least number of cough, asthma model group, slightly higher than the normal control group, but the two groups was not significant,5 groups the number of CVA cough was significantly higher than the normal control group P<0.05, CVA model group in which the number of cough was significantly higher than the other 4 groups. Histopathological sections from the observation of the trachea, bronchial wall of the normal control group and around a clear organizational structure, no inflammatory cell infiltration, bronchial asthma model group and the surrounding epithelial tissue damage off there, surrounded by a large number of inflammatory cell infiltration can be seen, eosinophil visible; CVA model group, inflammatory cells, eosinophil infiltration in model group than to reduce asthma; CVA hormone group,CVA HP group and CVA Chinese Medicines lowe-dose group of inflammatory cells, eosinophil infiltration in model group than to reduce CVA than asthma model group. CVA Chinese Medicines high-dose group of inflammatory cells, eosinophil infiltration CVA model group than the reduced model than the asthma group.Methacholine challenge test total inspiratory airway resistance (RL),there is no differenc between the 7 groups previor to the challenge.After the first challenge,RL increase significantly in the asthma model group.After the second challenge,RL increase in the CVAmodel group and CVA hormone group,and now,the RL of asthma model group has an significant difference to the other 6 groups.After the third challenge,RL increase in the CVA HP group and CVA Chinese Medicines lowe-dose group. after the fourth challenge,RL increase in the CVA Chinese Medicines high-dose group.During the RX test,there is no differenc between the 7 groups previor to the challenge.After the first challenge,RX increase in the asthma model group and the CVA model group. After the second challenge,RX increase in the CVA HP group and CVA hormone group,and now,the RX of asthma model group has an significant difference to the other 6 groups.After the third challenge,RX increase in the CVA Chinese Medicines lowe-dose group.and now,the RX of CVA model group has an significant difference to the other 6 groups.In the lung compliance (Cdyn) measure,there is no differenc between the 7 groups previor to the challenge.After the first challenge,Cdyn decrease in the asthma model group,the CVA model group and the CVA hormone group. After the second challenge,Cdyn decrease in the CVA HP group and the CVA Chinese Medicines lowe-dose group compared to the normal control group.After the third challenge,Cdyn decrease in the CVA Chinese Medicines high-dose group compared to the normal control group,and now,the Cdyn of asthma model group has an significant difference to the other 6 groups.After the fourth challeng,the Cdyn of CVA model group has an significant difference to the other 6 groups.Determination of cytokines, IL-2 levels measured in comparison with normal control group, asthma model group and significantly improved CVA model group, CVA among the three groups compared to normal control group and CVA model of traditional Chinese medicine group than in CVA group significant difference. Determination of IL-5 levels,asthma model group,CVA model group and CVA Chinese Medicines lowe-dose group are different to the normal control group.There are significant differences to asthma model group and CVA model group compared to the other 6 groups.Determination of IL-6 levels, in addition to CVA model group, the other group and the normal control group are significant differences; Determination of TNF-a level in comparison with normal control group, asthma, there are significant differences in the model group.Conclusion:CVA model of guinea pig airway responsiveness in pathological changes were lower than the level measured in guinea pig asthma model, and higher than the normal control group.Prescription RunFeiKechuan Fang CVA model of intervention in the reduction of guinea pig airway resistance and improve the efficacy of pulmonary obvious aspects of compliance, cytokine levels and hormone changes in the traditional Chinese medicine for the effect of the indicators are not identical, RunFei Kechuan Fang for airway inflammation have a role to improve.