| Asthma is a worldwide disease which is very common and frequently-occurring. According to statistics from United States, United Kingdom, Australia, New Zealand and other countries, the morbidity and mortality of asthma are in a rising tendency in the last ten years. There are about 300 million asthma patients all the world and around 18 million die of it each year. Asthma has been one of the main chronic diseases which severely threaten human being's health. Therefore, the World Health Organization put the prevention and treatment of asthma into the global strategies. In modern medicine's view, treatment in non-acute attack stage should be the core of the whole treatment in bronchial asthma.Objective:According to deeply understanding of Professor Zhou Zhongying's clinical experience and academic ideas in treating non-acute attack of bronchial asthma, the basic pathogenesis should focus on "deficiency in lung and kidney, wind and phlegm retention in lung" and the basic treatment rule should be "replenishing lung and kidney, dispelling wind and removing phlegm". In non-acute attack of bronchial asthma, there are two typical syndromes:"qi deficiency of lung and kidney, retention of cold phlegm" and "yin deficiency of lung and kidney, retention of phlegm-heat". Pro.Zhou created "Wenyang Huatan Decoction" (removing phlegm by warming method) and "Qingyang Huatan Decotion" (removing phlegm by clearing method) respectively. In this study, through the observation of Pro.Zhou's treatment comparing with conventional treatment, we give an objective evaluation to the rule "replenishing lung and kidney, dispelling wind and removing phlegm" and try to proven its efficacy and superiority. Further, the result can help us to refine Pro.Zhou's clinical experience and academic ideas on diagnosis and treatment in non-acute attack of bronchial asthma, to find out the uniqueness and creativity of Pro.Zhou's treatment and to form an effective, strong- operative, easy- spread treatment in prevention and treatment of asthma.Methods:The cohort study was used here.80 patients who met the inclusion criteria of non-acute attack of bronchial asthma were selected and randomized divided into 2 groups.40 for treatment group (Pro. Zhou's treatment group) and 40 for control group (conventional treatment group). Both groups included two syndromes: "qi deficiency of lung and kidney, retention of cold phlegm"(cold syndrome of asthma) and "yin deficiency of lung and kidney, retention of phlegm-heat" (heat syndrome of asthma).In treatment group,"Wenyang Huatan Decoction" and "Qingyang Huatan Decotion" were used respectively. In control group, Modified Guben Kechuan Decoction and Modified Maiwei Dihuang Decoction were used respectively. For both group,1 decoction for each day and take for 6 months. If there is an acute attack of bronchial asthma during decoction, deal with the conventional treatment for acute attack. Main indicators:(1) The main symptoms and signs score, as well as tongue and pulse, recorded every 2 weeks; (2) pulmonary function(PEF, FEV1, FVC) for those over 10 years old, before and after treatment; (3) blood eosinophil count (Eos), eosinophil cationic protein (ECP), before and after treatment; (4) serum immunoglobulin IgA, IgG, IgM, IgE, before and after treatment; (5) IL-4 and IFN-y level in mononuclear cells, before and after treatment; (6) Asthma Control Test (ACT), before and after treatment. Finally, both of the cold and heat syndrome of asthma from the treatment group and the control group respectively were comparative investigated.Results:Clinical studies have shown that, for cold syndrome of asthma, in treatment group, clinical control rate is 40.9%, clinical effective rate is 77.3% and the total effective rate is 90.9% while in the control group are 26.3%,31.6%,63.2%; for heat syndrome of asthma, in treatment group, clinical control rate is 27.8%, clinical effective rate is 66.7% and the total effective rate is 84.5% while in the control group are 4.8%,19.1%,57.2%. Statistically, for both of the syndromes, the clinical effective rate and total effective rate in treatment group is significantly higher than control group (P<0.05). In aspects of improving main symptoms and signs (like breathe, cough, wheeze and etc.) and secondary symptoms and signs (like dry mouth, dysphoria, easy to be cold, spontaneous sweating, aversion of wind and etc.), the total effective rate of the treatment group is higher than the control group. The improvement of lung function (FVC, FEV1, PEF) in treatment group is better than the control group. The two groups was statistically significant (P<0.05). In aspects of reducting peripheral blood eosinophils (Eos) and eosinophil cationic protein (ECP), the treatment group are better than the control group. In aspects of regulating IgG, IgA, IgE, IgM and improving the serum cytokines IL-4, IFN-y, most of the treatment group are better than the control group, except IgG, IgM in heat syndrome of asthma and IL-4 in cold syndrome of asthma(P <0.05). In aspects of long-term effect, frequency and severity of recurrence in half of a year, the treatment group is also better than the control group.Conclusion:In aspects of improving symptoms and signs, improving immune function, eliminating airway inflammation, preventing and reducing attacks of asthma, the treatment group were all better than the control group in each of the syndromes, which prove the rationality of the treatment "replenishing lung and kidney, dispelling wind and removing phlegm" in non-acute attack of bronchial asthma. |
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