Theoretical And Clinical Study On The Effect Of Yiqi Detoxification Side On TOLL Pathway In Chronic Obstructive Pulmonary Disease

The prevalence and mortality of COPD is very high,and the medical burden caused by COPD is more heavy than before, and the etiology and pathogenesis of COPD is so complicated that we need reveal and clarify from new perspective continuously to provide new ideas and methods for clinical treatment.In this article,through the study of ancient materials and modern literature, we sum up the ancient Chinese medicine understanding, pathogenesis, treatment, health care of COPD, and systematically review the progress of modern pathogenesis. Combined with modern "toxin", "lung collaterals"theory, we believe that "the toxin impairing lung collaterals" is one of the pathogenesis of COPD. Then we explore the theory and system construction, discusse the formation of qi deficient,phlegm,blood stasis,fire toxin,and the pathogenic characteristics, treatment of COPD disease.Objective:through studying the influence of Yiqi Paidu Decoction on inflammatory cytokines of TOLL signal transduction path,provide a theoretical basis for "the toxin impairing lung collaterals’ theory in the pathogenesis of COPD,disprove the pathogenesis,and provide new ideas and theoretical basis for the pathogenesis research,clinical prevention and treatment of COPD.Research Methods:Select 43 stable COPD patients that met the inclusion criteria, divided into 22 cases in the traditional TCM group,21 cases in the control group. Control group take Western medicine according to the treatment guidelines routine publish by Chinese Medical Association, the TCM group take the Yiqi Paidu Decoction meanwhile.After 2 months treatment, we summarize the main symptoms,TCM Syndrome points, mMRC, CAT scale score, SpO2, serum MyD88, TRAF-6, NF-κb factor data of the two groups, and analyze the varies of before and after treatment,and the differences between the treatment group.Results:The TCM group has 13 males and 9 females, the control group has 12 males and 9 females,males accounted for 58.14%, female 41.86% in two groups,and the average age is 68.42 years. After the statistical analysis,the TCM group and the control group have statistically significant in all respects,such as age, gender, disease duration, BMI index,lung function, symptom scale score,so they are comparable. Smoking is negatively correlated with the severity of lung function, the higher the index of smoking is, the lung function FEV1/ FVC value is lower, but the significance is not obvious.The efficacy after treatment:The main symptoms:Compared with the symptoms before treatment, the TCM group and the control group is improved after treatment(P<0.05), TCM group is superior to the control group(P<0.05). Syndrome:the lung,spleen,kidney qi deficiency, blood stasis, phlegm, fever symptoms score of TCM group after treatment is superior to the syndrome before treatment(P<0.05); the lung qi deficiency, blood stasis, phlegm syndrome of control group after treatment is superior to the syndrome before treatment(P<0.05), the spleen, kidney deficiency, fever syndrome is superior to the syndrome before treatment (P> 0.05); the lung, spleen, kidney deficiency, phlegm, fever syndrome of TCM group is superior to the control group(P<0.05); the blood stasis syndrome of TCM group is superior to the control group(P> 0.05). The total effective rate of lung, spleen, kidney deficiency, blood stasis, phlegm, fever syndrome of TCM group after treatment is superior to the control group(P<0.05).Scale score:the mMRC, CAT scale score of TCM group after treatment is superior to the score before treatment(P<0.05); the mMRC score of control group after treatment is superior to the score before treatment(P> 0.05), the CAT score is superior to the score before treatment (P<0.05); the mMRC, CAT score of TCM group is superior to the control group(P <0.05).Oxygen saturation SpO2:the SpO2 data of TCM group after treatment is superior to the data before treatment(P<0.05); the SpO2 data of control group after treatment is superior to the SpO2 data before treatment(P<0.05); the SpO2 data of TCM group is superior to the control group(P<0.05).Serum inflammatory factors:the MyD88, TRAF-6, NF-κb) factor level of TCM group after treatment is superior to the level before treatment(P<0.05); theMyD88, TRAF-6, NF-κb factor level of control group after treatment is superior to the level before treatment(P>0.05); the MyD88 factor level of TCM group is superior to the control group(P> 0.05); the TRAF-6,NF-κb factor level of TCM group is superior to the control group(P<0.05).Security index:the blood examination WBC data of TCM group after treatment is superior to the data before treatment(P<0.05),the NEUT, RBC, HGB, HCT, PLT data has no change before and after treatment (P>0.05);the WBC, NEUT, RBC, HGB, HCT, PLT data of control group has no change before and after treatment (P>0.05); the difference of WBC, NEUT, RBC, HGB, HCT, PLT between TCM group and control group before and after treatment is not statistically significant (P>0.05); the difference of liver and kidney function examination ALT, AST, ALB, BUN,CR data between TCM group and control group before and after treatment is not statistically significant (P>0.05).Conclusion:Combined Yiqi Paidu Decoction with Western medicine to treat stable COPD patients, the clinical symptoms and Chinese medical syndromes can be alleviated obviously, exercise tolerance and quality of life can be improved significantly. Yiqi Paidu Decoction can reduce the numerical value of MyD88,NF-κb,TRAF-6 of TOLL signal transduction path in the serum of patients with COPD, and improve the state of pulmonary inflammatory cell infiltration, inhibit the inflammation reaction of COPD.