| The paper is composed of literature review,clinical research and animal experimental study.Literature reviewLiterature review of Traditional Chinese Medicine summarized the cognition of cough and wind pathogen.The review also discussed the research progress of cough belongs to Wind Evil Invading Lungs Syndrome in detail,and showed a systemic discussion and evaluation about etiology and pathogenesis,also about treatment upon syndrome differentiation.Literature of western medicine suggested the definition and traits of PM2.5.Also,it demonstrated the inflammatory damage, oxidative damage and lung tissue structural changes due to PM2.5 in lung tissue,and the inpact on the immune balance of TH17/Treg.Clinical researchObjective:To observe the clinical efficacy of Guominjian and Zhisousan in patients with subacute and chronic cough who were evoked or aggravated by particulate matter.Methods:Subacute and chronic cough patients that fit the diagnosis standard of the case,were randomly divided into treatment group and control group.The study population consisted of 120 patients,but 13 cases lost.Finally,there were 107 cases that have complete results and statistical significance left.The treatment group has 57 cases while the control group has 50 when the research was over.The treatment group was treated with Guominjian and Zhisousan,and control group,Suhuang Zhike Capsule for 14d.The TCM symptom scale integration,curative effects on TCM syndromes,cough and minor symptom were compared between 2 groups.ResuIts:Compared with control group.there was significant improvement in TCM symp-tom scale integration, TCM syndromes and oppression in chest. TCM symptom scale integra-tion of treatment group decreased from (28.37±7.48) to (8.37±7.48). The total effective rate of cough was 71.93% and the curative rate was 21.05% after 7d’s treatment.After 14d’s treatment, the total effective rate and the curative rate were improved to 89.47% and 63.16% (P<0.05).The total effective rate of TCM syndrome was 75.44% and the curative rate was 26.31% after 7d’s treatment.After 14d’s treatment, the total effective rate and the curative rate were improved to 88% and 56%.In control group,the total effective rate of TCM syndrome was 88% and the curative rate 55.10%. Compared with treatment group, the difference was statistically significant(P<0.05).The comprehensive effects of chest oppression were as follows:in treatment group, the total effective rate was 85.71%, and in control group, the total effectiverate was 44.90%(P<0.05).Conclusion:Guominjian and Zhisousan improved the clinical symptoms of patients with subacute and chronic cough which were evoked or aggravated by air pollution after 7d’s treatment,and the improvements were more obvious after 14d’s treatment.Guominjian and Zhisousan has an obvious effect on patients with subacute and chronic cough which were evoked or aggravated by particulate matter.Experimental studyPurpose:To observe the lung injury caused by PM2.5 induced imbalance of TH17/Treg immune system and the uintervention effect of Guominjian and Zhisousan.Methods:The Wistar rats were randomly divided into normal group,model group, Guominjian and Zhisousan group(Chinese medicine-treated group 1) and Yupingfeng group(Chinese medicine-treated group2).Normal group was feeded normally without intervention. Model group was exposed by PM2.5 via airway instillation and was lavaged with normal saline. Chinese medicine-treated group 1was exposed by PM2.5 via airway instillation and was lavaged with Guominjian and Zhisousan. Chinese medicine-treated group 2 was exposed by PM2.5 via airway instillation and was lavaged with Yupingfeng. The pathological changes of bronchial and lung tissues were observed by HE staining.The contents of IL-8, IL-10, IL-17,NE, MUC5AC in blood and BALF in each group were compared by Elisa. The expression of Foxp3 and IL-17 in lung tissue was analyzed by immunohistochemistry. The mucus secretion was evaluated by AB-PAS staining.Results:The pathological changes were as follows:model groups had a severe inflammatoty infiltration in bronchioles,blood vessels and alveolar septums.Numberous inflammatory cells were infiltrated mainly with neutrophils and lymphocytes.Bronchiole walls were thickened,with globet cells proliferation and a small amount of bleeding and exudation in lumen. The alveolar septums were thickened, some of them were broken, the alveolar space was increased;some of alveolar structure disappeared with fibromatosis.Also,the pulmonary capillary wall thickened obviously. All above damage were released via intervention of Chinese medicine. Compared with normal group,the contents of IL-8, IL-17,NE and MUC5AC in blood and BALF of model group was increased significantly,IL-10 was decreased (P<0.05).Chinese medicine-treated groups had a lower contention of IL-8, IL-17 and NE, Chinese medicine-treated group 1 had a higher contention of IL-10 compared with model group (P<0.05).Also did Chinese medicine-treated group 1 in BALF.Model group had higher expression of IL-17 and lower expression of Foxp3 in lung tissue.The expression of IL-17was lower and Foxp3 was highter with intervention of Chinese medicine(P<0.05). AB-PAS staining showed that model group had a higher mucus secretion than normal group, Chinese medicine-treated groups had a lower secretion of mucus compared with model group.Conclusions:PM2.5 can incude inflammatoty infiltration and structural changes in lung tissue.These harms may caused by PM2.5 induced imbalance of TH17/Tregs immune system. Guominjian and Zhisousan can significantly improve the lung injury and probably improve the imbalance of TH17/Tregs immune system,and so as Yupingfeng powder. |
PDF Full Text Request