| Objective:Chronic Obstructive Pulmonary Disease (COPD) is a common, frequently-occurring and progressive disease. At present, there is no effective treatment measure for COPD, which has seriously affectted the patients'ability of work and quality of life. Up to now, most western medicine treatment to COPD, especially stationary phase, is symptomatic treatment. The focus of therapy is improving symptoms and(or) reducing complications. And traditional Chinese medicine treatment, which named "treatment of wintertime disease in summer by point application with Xiao chuan paste(XCP)", had been widely used in clinical practice. Guang an men hospital pulmonary department had done research before and point out the it can improve COPD patients'life quality and reduce attack frequency in winter. But till lack of co-relational research, especially the study of mechanism of action. Therefore, this research is designed for explore the possible target of "Xiao Chuan paste" cure COPD patients, through component testing of induced sputum. Also could supply scientific experiment evidence for further perfecting and promoting XCP'clinical practice, and reveal the scientific connotation of classical theory "treatment of wintertime disease in summer by point application" from a sideway.Methods:Case information:according to the diagnostic and exclusion criteria both in west medicine and TCM,56 COPD patients were randomly divided into two groups (6 expulsions). The treatment group with 30 patients were gave XCP stuck on fei shu (BL13),xin shu (BL15),ge shu (BL17) both sides 6 hours every day in dog-days of summer.20 patients in control group were gave placebo stuck on the same points 6hours in the same days as treatment group. Airway inflammation research:before treatment, got every patients'induced sputum,-70℃preserved. After 6-month follow-up, got induced sputum again, and compared with the first-time sputum. The main observed indexes were IL-8,SIgA,LEP,total quantity of inflammatory cell. Quality of life research:before first time paste, did St·George's respiratory disease questionnaire,rating of TCM syndrome type,MMRC score. And did the follow-up again at 3,6,12month. The main point of compare is the change of correlation analysis about follow-up questionnaire index。Results:Airway inflammation research:①Inflammation cells(common cell in COPD airway inflammation):The reducing of total quantity of inflammatory cell of treatment group is significantly better than control group(P<0.05), control group do not has obverse change in this index(P>0.05).②IL-8,LEP(mediators of inflammation, which can improve the inflammation):IL-8,LEP in supernatant fluid of induced sputum of control group is decreased obviously(P<0.05) after treatment, and much better than control group, IL-8 of control group even increased(P>0.05);③SIgA(tunicae mucosa immune proteins, reduce frequency of influence):SIgA in supernatant fluid of induced sputum of control group increased after treatment P< 0.05), which was depressed in control group(P<0.05)。Quality of life research:①SGRQ questionnaire:all index of treatment group has decreased after therapy (P<0.05), but they increased some in winter, control group do not has significant change.②MRC score:the grade of treatment group fall down compared to therapy before(P<0.05), after 12 months.③Traditional Chinese medicine symptom score:the grade of both group decreased after treatment(P<0.05), score of treatment group is lower than, control group, but not has statistics difference. There was no adverse reaction.Conclusion:Xiao Chuan paste point application treatment could enhance airway mucosal protection, improve the airway chronic inflammation, raise the QOL of COPD patients, lighten the exacerbation in winter, cure COPD patients in stable period at last. |
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