| Objective:1.To understand syndrome,etiology and pathogenesis,syndrome differentiation,and treatment of Traditional Chinese Medicine(TCM) of community-acquired pneumonia(CAP) symptoms through consulting relevant literature,and to provide theory basis for the understanding of TCM of CAP through reviewing the present status of TCM treatment.2.To provide certain clinical basis and research ideas for the further study of TCM in treating pneumonia through retrospective analysis of the epidemiological data,TCM in syndrome distributions,and clinical characteristics of hospitalized patients within the area.3.To observe the effects of the use of TCM to inflammatory factors and cellular imm-unity in each rat lung tissue and serum,and to guide the clinical medication,by establishing the rat model of pneumococcal infection,and after the treatment of pneumonic rats using Re Du Qing oral liquid.Method:1.The investigation of clinical medical record reviewDesign a clinical medical record form.The contents of the form include patient’s basic information,the symptom characteristics of TCM,and clinical characteristics,and so on.By collecting all clinical cases in hospitalized patients diagnosed with CAP in the first affiliated hospital of Anhui University of Chinese Medicine in recent five years(2009.1~ 2013.12),and using EXCEL table,the database was established,and the statistical analysis was performed by using SPSS19.0.2.The part of animal experimentThe rat model of pneumonia were infected by the route of through mouth and pharynx and drip into the trachea. The aged rats of age of 20-22 months and weight of 560 g ± 90 g SD were divided into 5 groups with 20 in each group based on principles of randomization:the normal group, model group, the Re Du Qing oral liquid group(hereinafter referred to as Chinese traditional medicine group),cefuroxime axetil group(hereinafter referred to as the western medicine group), Re Du Qing oral liquid combined to cefuroxime axetil group(hereinafter referred to as the combination of Chinese and western medicine group).Before the models were established,each group of rats were taken chest X-ray and blood routine were examined;After the models were established and before drug administration,each group of rats were taken chest X-ray;After drug administration,the chest X-ray and the white blood cells and neutral particle counting in the blood routine of each group of rats were observed.The expression level of IL-6 in serum were measured by ELISA method.The protein levels of IL-1βand TNF-α in lung tissue were measured by Western blot.The transcriptional level of IL-10 m RNA were measured by RT-PCR.Results:1.The investigation of clinical medical record reviewThis experiment study showed that the clinical characteristics of CAP in this area were the difference of the male to female ratio is not obvious,and the disease has a high incidence in aged people and in the season of winter and spring.Through a variety of statistical analysis,the research results show that the TCM syndrome types of CAP can be divided into 6 syndrome types,there are wind-heat invading lung,phlegm-damp obstructing lung,phlegm-heat stagnation in lung,intense lung heat pattern, exuberant heat in lung and stomach,and wind-cold attacking lung.2.The part of animal experiment.Routine blood tests showed:after 7 hours of drug administration,the sum of leukocyte and neutrophil in external blood,the rats of experimental group were obviously lower than the model group with a statistical significance(p<0.05),and there were no statistical difference compared to the normal group.This suggested that the three kinds of treatment methods all affected the sum of whole blood leukocytes and neutrophils of rats,and the combination of traditional Chinese and western medicine treatment had a greater impact;The analysis of the results of ELISA method showed:after 7 hours of drug administration,the content of IL- 6 in serum,the rats of experimental group were obviously lower than the model group with a statistical significance(p<0.05),and there were no statistical difference compared to the normal group.This suggested that the three kinds of treatment methods all affected the the content of IL- 6 in serum of rats,and the combination of traditional Chinese and western medicine treatment had a greater impact;RT-PCR tests showed:after 7 hours of drug administration,the protein relative expression of IL- 10 m RNA in the lung tissue,the rats of experimental group were obviously lower than the model group with a statistical significance(p < 0.05),and there was a statistical difference in the combination of traditional Chinese and western medicine group(P<0.01);This suggested that the three kinds of treatment methods all affected the protein relative expression of IL- 10 m RNA in the lung tissue,and the combination of traditional Chinese and western medicine treatment had a greater impact; Western blot tests showed:the protein expression of IL-1βand TNF-α in lung tissue,the rats of experimental group were obviously lower than the model group with a statistical significance(p < 0.05),this suggested that the three kinds of treatment methods all affected the protein expression of IL-1βand TNF-α in lung tissue,and the TCM group and the combination of traditional Chinese and western medicine group both had a greater impact.Conclusions :The retrospective analysis of clinical cases showed that the clinical characteristics of CAP in this area were the difference of the male to female ratio is not obvious,and the disease has a high incidence in aged people and in the season of winter and spring.Through a variety of statistical analysis,the research results show that the TCM syndrome types of CAP can be divided into 6 syndrome types,there are wind-heat invading lung,phlegm-damp obstructing lung,phlegm-heat stagnation in lung,intense lung heat pattern,exuberant heat in lung and stomach,and wind-cold attacking lung.But this cannot fully explained the syndrome differentiation of TCM of CAP,and further investigation and analysis research are needed;Animal studies showed that Re Du Qing oral liquid combined to antibiotic had a good therapeutic effect to the rats of pneumococcal infection,and had a modulatory role in the levels of inflammatory factor. |
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