Analysis On Clinical Syndromes Of COPD With Depression And Experimental Study On Intervention Effect Of Modifiederchen Decoction

Objective:The aim of the series of experiments is to analyze the clinical syndromes of COPD with depression and to study the intervention mechanism on COPD with depression model rats of the Modified Erchen Decoction. It will provide new ideas to study COPD with depression, basic information of TCM treatment of COPD with depression, and a reference for basic research.Methods:1. Clinical Research:Select 99 patients, who diagnosed with COPD from June 2015 to February 2016, to be involved in filling in the SDS Scale questionnaire with a cross-sectional survey research methods, investigation and analysis their TCM syndromes, and study the distribution of TCM syndromes of patients with depression by applying statistical methods.2.Experimental Study:Establish COPD model rats and COPD with depression model rats by giving intratracheal injection of LPS and smoke. Intervene COPD model rats and COPD with depression model rats with Erchen Decoction which was added with Atractylodes, Berberine and Polygalaceae additionally. Observe the effects of this decoction on Pathological changes in the lungs, airway inflammatory changes of COPD model rats, as well as on weight and the results of open-field behavior and sugar consumption test. Detect content changes of DA in rats’ hippocampus by UPLC.Results:1. COPD patients TCM Syndromes:99 patients, diagnosed with COPD, including 53 males and 46 females, whose average age is (68.14±9.04) years, was divided into 3 groups according to different kinds of TCM Syndromes. There were 64 patients with the syndrome of phlegm and heat accumulated in lung,14 patients with the syndrome of turbid phlegm obstructing lung,21 patients with the syndrome of deficiency of both qi and yin of lung.2. Analysis of COPD patients with depression:according to the analysis of the SDS scale questionnaires’ results, there were 48 patients suffered by depression, and the proportion of them is 48.48%. Among them,14 patients scored from 0.5 to 0.59 in the SDS scale questionnaire, which means they got in mild depression,24 patients scored from 0.6 to 0.69 in the SDS scale questionnaire, which means they got in moderate depression, and 10 patients scored higher than 0.7 in the SDS scale questionnaire, which means they got in severe depression. The majority of these 48 patients were those who had the syndrome of phlegm and heat accumulated in lung. The number of them is 30, which accounts for 62%. Those who had the syndrome of turbid phlegm obstructing lung account for 23%. The proportion of patients with the syndrome of deficiency of both qi and yin of lung is 15%.3. The results of the experiment suggest that COPD with depression model rats had more obvious pulmonary pathological changes and more severe airway inflammation. Erchen Decoction with Atractylodes, Berberine and Polygalaceae could improve COPD model rats’pulmonary pathological changes and reduce the proportion of inflammatory cells in BALE Compared with model group, control groups has significant difference (P<0.01-0.05). Erchen Decoction with Atractylodes, Berberine and Polygalaceae could not improve COPD with depression model rats’ pulmonary pathological changes too much. But the decoction could decline the proportion of inflammatory cells in BALF obviously (P<0.01-0.05).4. The weights of COPD with depression model rats raised at first, then downward to the bottom, ending up increasing but not even close to blank control group’s. The weights of COPD with depression model group and blank control group had statistically significant differences (P<0.01). The weights of control groups with COPD with depression model rats showed a significant upward trend. They significantly differented form COPD with depression model group’s weights(P<0.01-0.05).5. The results of the experiment suggest that Erchen Decoction with Atractylodes, Berberine and Polygalaceae do improve the results of open-field behavior test and do increase COPD with depression model rats’ and COPD model rats’ sugar consumption.6. The results of UPLC suggest that Erchen Decoction with Atractylodes, Berberine and Polygalaceae can increase the content of DA in COPD with depression model rats’ hippocampus.Conclusion:In this study,99 cases of COPD clinical data were collected to analyze the clinical syndrome features of COPD patients and COPD patients with depression. The incidence of COPD patients occurred depression was counted. The patients were classified to different groups according their depression degree. The relationship between COPD and COPD with depression in terms of TCM Syndrome was studied. This study will surely provide basic information of TCM treatment of COPD and COPD with depression. The results show that COPD model rats’ pulmonary pathological changes were improved significantly and the proportion of neutrophils in BALF was reduced by Erchen Decoction with Atractylodes, Berberine and Polygalaceae. Furthermore, the decoction had the same impacts on COPD with depression model rats, and it can also raise the COPD with depression model rats’ weights, improve their performances in the open-field behavior test, increase their sugar consumption, and increase the content of DA in hippocampus. The results of the experiments suggest that Erchen Decoction with Atractylodes, Berberine and Polygalaceae may have significant intervention on COPD patients and COPD patients with depression.