Study On The Regulatory Immune Mechanism Of Qingjin Huayu Decoction In Treating Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

This paper is divided into two parts:The first part is the literature review,introducing the relevant mechanism of immune regulation in the acute exacerbation of chronic obstructive pulmonary disease and the progress of traditional Chinese medicine treatment of chronic obstructive pulmonary disease.The second part is clinical research.Objective:To observe and analyze the effect of qingjin huatan decoction and compare the percentage of CD4+CD25+FoxP3+Treg cell?Th17 in the Venous blood before and after treatment.To explore the therapeutic mechanism of qingjin huatan decoction through the regulatory immune pathway to the acute exacerbation of chronic obstructive pulmonary disease.Methods:Patients who meet the inclusion and exclusion criteria were randomly divided into two groups:the traditional Chinese medicine group and the control group.The patients in the control group were treated with routine western medicine.The patients in the traditional Chinese medicine group were treated with routine western medicine and Qingjinhuatan Decoction granules 2 bags bid,continuous treatment for 7 days.On 1st day and 7th day,took the venous blood measurement indicators and fill the CRF table.Observe:?general situation of age,gender,smoking history.?symptoms include cough?sputum?pant?short breath?spontaneous sweating?wheezing?anorexia?fatigue?abdominal distension and so on,score 0-3 points from light to heavy quantification according to the patient's subjective feelings,and calculate the total score.?mMRC score?CAT score(see attached table).?pulmonary function test FEV1/FVC,FEV1%expected(Use only for disease evaluation).?Security Index:ALT?AST?BUN?Cr in the Venous blood.? CRP in the Venous blood.? the percentage of CD4+CD25+FoxP3+Treg cell?Th17 in the Venous blood.Results:A total of 71 patients were collected for the symptom observation,the data were completed in 64 cases,including 33 cases in the traditional Chinese medicine group and 31 cases in the control group.At the same time,a total of 54 patients were collected for the clinical test,the data were completed in 41 cases,including 21 cases in the traditional Chinese medicine group and 20 cases in the control group.Before the treatment,the age,sex,mMRC score,CAT score,symptom score,severity of lung function,smoking history and the percentage of CD4+CD25+FoxP3+Treg cell?Th17 in the Venous blood were compared between the two groups,there was no statistically significant difference(P>0.05).Both the control group and the traditional Chinese medicine group,the sore of CAT.symptom and the percentage of CD4+CD25+FoxP3+Treg cell?Th17 in the Venous blood decreased after treatment(P<0.05).After treatment,the symptom scores of cough?sputum?pant?short breath?spontaneous sweating?wheezing?fatigue and total symptom scores of the patients of the control group were significantly lower than those before treatment(p<0.05).In terms of anorexia and spontaneous abdominal distension were no significant difference between before and after the treatment(p>0.05).After treatment,the symptom scores of cough?sputum?pant?short breath?spontaneous sweating?wheezing?fatigue?abdominal distension and total symptom scores of the patients of the traditional Chinese medicine group were significantly lower than those before treatment(p<0.05).In terms of spontaneous fatigue was no significant difference between before and after the treatment(p>0.05).Compared with the control group,the percentage of Th17 in the Venous blood of the traditional Chinese medicine group was significantly lower than those in the control group(p<0.05).Compared with the control group,the symptoms and the total scores of sputum?pant?wheezing?abdominal distension were significantly lower than those of the control group(p<0.05).In term of cough?spontaneous sweating?anorexia?fatigue,there was no significant difference between the two groups(P>0.05).Both group showed no significant improvement in anorexia.Conclusion:1.Traditional western medicine on the basis of the addition of Qingjinuatan Tang,in improving the symptoms compared to the simple Western medicine group has a better effect,especially in the sputum?pant?wheezing?abdominal distension and other symptoms.2 The regulatory immune pathway which mediated by CD4+CD25+Foxp3+Treg and Th17 was the channel of treatment of AECOPD.,Th17 maybe the target.