Effect Of Qingre Huoxue Huayu Method On The Transport Ability Of Antibiotics In Lung Tissue Of Patients With AECOPD And Phlegm Syndrome

Object:Objective To study the effect of louqinzhisou Decoction with danshen and chishao of heat-clearing,stasis-invigorating and blood-activating methods on transport ability of antibiotic in lung tissue in AECOPD patients with respiratory fever lung syndrome,and further discuss whether heat and blood circulation method which is acting on airway mucus hypersecretion mechanism to increase antibiotic normal phase transfer capacity in lung tissue or not.Method:select clinical thirty patients of AECOPD with respiratory fever lung syndrome and randomly are divided into control group which is administered by Ambroxol and therapy group which is administered by louqinzhisou Decoction with blood medicine.Fifteen patients in each group.Observe for seven days.The treated sputum supernatant and serum were collected separately for each patient on the first and seventh days of treatment,which were stored in a-80 ? environment.After the qualified case is collected,Testing the concentration of antibiotic named Piperacillin sodium Sulbactam sodium in blood and sputum through high performance liquid chromatography-tandem mass spectrometry after seven days and testing MUC5AC in sputum and NE in blood by ELISA method seven days before and after.Statistics Patient's TCM symptoms and signs score on first day,fourth day and seventh day of patient treatment;blood tests,blood gas analysis,blood coagulation,lung function,and other laboratory test indexes on first day and seventh day of patient treatment;CAT scale scores and mMRC dyspnea questionnaire on admission;the total effective rate of TCM efficacy after 7 days of treatment.Result:Antibiotic concentration:There were no significant difference in the determination of antibiotic concentration in blood and sputum between the two groups after seven days(P>0.05);NE and MUC5AC in sputum and blood:Two groups'quantity of NE and MUC5AC in sputum and blood.Both decreased after seven days which explains that both groups have the effect of improving airway inflammation and reducing airway mucus secretion;the non-parametric P value of NE in blood of the therapy group was 0.061,which was close to 0.05,showing a trend of comparison;the results showed that the therapy group was more effective in reducing the quantity of NE in the blood than the control group after seven days of treatment;prompted therapy group has a tendency to have better anti-inflammatory effects;TCM symptoms and signs:Reduction in the number of TCM symptoms and signs on the fourth day compared with the first day and on the seventh day compared with the first day(P<0.05);therapy group's number dropped more clearly after seven days.It shows that the TCM symptoms and signs of patients have improved no matter they are treated with traditional Chinese medicine or western medicine,and the improvement of Chinese medicine is more obvious;Blood routine:Both groups showed a decrease in WBC,NE#,NE%and CRP treatment on seventh day compared to first day and NE#and NE%in therapy group decreased significantly after seven days compared with control group(P<0.05).It shows that both groups can reduce the inflammatory index after treatment,and the therapy group is better than the control group in improving inflammation to a certain extent;In addition,CRP in the therapy group decreased significantly on the seventh day compared with the control group,further indicating that the therapy group had better inflammation reduction.Blood gas analysis:Increased PaC02 indicator value in therapy group compared seventh day to first day and Pa02 of the therapy group after seven days of treatment was significantly higher than that of the control group(P<0.05)It shows that the therapy group can improve airway ventilation and increase blood oxygen;Lung function:The FEV1/FVC%on the seventh day of the therapy group was significantly higher than the FEV1/FVC%on the first day(P<0.05),It shows the therapy group can improve lung function.Conclusion:First,louqinzhisoujian Decoction with danshen and chishao and ambroxol both can clearly improve the patient's symptoms,sign,laboratory indicators such as NE#,NE%,CRP,PaO2,etc and have therapeutic effect on AECOPD patients with respiratory fever lung syndrome;The role of traditional Chinese medicine is somewhat stronger than Western medicine;Second,louqinzhisoujian Decoction with danshen and chishao and ambroxol both can reduce NE,MUC5AC;It shows that both them can reduce the secretion of mucus in the airway acting on the hypersecretion mechanism of airway mucus to improve the clinical efficacy of antibiotics;in contrast,the Chinese medicine group has a stronger role in reducing NE in blood and presage that Chinese medicine improve airway inflammation and intervention on airway mucus mechanism to increase the transport of antibiotics in lung tissue and increase the concentration of local antibiotics if you extend the observation time;that we will know the efficacy of treatment in patients with AECOPD is much better than Ambroxol;Third,louqinzhisoujian Decoction with danshen and chishao is effective in treatment of AECOPD patients with respiratory fever lung syndrome,to a certain extent,it can be explained that heat-clearing,stasis-invigorating and blood-activating methods improve airway inflammation by reducing NE and MUC5AC and increase antibiotic transport in lung tissue and affect the absorption of anti-infective drugs in the local area.