From The Perspective Of The Action Link, The Connotation Of The Same Disease And Treatment Of "Jinyi" Based On The Mucus High Secretion Model Was Discussed

"Jingui Yaoliie " contains:"Treatment of shortness breath caused by minor case of Fluild-retention syndrome should follow the principle of removing pathogenic factor from urine.Linggui Zhugan Decoction can be adopted.Shenqi Pill can also be adopted"."Different treatments for the same disease" is presented in several chapters,such as phlegm and retained fluid disease in this book,which reflects the important diagnosis and treatment characteristics of synopsis of "Jingui Yaoliie ".This research is based on discussing the connotation of"different treatments for the same disease" in the recordation——"Treatment of shortness breath caused by minor case of Fluild-retention syndrome should follow the principle of removing pathogenic factor from urine.Linggui Zhugan Decoction can be adopted.Shenqi Pill can also be adopted",which is recorded on the "Jingui Yaolue ",in the chapter talking about phlegm and retained fluid disease.Through literature and experimental research,remodel acrolein-induced airway mucus hypersecretion in rats to disscuss the regulation and influencing mechanism of the pulmonary function of the rats suffering airway mucus hypersecretion,and the connotation of "different treatments for the same disease".This paper mainly discusses the following three aspects:literature review,theoretical research and experimental research.Literature review section:In this part,by referring to ancient medical records,combining with the results of modern experiments and clinical studies,the research progress of the etiology,pathogenesis,treatment and prescription of the airway mucus hypersecretio are described.The treatment of"phlegm" is the focal point and key link in the treatment of high secretion disease of airway mucus.The signaling pathways related to the mechanism of high secretion of mucus contain key cytokines,including NE?TGF-??EGFR?IL-13?IL-1??IL-8?&TNF-? etc.Modem studies have shown that TCM can intervene in these cytokines from multiple channels and links.Theory research section:This section discuss the characteristics of the diagnostic and treatment about phlegm-fluid retention disease and the water vapour disease.(1)The characteristics of diagnosis and treatment of "different treatments for the same disease" are both presented in the chapters of the phlegm-fluid retention disease and edema disease.Besides the traditional explainations,there is also the possibility of discussing from the perspective of "the same disease-the same syndrome-the different prescription ".(2)Edema disease emphasis on early diagnosis and treatment:according to the characteristics of the two chapters,it can be seen that zhongjing zhang attaches great importance to early differential diagnosis and treatment of edema disease.(3)Compare with the phlegm-fluid retention disease,edema disease,the disease is more widespread,more urgent,and the effect is obvious and the prognosis is better.Phlegm-fluid retention disease are easy to become chronic illness,because it is prone to relapse.Its disease location is inclined to be the above.And it's common to see cough,asthma,full,dizziness,palpitations,etc.Experiment research section:Objective:Preliminary research confirms that Linggui Zhugan decoction and Shenqi pill can improve the "shortness breath ".And the difference between Linggui Zhugan decoction group and Shenqi pill was no significant.This study,based on the confirmed conclusion,will discuss the connotation of " different treatments for the same disease " from from the point of view of the action link.Method:30 rats were randomly selected as the model group,and the remaining 10 were treated as normal control group.Remodel acrolein-induced airway mucus hypersecretion in rats,rat model of airway mucus hypersecretion was established by inhalation of acrolein on 2 consecutive weeks.Rats were randomly divided into three groups:model group,Linggui Zhugan decoction group and Shenqi pill group,and 10 rats per group.Each group was intragastric administration for 4 consecutive weeks from the third week.Normal group and model group were intragastric administration by water.The test was conducted in 4 weeks.(1)The change of pulmonary ventilation function and pathological structure of rats were selected to be the biological basis:lung function determination and blood gas analysis were performed to detect pulmonary ventilation in each group;The pathological changes of lung tissues were observed under light microscop;(2)observe the intervention effect of rhizoma glycyrrhizae and kidney qi pills on urine volume of rats:determine the content of Na+,K+,Cl-content and AQP2 in urine of rats in each group by colorimetric method;(3)Observe the impact and difference of Linggui Zhugan Decoction and Shenqi Pillin on the key cytokines in the pathogenesis of airway mucus secretion:by enzyme-linked immunosorbent assay to detect the rat mucins in bronchoalveolar lavage fluid of MUC5AC,MUC5B and cytokine IL-13,IL-1 beta,IL-8,TNF alpha,NE,TGF-alpha and EGF.Results:Test Result of Pulmonary Functions and Qi and Blood AnalysisCompared with the normal group,FEV1,FVC,FEV1/FVC?pH?PaO2?SaO2 of the model group were all decreased,while PaCO2 was increased(P<0.05).Compared with model group,both of pulmonary functions and the datas of arterial blood gas analysis were improved in rats in Linggui Zhugan Decoction group and Shenqi Pill group(P<0.05).There was no significant difference in the pulmonary functions and the datas of arterial blood gas analysis between Linggui Zhugan Decoction group and Shenqi Pill group(P>0.05).Pathological section of lung tissueNormal group of rat lung tissue visible the bronchial wall and alveolar mucosa structure is complete,the cilia arranged orderly,no inflammatory exudate in the bronchial lumen,lung blood vessel with a small amount of inflammatory cells,congestion is not obvious.The bronchial and alveolar mucosa of the rat lung tissues in the model group were incomplete,and the cilia were poorly aligned,and the goblet cells and mucous glands were hypertrophic and hyperplasia,secreting hyperactivity and blocking the bronchial tubes.Infiltrating and hyperemic inflammatory cells are seen in the bronchial wall.The alveolar structure is disorganized,the alveolar cavity is enlarged and fused,and the alveoli have a lot of inflammatory cell infiltration.Compared with model group,Linggui Zhugan Decoction group and Shenqi Pill group rat bronchial wall goblet cells and mucus gland hypertrophy and hyperplasia,alveolar cavity burst,expand,structure disorder,with inflammatory cells infiltration,reduced but the degree of pathological changes compared with model group.Results of the content of mucin and cytokines in alveolar lavageCompared with the normal group,the contents of mucin MUC5AC,MUC5B and cytokines IL-13?IL-1??IL-8?TNF-??NE?TGF-? and EGF were all increased in the model rat alveolar lavage(p<0.05).Compared with the model group,the content of MUC5AC was decreased(p<0.05),while the content of MUC5B was not significantly changed(p>0.05).The content of cytokines in the alveolar lavage solution of rats in the two groups was down-regulated,among which:the NE content of the rats in Linggui Zhugan Decoction group and Shenqi Pill group was decreased(p<0.05).The contents of EGF?IL-1??TNF-? were decreased in the rats of the Linggui Zhugan Decoction group(p<0.05),and no significant change in TGF-alpha content(p>0.05).The contents of TGF-??IL-13?IL-8 in the rats of Shenqi Pill group were significantly reduced(p<0.05),and no significant change in EGF content(p>0.05).Compared the rats of Linggui Zhugan Decoction group with those in Shenqi Pill group,the expression of MUC5AC and the influence ofNE?EGF?IL-1??TNF-?were not significantly different between the two administration groups(p>0.05).The content of TGF-??IL-13?IL-8 in Shenqi Pill group decreased significantly(p<0.05)It suggests that the expression of mucoprotein is down-regulated and the high secretion of the airway mucus is improved in the rats of the Linggui Zhugan Decoction group,which is related to the key signaling factors such as NE?IL-1??TNF-?.The high secretion of the mucous cell and the airway mucus was inhibited in Shenqi Pill group,which was related to the suppression of the expression of NE/TGF-alpha/EGFR signaling pathway and down-regulation of IL-13?IL-8.Urine volume and urine of Na+,K+,Cl-,and AQP2 contentIn the model group,the urine volume of rats was significantly reduced compared with that in the normal group,and the excretion of K+ and AQP2 in urine increased,and the amount of Na+ and Cl' was decreased,and the difference was statistically significant(p<0.05).Compared with model group,the rat urine of Linggui Zhugan Decoction group and Shenqi Pill group were increased,the volume of K+?AQP2excretion in the urine reduced,Na+?Cl-discharge increases,the difference was statistically significant(p<0.05).Compared the rats of Linggui Zhugan Decoction group with those in Shenqi Pill group,the difference was not statistically significant(p>0.05)It suggests that both sides can increase the urine volume of rat model by inhibiting the reabsorption of urine and down-regulating the expression of AQP2,and the difference of the difference is not significant.Conclutions:1.The lung ventilation function of the rats with high secretion model of airway mucus was significantly improved by both Linggui Zhugan Decoction group and Shenqi Pill group,and there was no significant difference in effect between the two sides.That is,"the same diease-the same syndrome-different prescriptions" may be potentially existed.2.Linggui Zhugan Decoction and Shenqi Pill can both improve high airway mucus secretion by inhibiting the goblet cells metaplasia,sticky protein expression and inhibiting inflammatory reaction.The Shenqi Pill can significantly reduce the expression of IL-13?IL-8 in BALF,and inhibit the NE/TGF-alpha/EGFR signaling pathway,etc.While Linggui Zhugan Decoction may reduce the expression of IL-1 and TNF-? in BALF.That is,"the same disease-the same syndrome-different prescriptions" may happen when different prescriptions acts on different parts of the disease.