Clinical And Metabonomics Research On Xiaofeng Xuanqiao Decoction In Treating Pediatric Allergic Rhinitis With Syndrome Of Cold And Qi Deficiency Of Lung And Wind-phlegm Restraining Nasal Orifices

ObjectiveThis study intends to further study the therapeutic efficacy and dynamic metabolic mechanism of the treatment of pediatric allergic rhinitis by Xiaofeng Xuanqiao Decoction,based on the existing clinical efficacy of Xiaofeng Xuanbi Decoction and the metabolomics study of AR mice.The aim is to achieve the microcosmic and objective treatment of TCM treatment of this disease.Methods1.Clinical curative effect observation is conducting a clinical study on Pediatric Allergic Rhinitis with Syndrome of Cold and Qi Deficiency of Lung and Wind-phlegm Restraining Nasal Orifices by using the Xiaofeng Xuanqi Decoction.One month is a course of treatment,so patients were observed for 4 weeks and some cases were observed for 8-12 weeks.Observe the the main symptoms before and after treatment such as nasal itching,nasal obstruction,sneezing,nasal discharge,and observe secondary symptoms before and after treatment such as cough,squeaky throat,itchy eyes,itchy skin,smell,tongue coating,pulse,etc.Statistical analysis was performed using SPSS 23.0 software.2.Metabolomics study is collecting clinical data of 42 children accord with the diagnosis of allergic rhinitis and TCM diagnostic criteria,including the normal control group of 35 children,the treatment group of 40 children who were treated with Xiaofeng Xuanqiao Decoction for 2 weeks,and visiting group of 13 children who were treated with Xiaofeng Xuanqiao Decoction for 4 weeks.The urine metabolites of four groups of children were collected.The gas chromatography-mass spectrometry(GC-MS/MS)metabolomics technique was used to study the changes of metabolites in each group,and the mechanism of the drugs.Results1.The total effctive rate of 190 patients with pediatric allergic rhinitis with syndrome of cold and qi deficiency of lung and wind-phlegm restraining nasal orifices treated with Xiaofeng Xuanqiao Decoction for 2 weeks was 85.8%,the total effective rate 93.7%for 4 weeks.The total effective rate of 90 cases was 92.2%for 8 weeks,and the total effective rate of 90 cases was 98.9%for 12 weeks.2.There was a significant difference on mian symptoms such as nasal itching,nasal obstruction,sneezing,nasal discharge,and on secondary symptoms such as cough,squeaky throat,itchy eyes,itchy skin,smell,tongue coating,pulse,etc,in 90 AR children with Syndrome of Cold and Qi Deficiency of Lung and Wind-phlegm Restraining Nasal Orifices treated with Xiaofeng Xuanbi Decoction for 2 weeks,4 weeks,8 weeks,12 weeks,indicating that Xiaofeng Xuanbi Decoction has a significant effect on improving nasal itching,nasal obstruction,sneezing and nasal discharge.3.Metabolomics study:Principal component analysis of urine metabolites in AR group,treatment group,visiting group and normal control group(P<0.01),suggests that the difference between the four groups was statistically significant.After 2 weeks and 4 weeks treatment of children with allergic rhinitis,Xiaofeng Xuanqi Decoction showed a trend of separation of metabolites,indicating that Xiaofeng Xuanqiao Decoction for children with allergic rhinitis is useful.Metabolites have a good regulatory effect.Twelve metabolic differences were identified as potential biomarkers for allergic rhinitis in children.The contents of jaundice,guanine and isoxanthin decreased in the urine of children with allergic rhinitis(P<0.05),and L-threonine,L-methionine,taurine and other substances in the urine of children with allergic rhinitis were up-regulated(P<0.05).Conlusion1.Xiaofeng Xuanbi Decoction has good short-term and long-term effects in treating children with nasal sputum,lung deficiency and wind-stagnation.It has a significant improvement in the main symptoms of nasal discharge.In terms of safety evaluation,Xiaofeng Xuanbi Decoction has no adverse reactions in treating children with nasal discharge.2.Metabolomics research proved that Xiaofeng Xuanbi Decoction has obvious regulation on metabolites of allergic rhinitis in children.The mechanism may be related to the regulation of amino acids and carbohydrate metabolism of children with nasal sputum.Screening for differential metabolites may be a potential biomarker for pediatric allergic rhinitis.