| Objective1 To study the correlation between serum APTT,FBG,D-D,HIF-1a,PDGF,PEDF,ES and syndrome types in IPF patients with phlegm-dampness retention lung syndrome,phlegm-stasis obstruction lung syndrome and Qi-Yin Deficiency combined with blood stasis syndrome.2 To study the dynamic effects of Shenqi Cordyceps Militaris Prescription on lung histopathology,serum HIF-1a,PDGF,PEDF and ES in rats with pulmonary fibrosis.Methods1 Clinical research:Collecting 30 cases of IPF patients with phlegm-dampness lung syndrome,phlegm-stasis obstruction lung syndrome,Qi-Yin Deficiency and blood stasis syndrome,30 healthy people as normal group.Collect four groups of patients serum APTT,FBG,D-D,HIF-1a,PDGF,PEDF,ES to compare the correlation between syndrome types.2 Animal experiment:128 rats were randomly divided into blank group(K group),model group(M group),prednisone group(P group)and Shenqi Cordyceps sinensis group(S group),32 rats in each group.The rats in blank group were sham operated by intratracheal drip of saline.The other three groups were induced by intratracheal drip of bleomycin in the same way.The left lungs were taken on the 7th,14 th,21st and 28 th day after the model establishment.The lower lobe was stained with HE and Masson staining to observe the pathological changes of lung tissue,and the abdominal aorta blood serum was collected at each time point.The contents of HIF-1a,PDGF,PEDF and ES were detected by ELISA.Results1 Clinical research1.1 Compared with the normal group,the serum APTT content of IPF patients decreased significantly(P < 0.01).The serum APTT content of phlegm-dampnessretention Lung Group was higher than that of phlegm-stasis obstruction Lung Group and Qi-Yin Deficiency and blood stasis clamping group(P < 0.01).Compared with the normal group,the serum FBG content of IPF patients increased significantly(P < 0.01).Compared with the phlegm-dampness retention lung group,the FBG content of phlegm-stasis obstruction Lung Group and Qi-yin deficiency and blood stasis group increased significantly(P < 0.01).Compared with the normal group,the expression of D-D was higher in the three groups of IPF patients(P < 0.01).Compared with the phlegm-dampness retention lung group,the content of D-D in the phlegm-stasis obstruction Lung Group and the Qi-Yin Deficiency combined with blood stasis group was higher(P < 0.01).1.2 Compared with the normal group,the serum levels of vascular growth factor HIF-1a and PDGF in IPF patients were significantly higher(P<0.01),and the levels of vascular growth factor HIF-1a and PDGF in phlegm-stasis obstruction Lung Group and Qi-yin deficiency and blood stasis group were higher than those in phlegm-dampness retention Lung Group(P<0.05).Compared with the normal group,the levels of PEDF and ES in the three groups of IPF patients were significantly higher(P<0.01).Compared with the phlegm-dampness retention lung group,the levels of PEDF and ES in the phlegm-stasis obstruction Lung Group and the Qi-Yin Deficiency combined with blood stasis group were higher(P<0.05).2 Animal experiment2.1 HE staining: At 7,14,21 and 28 days after the establishment of the model,the lung tissue structure of rats in the blank group was normal and intact.On the 7th,14 th,21st and 28 th day after modeling,the alveolar septum of the rats in the model group gradually widened,and the inflammatory cells in the interstitium gradually decreased.On the 21 st day,the inflammatory cells were fewer than those on the 14 th day,and almost no inflammatory cells were found on the 28 th day.The pathological changes of prednisone group and Shenqi Cordyceps militaris group were similar to those of model group,but the degree was relatively mild,especially in Shenqi Cordyceps militaris group.2.2 Masson staining:There was no blue-stained area in the alveolar septum of the rats in the blank group on the 7th,14 th,21st,and 28 th day after modeling.On the 7th,14 th,21st and 28 th day after modeling,the alveolar septum of the model group showed blue collagen fiber deposition,the color gradually deepened,the area of the blue area gradually increased.Compared with the corresponding points of the model group,prednisone group and Shenqi Cordyceps militaris group,the blue area was smaller,the color was lighter,and the degree of fibrosis was lighter,especially in Shenqi Cordyceps militaris group.2.3 On the 7th,14 th,21st and 28 th day after modeling,compared with the blank group,the content of HIF-1a in model group,prednisone group and Shenqi Cordyceps militaris group increased significantly(P<0.01).Compared with model group,the content of HIF-1a in prednisone group and Shenqi Cordyceps militaris group decreased significantly at corresponding time points(P<0.01).There was no significant difference between prednisone group and Shenqi Cordyceps group,but the content of HIF-1a in Shenqi Cordyceps group was low.2.4 On the 7th,14 th,21st and 28 th day after modeling,compared with the blank group,the PDGF content of model group,prednisone group and Shenqi Cordyceps militaris group increased significantly(P<0.01).Compared with model group,the expression of PDGF was lower in prednisone group and Shenqi Cordyceps militaris group(P<0.01).There was no significant difference between prednisone group and Shenqi Cordyceps militaris group.The content of PDGF in Shenqi Cordyceps militaris group was low.2.5 On the 7th,14 th,21st and 28 th day after modeling,the PEDF content of model group,prednisone group and Shenqi Cordyceps militaris group was higher than that of blank group(P<0.01).Compared with model group,the expression of PEDF in prednisone group and Shenqi Cordyceps militaris group increased significantly at corresponding time points(P<0.01).There was no significant difference in the content of PEDF between the prednisone group and the Shenqi Cordyceps militaris group,but the PEDFcontent of the Shenqi Cordyceps militaris group was higher.2.6 On the 7th,14 th,21st and 28 th day after modeling,compared with blank group,ES content in model group,prednisone group and Shenqi Cordyceps militaris group increased significantly(P<0.01).Compared with model group,the expression of ES in prednisone group and Shenqi Cordyceps militaris group increased significantly at corresponding time points(P<0.01).There was no significant difference in the content of ES between prednisone group and Shenqi Cordyceps militaris group,but ES content in Shenqi Cordyceps militaris group was higher.Conclusions1 IPF belongs to "pulmonary flaccidity".The main pathogenesis of traditional Chinese medicine is "pulmonary dysfunction and stagnation due to deficiency".2 IPF patients have hypercoagulable state,phlegm and blood stasis obstructing lung syndrome and Qi-Yin Deficiency with blood stasis syndrome are more significant than phlegm and Dampness Retention lung syndrome.3 The expression of angiogenic factors and inhibitors was high in IPF patients.The expression of angiogenic factors in patients with phlegm-stasis obstructing lung syndrome and Qi-Yin Deficiency combined with blood stasis syndrome was more vigorous than that in patients with phlegm-dampness stagnation of lung syndrome.4 The pathogenesis of IPF is closely related to angiogenesis.Shenqi Cordyceps may inhibit angiogenesis and relieve pulmonary fibrosis by inhibiting the expression of pro-angiogenic factors and promoting inhibitory factors.5 Legislative treatment of Yiqi Yangyin Huoxue can improve pulmonary fibrosis,which may be related to the regulation of angiogenesis-related factors and the inhibition of angiogenesis. |
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