| 1.Objective 1.1Clinical Research: To investigate the rules of TCM syndromes in the acute exacerbation of bronchiectasis.1.2Experimental study:To explore the effect of Qin Jin Wei Jing Di Huang Tang decoction on the NF-?B signaling pathway in bronchiectasis rats,and to provide a reliable scientific basis for the clinical application of the prescription.2Method 2.1 Clinical Research: The TCM syndromes of 105 patients with acute exacerbation of bronchiectasis were investigated to analyze the relationship between gender,age,disease course,body mass index,etc.,and TCM syndrome types,and to summarize the distribution characteristics of TCM syndromes in the acute exacerbation of bronchiectasis.2.2Experimental study: SD male rats were randomly divided into 5 groups,with 10 rats in each group: blank control group,model control group,TCM group,CIP group and TCM +CIP group.The model control group,the Chinese medicine group,the CIP group and the Chinese medicine +CIP group were injected into the trachea with pseudomonas aeruginosa bacterial solution to construct an bronchiectasia mouse model.After evaluating the success of the mold,blank control group,the rats were divided into 5 groups.model control group(treat with saline daily),Chinese medicine group(treat with Chinese medicine daily),CIP group(treat with moxifloxacin daily),traditional Chinese medicine(TCM)+ CIP group(treat with Chinese medicine andmoxifloxacin daily),one times a day,for 14 days.Pathological observation was carried out on the right lung tissue after HE staining.Rat abdominal aortic blood was taken for real-time quantitative PCR detection of serum NF-?Bp65 mRNA,NF-?Bp50 mRNA and I?B-?mRNA levels.3Result 3.1 Clinical studies:In the acute exacerbation stage,there were 38 cases(36.19%)of phlegm-heat obstructing lung syndrome,21 cases(20.00%)of irascibility makes lung syndrome,16 cases(15.24%)of Yin deficiency and fire flourishing syndrome,13 cases(12.38%)of wind-heat invading lung syndrome,9 cases(8.57%)of phlegm obstructs the lung syndrome,and 8 cases(7.62%)of Blood stasis of lung collaterals syndrome.3.2Experimental study: 3.2.1State of the rat:The mental and weight gain of the model rats were significantly worse than that of the blank group.Symptoms include cough,wheezing,irritability,reduced diet,and slow weight gain.After treatment in the TCM group,CIP group and TCM +CIP group,the mental state of the rats was significantly restored,the weight was increased,and the symptoms of cough and asthma were significantly improved.The improvement of TCM +CIP group was the most obvious,while the effect of TCM group and CIP group was less.3.3.2Pulmonary pathology:In the blank control group,there was no inflammatory exudation in the bronchus and alveoli,and there were no abnormal tissue and cell morphology in the bronchial wall and alveolar wall.In the other four groups,the elastic tissue and muscle layer of the bronchial wall were damaged to different degrees,which were replaced by fibrous tissue.The cilia columnar epithelial cells were squamous or atrophic,the lumen was deformed and expanded,and the inflammatory cells were infiltrated,which was consistent with the pathologic changes of bronchiectasis.3.3.3Serum NF-?B p65 mRNA was detected by real-time quantitative PCR: The relative expression levels of NF-?B p65 in different treatment groups were significantly different(P<0.01).The expression level of the model control group was the highest,followed by that of the Chinese medicine group.The expression level of the CIP group was lower than that of the Chinese medicine group,and the expression level of the Chinese medicine +CIP group was the lowest,with statistically significant difference(P<0.01).3.3.4Serum NF-?B p50 mRNA was detected by real-time quantitative PCR:The relative expression of NF-?B p50 in the model control group,CIP group and TCM group was generally higher than that in the blank control group and CIP+ TCM group,and the difference between the former three and the latter two was statistically significant(P<0.01).The relative expression levels of NF-?B p50 in the model control group,CIP group and TCM group were significantly different(P<0.01).There was no significant difference between the blank control group and the CIP+ TCM group.3.3.4Serum I?B-? mRNA was detected by real-time quantitative PCR: The relative expression of I?B-?in the blank control group was the highest,and the difference between the two groups was statistically significant(P<0.01).In the latter four treatments,the expression level of CIP+ TCM group was the highest,followed by CIP group,followed by TCM group,and the model control group was the lowest.The difference between the four groups was statistically significant(P<0.05).Pseudomonas aeruginosa infection can lead to the over-activation of NF-?B signaling pathway and promote the inflammatory response of rat tracheal expansion.The activation of NF-?B signaling pathway was inhibited in the Chinese medicine group,the CIP group,and the Chinese medicine +CIP group.The inhibition of NF-?B signaling pathway in the CIP group was superior to that in the Chinese medicine group,and the inhibition of NF-?B signaling pathway in the Chinese medicine +CIP group was the most significant.4.Conclusion 4.1Clinical studies:Clinical syndrome investigation found that phlegm-heat obstructed lung syndrome and liver gas makes lung syndrome is the common witness type of acute exacerbation of bronchiectasis.There was a correlation between the distribution characteristics of the acute exacerbation stage syndrome type and gender and BMI,but no correlation with smoking.4.2Animal experiments:Qin Jin Wei Jing Di Huang Tang can inhibit the activation of NF-?B signaling pathway,reduce the inflammatory response in the lungs caused by infection,and reduce lung tissue damage. |
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