Preliminary Study On The Effect Of Tonifying Lung And Kidney On Acute Attack Of Bronchial Asthma

ObjectiveTo systematically evaluate the clinical efficacy of bailing capsule in the treatment of bronchial asthma through literature analysis.At present,there is no clinical study on the treatment of acute attack of bronchial asthma with bailing capsule in clinical practice.This study observed the effect of tonifying lung and tonifying kidney on acute attack of bronchial asthma,providing objective basis for further clinical promotion.Methods(1)formulate the retrieval strategy and search CNKI,Chinese biomedical literature database(CBM),Wan Fang Data database and VIP database.The retrieval time is from December 2019.The literatures were screened according to the inclusion criteria and exclusion criteria formulated in this study,and the included literatures were finally determined.Information was extracted from the included literature and the risk of bias was assessed by Cochrane.Review Manager5.3 was used for Meta analysis to systematically evaluate the clinical efficacy of bailing capsule in the treatment of bronchial asthma.(2)A total of 50 patients with chronic asthma in the respiratory department of the second affiliated hospital of tianjin university of traditional Chinese medicine from October 2018 to March 2019 with complete medical records were collected.The patients were divided into two groups according to whether or not they took the baling capsule orally(traditional Chinese medicine baling group: baling capsule + western medicine routine basic treatment,western medicine routine group: western medicine routine basic treatment).Outpatient follow-up was conducted for 6 months,once every 4 weeks,to inquire about and record the specific conditions of acute asthma attack.Results(1)A total of 11 articles met the inclusion criteria,but the literature quality was low.The results showed that the total effective rate of belling capsule combined with conventional western medicine for bronchial asthma was better than that of conventional western medicine alone [RR = 1.18,95%ci(1.12,1.24),P = 0.54].Bailing capsule showed statisticalsignificance in improving lung function of patients with bronchial asthma by FEV1(L)[MD= 0.15,95%ci(0.08,0,22),P=0.43],FVC: [MD = 0.23,95%ci(0.03,0.43),P= 0.03],FEV1/FVC[MD = 8.24,95%ci(4.59,11.89),P= 0.02].Blood gas analysis: PCO2[MD =-4.6,95%ci(-5.97,-3.22),P = 0.13],PO2[MD = 6.92,95%ci(6.07,7.77),P = 0.007] were all statistically significant.Inflammatory indicators: TNF-a [MD =-13.97,95% CI(-31.04,4.00),P = 0.003] were not statistically significant.(2)By observing the acute attack of 50 cases of bronchial asthma,it is concluded that respiratory tract infection is the main factor inducing the acute attack of bronchial asthma.Wheezing,shortness of breath and chest tightness are the three most serious symptoms in the acute attack of bronchial asthma.There were no statistically significant differences in the use dose of short-effect bronchodilator(SABA),the number of visits to the emergency department,the number of hospitalizations,the severity of acute asthma attacks,nitric oxide(Feno),and the scores of TCM symptoms(wheezing,wheezing,shortness of breath,lumbar and knee tenderness,and chest tightness)between the groups(P >,0.05).The difference of TCM syndrome cough between the two groups was statistically significant(P <0.05).After observation,there were statistically significant differences between the groups before and after observation in the use dose of short-effect bronchodilator(SABA),the number of visits to the emergency department and the score of TCM syndrome(wheezing,wheezing,coughing,shortness of breath,lumbar and knee tenderness,chest tightness)(P <0.05).There was no significant difference in hospitalization frequency and nitric oxide(Feno)(P>0.05).In the conventional western medicine group,the dosage of short-effect bronchodilator(SABA),the number of emergency visits,and the score of TCM syndrome(wheezing,wheezing,coughing,shortness of breath,lumbar and knee tenderness,chest tightness)were compared with those in the pre-observation group after observation,and the differences were statistically significant(P<0.05).There was no significant difference in hospitalization frequency and nitric oxide(Feno)(P>0.05).Conclusion(1)Literature studies have shown that the total effective rate of Bailing Capsule combined with conventional western medicine in the treatment of bronchial asthma is better than that of conventional western medicine alone in the treatment of bronchial asthma,which can improvepatients’ lung function(especially FEV1 and FVC),and improve blood gas analysis(especially Pa CO2 and Pa O2).However,due to the low quality of the included literature,the results may be biased.(2)Clinical studies have shown that supplementing lung and benefiting kidney can relieve the clinical symptoms of bronchial asthma(such as wheezing and coughing),improve TCM syndrome score,and reduce the number of acute attacks of bronchial asthma.