System Evaluation And Drug Analysis Of The Clinical Curative Effect Of Tongluo Method In Intervention Of Pulmonary Collateral Disease

Purpose:To evaluate the curative effect of traditional Chinese medicine compound prescription based on Tongluo method in treating pulmonary collateral disease and to analyze its medication regularity.Material and method:The search terms were extracted and the computer was used to search CNKI,VIP database,the Wanfang database,and CBM?From the date of database establishment to 31 December 2018?.A total of 1839 cases of Pulmonary Fibrosis,Chronic Obstructive Pulmonary Disease and Bronchial Asthma were retrieved.There were 622 cases of pulmonary fibrosis,339 cases in the observation group and 289cases in the control group.There were 549 cases of chronic obstructive pulmonary disease,279 cases in the observation group and 270 cases in the control group.There were 668 cases of bronchial asthma,337 cases in the observation group and 331 cases in the control group.Data analysis was performed using Revman 5.3,and the Corchrane Collaboration Network was used for document quality evaluation.The outcome measures studied in this trial included:total clinical effectiveness,TCM syndrome scores,and individual symptoms?cough,sputum,wheezing,dyspnea,velcro,etc.?,lung function?FEV1,FEV1%,FEV1/FVC%,VC,PVC,TLC,PEF,FEV1/Predicted value%?,blood gas analysis?PaO₂?,6WMD,CAT score,ACT score,and IL-4,INF-?.OR is used for the resulting calculated data,and the measurement data are expressed by MD or SMD and their 95%confidence intervals.Then,cluster analysis and association analysis were applied to evaluate the drug combinations of the 33 Chinese herbal medicines.Results:Traditional Chinese medicine compound?Tongluo method?has a certain effect on the intervention of pulmonary collateral disease.?1?Pulmonary Fibrosis:compared with the control group,Chinese herbal compound can improve the overall clinical efficacy[Z=6.63,OR=3.62;95%CI?2.47,5.29?,P<0.00001];decreased the symptoms of"cough"[Z=6.19,MD=-0.76;95%CI?-1.01,-0.52?,P<0.00001];decreased"sputum"symptoms[Z=2.03,MD=-0.53,95%CI?-1.04,-0.02?,P=0.04];decreased"wheeze"symptoms[Z=2.64,MD=-0.40,95%CI?-0.69,-0.10?,P=0.008];decreased"dyspnea"symptoms[Z=2.12,MD=-1.10,95%CI?-2.12,-0.08?,P=0.03];improved FEV1[Z=29.29,MD=0.64,95%CI?0.60,0.68?,P<0.00001];improved FEV1%[Z=3.52,MD=4.77,95%CI?2.12,7.42?,P=0.0004];improved FEV1/FVC%[Z=13.98,MD=8.20,95%CI?7.05,9.35?,P<0.00001];improved VC[Z=3.49,MD=5.76,95%CI?2.53,8.99?,P=0.0005];improved DLco[Z=3.14,MD=2.22,95%CI?0.83,3.60?,P=0.002];improved SGRQ volume Table[Z=6.61,MD=-5.98,95%CI?-7.76,-4.21?,P<0.00001];improved PaO2[Z=2.72,MD=4.79,95%CI?1.34,8.24?,P=0.006];improved 6MWD[Z=6.10,MD=35.90,95%CI?24.37,47.44?,P<0.00001].There was no significant difference between the observation group and the control group in improving FVC,TLC and Velcro scores?P>0.05?.?2?Chronic Obstructive Pulmonary Disease:Compared with the control group,Chinese herbal compound can improve the overall clinical efficacy,chronic obstructive pulmonary disease[Z=5.45,OR=3.55;95%CI?2.25,5.60?,P<0,00001];decreased the symptoms of"cough"[Z=2.26,MD=-0.25;95%CI?-0.47,-0.03?,P=0.02];decreased the symptoms of TCM score[Z=2.81,MD=-2.59,95%CI?-4.41,-0.78?,P=0.005];improved FEV1[Z=2.86,SMD=0.34,95%CI?0.11,0.57?,P=0.004];improved FEV1%[Z=3.06,SMD=0.53,95%CI?0.19,0.87?,P=0.002];improved FEV1/FVC%[Z=3.95,MD=4.23,95%CI?2.13,6.33?,P<0.0001];improved 6MWD[Z=3.77,MD=43.79,95%CI?21.03,66.54?,P=0.0002];improved CAT score[Z=2.19,MD=-1.38,95%CI?-2.60,-0.15?,P=0.03].In the improvement of"phlegm","wheeze","FVC","PEF"and"FEV1/predicted value%",there was no statistically significant difference between the observation group and the control group?P?0.05?.?3?Bronchial Asthma:compared with the control group,Chinese herbal compound can improve the overall clinical efficacy,bronchial asthma[Z=5.15,OR=3.60;95%CI?2.21,5.85?,P<0.00001];decreased the symptoms of"cough"[Z=5.05,SMD=-0.83;95%CI?-1.16,-0.51?,P<0.00001];decreased"phlegm"symptoms[Z=3.34,MD=-0.25,95%CI?-0.39,-0.10?,P=0.0008];improved"xiaomingyin"symptoms[Z=4.77,MD=-0.30,95%CI?-0.43,-0.18?,P<0.00001];improved FEV1%[Z=7.23,MD=8.61,95%CI?6.28,10.95?,P<0.00001];improved FVC[Z=6.51,MD=0.32,95%CI?0.22,0.41?,P<0.00001];improved PEF[Z=2.94,MD=0.67,95%CI?0.22,1.11?,P=0.003];improved ACT[Z=2.11,SMD=0.82,95%CI?0.06,1.59?,P=0.03];improved FEV1[Z=4.46,MD=0.50,95%CI?0.28,0.71?,P<0.00001];improved IL-4[Z=3.24,SMD=-1.96,95%CI?-3.15,-0.77?,P=0.001;INF-?was improved[Z=3.24,SMD=2.05,95%CI?0.81,3.30?,P=0.001].In the improvement of FEV1/FVC%,there was no significant difference between the observation group and the control group ?P=0.05?.?4?Tongluo method for the treatment of pulmonary collateral disease,the total effective rate of the observation group was higher than the control group,and can decrease the single symptom"cough"and improve lung function?FEV1,FEV1%?.?5?Cluster analysis based on pulmonary collateral disease showed that when the drug was clustered into 8categories,the effect was better.The 8 types of composition were C1:Astragalus membranaceus;C2:Earthworm;C3:Licorice;C4:Angelica-Chuanxiong;C5:Poria cocos-Baizhu-Salvia;C6:Pinellia;C7:Dried tangerine peel-Rehmannia glutinosa-Gekko-Cornus officinalis-Codonopsis-Mai Dong-Schisandra;C8:Trichosanthes-Scutellaria baicalensis-Morus alba-Aster-Ephedra-FangFeng-Medicinal Silkworms-Cicada slough-Almond.?6?Correlation analysis based on pulmonary collateral disease showed 20 association rules in the prescription for treating pulmonary collateral disease.For example,Pinellia-Trichosanthes,Astragalus membranaceus-Codonopsis?Astragalus membranaceus-Baizhu,Pinellia-Dried tangerine peel,Earthworm-Trichosanthes-Pinellia;Astragalus membranaceus-Angelica-Salvia.Among them,there are 13 association rules for the composition of 2 herbs,and 7 rules for the association of 3 herbs.Results:1.Traditional Chinese Medicine Compound Prescription?Tongluo method?can improve the clinical efficiency of Pulmonary Fibrosis,relieve clinical symptoms?"cough","sputum","wheeze","dyspnea"?,improve lung function and blood gas analysis index?"FEV1","FEV1%","FEV1/FVC%","VC","DLco","PaO₂"?,and"SGRQ scale""6MWD"and so on.2.Traditional Chinese Medicine Compound Prescription?Tongluo method?can improve the clinical effectiveness of Chronic Obstructive Pulmonary Disease,relieve clinical symptoms?"cough"?,improve lung function indicators?"FEV1","FEV1%","FEV1/FVC%"?And indicators such as"Traditional Chinese Medicine Syndrome Points","6MWD",and"CAT Score".3.Traditional Chinese Medicine Compound Prescription?Tongluo method?can improve the clinical effectiveness of Bronchial Asthma,relieve clinical symptoms?"cough","sputum","xiaomingyin"?,improve lung function indicators?"FEV1","FEV1%","FVC","PEF"?,and indicators such as"IL-4","INF-?",and"ACT Table".4.The Tongluo method can improve the clinical effectiveness of pulmonary collateral disease and improve the individual symptoms of"cough"and lung function?FEV1,FEV1%?.5.Through the first part,we summed up the traditional Chinese medicine compound for treating pulmonary collateral disease.In this study,we studied three diseases:Pulmonary Fibrosis,Chronic Obstructive Pulmonary Disease,and Bronchial Asthma,including 13articles on Pulmonary Fibrosis,10 articles on Chronic Obstructive Pulmonary Disease,and 10articles on Bronchial Asthma.6.According to the results of cluster analysis,the number of clusters is 8 and the effect is good.There are Tonifying drugs,antitussive and antiasthmatic drugs,phlegm-resolving and collateral-dredging drugs,blood-activating and stasis-removing drugs.According to different etiology and pathogenesis,the method of dredging collaterals is used to treat pulmonary collateral disease.7.Based on the correlation analysis of pulmonary collateral disease,the two rules of drug use are summarized:?1?compatibility between drugs of the same efficacy,such as Pinellia-Trichosanthes,Astragalus membranaceus-Codonopsis,Astragalus membranaceus-Baizhu;?2?Compatibility of different efficacy drugs,such as Pinellia-Dried tangerine peel,Earthworm-Trichosanthes-Pinellia,Astragalus membranaceus-Angelica-Salvia.