| First,animal experimental researchObjective:1.The viral pneumonia model was established in SD rats,and it was treated by enema with traditional Chinese medicine to provide direction and basic support for clinical trial research.2.By comparing the concentration of Calprotectin(CALP)in the feces of pneumonia rats before and after treatment,and the concentrations of A(secretory Immunoglobulin A(sIgA)and 1(Rat Beta Defensins 1(rBD1)in alveolar lavage fluid after treatment,the effect of enema with traditional Chinese medicine on pneumonia rats was comprehensively evaluated,and the mechanism of enema treatment for pneumonia was further clarified.Method:Forty SD rats were divided into four groups randomly,which were the blank group(K Group)with 12 rats,the model group(M Group)with 12 rats,the high-dose enema with traditional Chinese medicine group(G Group)with 12 rats and the low-dose enema with traditional Chinese medicine group(D Group)with 12 rats.In the blank group,the normal culture medium without RSV virus was used to make the model by tracheal puncture injection;The other three groups were made by injecting RSV virus suspension into trachea.The treatment observation period is 7 days.After the treatment,the contents of sIgA and rBD1 in alveolar lavage fluid and CALP in feces were statistically analyzed and compared by SPSS 21.0 software.finally,the curative effect of Maxing Shigan Decoction enema on pneumonia rats was comprehensively evaluated,and its mechanism was discussed to provide experimental basis for clinical trials.Results:1.The sIgA concentration in alveolar lavage fluid(μg/ml): the sIgA concentration in high-dose Chinese medicine group after treatment was 6.50±1.51.After treatment,the sIgA concentration in low dose group of traditional Chinese medicine was 3.87±0.72.After treatment,the sIgA concentration in model group was 2.31±0.89.The sIgA concentration in blank group was 7.53±1.29.After treatment,the sIgA concentration of the rats’ alveolar lavage fluid which were in the other three groups,compared with that in the blank group: only the sIgA concentration in the blank group was approximate to the sIgA concentration in the high dose group of traditional Chinese medicine enema.(P>0.05),and the other two groups’ sIgA concentration were lower than that in the blank group.The results showed that the sIgA concentration in the high dose enema group was higher than the sIgA concentration in the low dose of traditional Chinese medicine enema group(P < 0.05),and the saliva sIgA concentration in the low-dose group of traditional Chinese medicine enema was higher than the saliva sIgA concentration in the model group(P<0.05).2.The rBD1 concentration in alveolar lavage fluid(μg/ml): the rBD1 concentration in high dose group after treatment was 0.78±0.36.The rBD1 concentration in the low dose group after treatment was 1.57±0.57.The rBD1 concentration in the model group after treatment was 3.89±0.95.The rBD1 concentration in the blank group was0.49±0.27.After treatment,the rBD1 concentration of alveolar lavage fluid in the three groups was compared with that in the blank group: only the rBD1 concentration in the high dose group of traditional Chinese medicine was equivalent to that in the blank group(P>0.05),and the other two groups were higher than that in the blank group.Comparing the three groups,the rBD1 concentration in high-dose group of traditional Chinese medicine enema was lower than that in low-dose group of traditional Chinese medicine enema(P < 0.05),and that in low-dose group of traditional Chinese medicine enema was lower than the saliva rBD1 concentration in model group(P<0.05).3.The CALP concentration in feces(ng/ml): after treatment,it was 75.95±9.25 in the high dose group of Chinese medicine;122.48±21.94 in low dose group.The model group was 382.21±60.75.The blank group was 67.70±20.44.After treatment,the fecal CALP concentration of the three groups was compared with that of the blank group: only the fecal CALP concentration in the high dose group of Chinese medicine enema was comparable to that of the blank group(P>0.05),and the other two groups were higher than that of the blank group.The results showed that the concentration of CALP in the high dose group of Chinese medicine enema was lower than the concentration of CALP in the low dose enema group(P<0.05).The concentration of CALP in the low dose group of Chinese medicine enema was lower than the concentration of CALP in the model group(P<0.05).Conclusion:After treatment in the high-dose group of traditional Chinese medicine enema,the concentration of sIgA in the alveolar lavage fluid of rats with viral pneumonia can increase,which is equivalent to the blank group.The rBD1 and CALP concentrations can be reduced,which is equivalent to the blank group.The effect of increasing sIgA concentration and decreasing rBD1 and CALP concentration in low dose group of traditional Chinese medicine is lower,but the effect is more significant than that in model group.Second,the clinical trial researchObjective:1.To evaluate the clinical effect of Maxing Shigan Decoction enema in treating children with pneumonia by comparing before and after treatment,comparing the curative effects between groups after treatment and improving TCM syndromes.2.By comparing the concentrations of A(secretory Immunoglobulin A(sIgA),human beta defensins 2(hBD2)in saliva and Calprotectin(CALP)in feces of children before and after treatment,the effect of enema with traditional Chinese medicine on intestinal microenvironment of infants was comprehensively evaluated,and the mechanism of enema in treating pneumonia asthma was further clarified.Method:Children with viral pneumonia were selected as the research objects for this experiment,who were treated in the Pediatric Inpatient Department and Outpatient Department from January 2020 to February 2021,where were in the Second Affiliated Hospital of TJUTCM.Conduct a prospective randomized controlled study,generate a random code based on a random number table,and the patients were randomly divided into groups according to the order in which they entered the group.Children were randomly divided into three groups: the high-concentration enema group,the low-concentration enema group and the western medicine group.The observation period of treatment is 7 days.After the course of treatment,the effective rate and total symptom score of each group are statistically analyzed and compared by SPSS 21.0software.We observed the changes of sIgA,hBD2,CALP content before and after treatment in each group and between groups,and finally assessed the clinical efficacy of Maxing Shigan Decoction enema comprehensively,which was in treating the infant with viral pneumonia.Results:1 clinical efficacy:1.1 Comparison of the effective rate: the effective rate in high concentration enema group was 100%.The effective rate in low concentration enema group was 95%.The effective rate in western medicine group was 70%.Compare the total effective rates of the three groups after treatment,P<0.05;The results showed that three groups can improve the clinical efficacy.There is no statistical difference between the low-concentration enema group and the high-concentration enema group(P>0.05).There was a discrepancy between the western medicine group and the low concentration enema group,and the high concentration enema group statistically(P<0.05).1.2 Comparison of total symptom score: the total symptom score before treatment in high concentration enema group was 23.35±0.93.The total symptom score in low concentration enema group before treatment was 23.40±1.04;That in western medicine group was 23.25±1.33 before treatment,P>0.05.Comparison among the three groups’ total symptom score after treatment was that: There was no discrepancy between the western medicine group and the low concentration enema group statistically(P>0.05);There was significant discrepancy between the high concentration enema group and the western medicine group(P < 0.01).There was significant discrepancy between the low concentration enema group and the high concentration enema group(P<0.05).It showed that after treatment,the symptoms of the three groups could be improved,and the symptoms of the high concentration group of Chinese medicine enema were improved significantly compared with the western medicine group and the low concentration enema group.There was no discrepancy in improving symptoms between the western medicine group and the low concentration enema group statistically.2 Salivary sIgA concentration(ng/ml): sIgA concentration in high concentration group was 47.49±12.59 before treatment and 69.62±8.23 after treatment;In low concentration group,sIgA concentration was 46.03±12.76 before treatment,and it is72.35±6.50 after treatment.That in western medicine group was 54.74±15.91 before treatment and 84.58±12.21 after treatment.Comparison of sIgA concentration before treatment among the three groups showed that there was no discrepancy statistically(P>0.05).The concentration of sIgA after treatment among the three groups was different significantly(P < 0.05).After many pairing comparisons: the western medicine group: t=4.802,P < 0.01.Low-concentration Chinese medicine enema group: t=9.002,P < 0.01.High-concentration Chinese medicine enema group:t=14.925,P<0.01.There was a difference in sIgA concentration in saliva before and after treatment significantly.The results showed that the sIgA concentration can be increased in all three groups after treatment,and the sIgA concentration of the high concentration enema group is higher than that in low concentration enema group,than the western medicine group significantly.There was no discrepancy in increasing the sIgA concentration between the low-concentration enema group and the western medicine group.3 Saliva hBD2 concentration(ng/ml): hBD2 concentration in high concentration group was 124.51±31.17 before treatment and 60.39±14.37 after treatment;The concentration of hBD2 in low concentration group was 108.57±26.77 before treatment and 67.76±23.15 after treatment.HBD2 concentration in western medicine group was 108.21±20.84 before treatment and 82.72±29.86 after treatment.There was no difference in hBD2 concentration among the three groups before treatment significantly(P>0.05).After treatment,there were differences in hBD2 concentration among these groups(P<0.05).After multiple pairing comparisons,the comparison in each group with before treatment and after treatment is that: the western medicine group: t=5.70,P < 0.01.Low concentration group: t=9.65,P < 0.01.High concentration group: t=11.43,P < 0.01.There was a difference in saliva hBD2 concentration before and after treatment in high concentration group of traditional Chinese medicine enema significantly.The results showed that after treatment,the concentration of hBD2 can be reduced in all three groups,and the concentration of hBD2 in high-concentration group of traditional Chinese medicine enema and low-concentration enema group were lower than the concentration of hBD2 in the other group.There was no discrepancy in reducing hBD2 concentration between high concentration group of traditional Chinese medicine enema and low concentration group of traditional Chinese medicine enema.4 Fecal CALP concentration(ng/ml): before treatment,CALP concentration in high concentration group was 148.74±10.57,and after treatment,it was 118.84±24.79;The concentration of CALP in low concentration group was 151.47±11.83 before treatment and 98.65±12.28 after treatment.CALP concentration in western medicine group was 144.37±19.30 before treatment and 118.84±24.79 after treatment.There was no difference in CALP concentration among the three groups before treatment significantly(P>0.05).After treatment,there were differences statistically(P <0.05).After multiple comparisons.Comparison of CALP concentration before and after treatment among the three groups: western medicine group: t=5.38,P<0.01.Low-concentration group: t=13.55,P<0.01.High concentration group: t=24.14,P<0.01.There was a significant difference in fecal CALP concentration before and after treatment in high-concentration group.The results showed that after treatment,the concentration of CALP in all three groups could be reduced,and the CALP concentration in the high concentration enema group was lower than that in the low concentration group of traditional Chinese medicine enema.The concentration of CALP can be reduced in the low concentration group of traditional Chinese medicine enema,which is more significant than that in the western medicine group.5 Adverse reactions: During the treatment,there were no obvious physical adverse reactions among the three groups of children.Conclusion:1.Maxing Shigan Decoction enema and western medicine symptomatic treatment can improve the clinical symptoms of children with pneumonia asthma,and Maxing Shigan Decoction enema is obviously superior to western medicine symptomatic treatment.After the experiment,the concentrations of HBD2 in saliva and CALP in feces of the three groups were all decreased,which indicated that Maxing Shigan Decoction enema and western medicine symptomatic treatment could reduce the inflammation of children,and Maxing Shigan Decoction enema was obviously superior to western medicine symptomatic treatment.3.Maxing Shigan Decoction enema and western medicine symptomatic treatment can improve sIgA concentration of children,and Maxing Shigan Decoction enema can improve mucosal immune function of children better than western medicine symptomatic treatment.4.Compared with the low concentration group,the high concentration enema with Maxing Shigan Decoction has better curative effect.5.Before,after and during treatment,the three groups of children with viral pneumonia had no obvious clinical adverse reactions,which indicated that Maxing Shigan Decoction enema and western medicine were effective,safe and reliable in treating infantile pneumonia asthma. |
