Clinical Effect of Yinhuang Qingfei Capsules in Treatment of Asymptomatic and Mild/Common Severe Acute Respiratory Syndrome Coronavirus 2 Infection:An Analysis of 242 Cases

[Objectives]To investigate the clinical effect of Yinhuang Qingfei capsules in the treatment of asymptomatic and mild/common severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.[Methods]A total of 362 patients with SARS-CoV-2 infection were divided into the treatment group with 242 patients and control group with 120 patients according to their treatment regimen.The patients in the control group were given standard treatment regimen and those in the treatment group were given Yinhuang Qingfei capsules in addition to the treatment in the control group.The two groups were observed in terms of average length of hospital stay,mean time for nucleic acid clearance,TCM syndrome score,and progression to severe/critical illness,and clinical outcome was compared between the two groups.[Results]There was a significant difference in the overall response rate between the treatment group and the control group[97.52%(236/242)vs 95.00%(114/120),P<0.05].Compared with the control group,the treatment group had significantly shorter length of hospital stay and time for nucleic acid clearance(P<0.05).After 7 days of treatment,both groups had a significant change in TCM syndrome score,and there was a significant difference in TCM syndrome score between the two groups(P<0.05);after 15 days of treatment,both groups had a TCM syndrome score of 0.Progression to severe/critical illness was not observed in either group.[Conclusions]Compared with the standard treatment regimen alone,standard treatment regimen combined with Yinhuang Qingfei capsules can effectively shorten the length of hospital stay and time for nucleic acid clearance and improve TCM symptoms in patients with asymptomatic and mild/common SARS-CoV-2 infection.

Experimental study on the regulation effect of Qiaoqin Qingfei agent on cough variant asthma based on airway neurogenic inflammation

Objective:To investigate the mechanism of regulation of airway neurogenic inflammation by Qiaoqin Qingfei agent in rats with cough variant asthma(CVA).Methods:48 SD rats were randomly divided into blank group,model group,montelukast sodium group(1.05 mg/kg)and high,medium and low dose groups(26,13,6.5 g/kg),with 8 rats in each group.The rat CVA model was established by the method of ovalbumin(OVA)combined with aluminum hydroxide(Al(OH)3)sensitization and repeated stimulation.From the second day of sensitization,the rat CVA model was given by gavage for 28 days.The pathological changes of lung tissue were observed under microscope by HE staining.The content changes of nerve growth factor(NGF)and substance P(SP)in alveolar lavage fluid(BALF)were determined by double-antibody sandwich ABC-ELISA,and the protein expression levels of NGF and SP in lung tissue were detected by immunohistochemistry.Results:Pathological findings showed significant inflammatory manifestations in the model group,and the inflammatory infiltration in the high-dose,medium-dose and low-dose groups of Qiaoqin Qingfei agent and montelukast sodium groups were alleviated to varying degrees.Compared with blank group,the protein expression levels of NGF and SP in lung tissue of model group were significantly increased(P<0.01).Compared with model group,the protein expression levels of NGF and SP in lung tissue and the contents of NGF and SP in alveolar lavage fluid in high-dose,medium-dose and low-dose groups and montelukast sodium group were significantly decreased(P<0.05).Conclusion:Qiaoqin Qingfei agent may reduce airway inflammation and relieve cough variant asthma by regulating the protein expression levels of NGF and SP in airway neurogenic inflammation.

Qingfei oral liquid downregulates TRPV1 expression to reduce airway inflammation and mucus hypersecretion injury caused by respiratory syncytial virus infection and asthma in mice

Objective:Qingfei oral liquid(QF),an experimental Chinese medicine prescription developed from the ancient priscription of traditional Chinese medicines Ma Xin Shi Gan decoction and Tingli Dazao Xie Fei decoction,has been effectively used since decades to treat patients with viral pneumonia and asthma.In our previous study,we had demonstrated that QF can significantly reduce airway hyperresponsiveness,hyperemia,lung tissue edema,inflammatory lung tissue infiltration in mice,airway mucus secretion,and peripheral airway collagen hyperplasia;however,its mechanism of action is unknown.Methods:Fifty 6–8-week-old male BALB/c mice were equally and randomly divided into five groups:the control,ovalbumin(OVA),OVA+respiratory syncytial virus(RSV),QF,and dexamethasone(Dxms)groups.The QF group was administered QF at 1.17 g·kg−1·d−1,the Dxms group received dexamethasone injections at 0.2 mg·kg−1·d−1,and the remaining groups were administered PBS.Inflammation in the lung tissue was assessed by hematoxylin and eosin(HE),periodic acid–Schiff(PAS),and Van Gieson staining.ELISA was used to evaluate the IL-13,IL-25,and IL-33 in the mice.Western blotting was used to examine changes in the proteins levels of transient receptor potential vanilloid-1(TRPV1)and mucin 5AC(MUC5AC)in the lung tissues of mice.Results:Histopathological evaluation revealed that the OVA and OVA+RSV groups exhibited lung tissue edema and inflammatory lung tissue infiltration in the HE staining and airway secretions in the PAS staining;collagen hyperplasia around the airway was increased in these two groups compared with the control group.The QF group exhibited significantly reduced lung tissue edema,inflammatory lung tissue infiltration,airway secretions,and collagen hyperplasia around the airway compared with the OVA+RSV group.We analyzed the serum levels of IL-13,IL-25,and IL-33 in the mice and found that these levels were higher in the OVA and OVA+RSV groups than in the control group(P<0.05 in the OVA group,P<0.01 in the OVA+RSV group).The QF group exhibited significantly decreased serum levels of IL-13,IL-25,and IL-33 compared with the OVA+RSV group(all P<0.05).The Dxms group also exhibited significant decreases in the serum levels of IL-13 and IL-33(all P<0.05)but no significant decrease in the serum levels of IL-25 compared with the RSV+OVA group.Finally,we examined the protein levels of TRPV1 and MUC5AC in the lung tissues of mice using Western blotting.After identifying RSV infection in the mice with asthma,the protein levels of TRPV1 and MUC5AC in the lung tissues of mice were significantly higher than those in the control group(P<0.05,P<0.01).We found that compared with RSV+OVA,QF can significantly downregulate the protein level of TRPV1;further,the protein level of MUC5AC was also significantly reduced(all P<0.001).Conclusion:QF can inhibit RSV replication and reduce airway inflammation and mucus hypersecretion injury caused by RSV infection and asthma,and its mechanism of action may be associated with the downregulation of TRPV1 expression and a decrease in airway mucus hypersecretion injury.

“Qingfei Paidu Decoction”—A Possible Choice of Phytotherapy for Severe Acute Respiratory Infection Caused by Coronavirus Disease-19

This work is aimed to study the therapeutics and pharmacology of the treatment of severe acute respiratory infection caused by coronavirus disease-19 (COVID-19) with traditional Chinese medicine (TCM) “Qingfei Paidu Decoction”. We analyze the “Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia” (Version I to Version VII) made by China, “Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected—Interim guidance” made by World Health Organization (WHO), “Therapeutic Guidelines: Respiratory” published by Australia, and the origin of classical prescription of Qingfei Paidu Decoction: “Shanghan Lun (Treatise on Febrile Diseases)” and “Jinkui Yaolue (Synopsis of Golden Chamber)”. We search the dictionary of traditional Chinese medicine (Version II) manually. We search literatures from 2001 to 2020 on Wiley online library. We conduct a comparative study on the therapeutic options and indications among Qingfei Paidu Decoction, COVID-19 and chronic obstructive pulmonary disease (COPD). And we carry out pharmacological inquiry of Qingfei Paidu Decoction. The therapeutic options and indications of Qingfei Paidu Decoction in China, COVID-19 and COPD are considered to be basically consistent. Qingfei Paidu Decoction has a definite therapeutic effect on the symptoms, basic diseases and complications for COVID-19 and COPD. Qingfei Paidu Decoction is a possible choice of phytotherapy for severe acute respiratory infection caused by COVID-19.

Network pharmacological study of Qingfei Paidu Decoction intervening on cytokine storm mechanism of COVID-19

Objective:To explore the possible mechanism of Qingfei Paibu Decoction in the treatment of COVID-19 from the perspective of cytokine storm by network pharmacology.Methods: The TCMSP and SymMap databases were used to screen out the active components and targets of Qingfei Paibu Decoction;The GeneCards database was used to screen the predicted targets of COVID-19;Two targets were mapped;The STRING database and Cytoscape3.7.2 software were used to construct the network diagram of active drag-ingredient-target and screen out the core components and targets;The GO enrichment analysis and KEGG pathway enrichment analysis were carried out by OmicShare cloud platform and David respectively.Results:A total of 52 potential targets of Qingfei Paibu Decoction for the treatment of COVID-19 were obtained, among which 17 were core targets related to inflammation, mainly including cytokines such as IL, IFN, TNF and chemokines. And 26 core components were obtained, including quercetin, luteolin, kaempferol, naringenin, and baicalein;The GO enrichment results showed 224 biological processes, 15 molecular functions and 33 cell components related to inflammation;There were 5 inflammatory signaling pathways in KEGG enrichment results, including TNF signaling pathway, Nod-like receptor signaling pathway, Toll-like receptor signaling pathway, MAPK signaling pathway and cytokine receptor interaction. Conclusion: Qingfei Paibu Decoction can inhibit cytokine storms by acting on multiple targets and pathways with multiple components and thus treat COVID-19.

Discussion on the composing principle of "Qingfei Paidu Decoction"in the treatment of anti-COVID-19 from the theory of syndrome-differentiation of the six meridians in Treatise on Febrile Diseases

The coronavirus disease 2019(COVID-19)was a newly discovered infectious respiratory disease and characterized by wide prevalence,high incidence rate and fast progress and dangerous,which belonged to the category of"cold-wet plague"in TCM.The onset of COVID-19 was caused by pestilence,which mingled with seasonal cold-dampness and invaded the human body when external defensive qi was weak and then leaded to the accumulation of Yang qi.Different from exogenous pathogenic factors transmitted from the external to the internal or followed the transmission law of Wei,Qi,Ying and Xue,the nature of pestilence belonged to the category of pathogenic fire,spreading as soon as possible,from the external to the internal and from the upper and lower part of triple energizer,even to every part.At the very beginning,the pestilence attacked from the Taiyang meridian into the Yangming meridian quickly,or straight into the three Yang meridian,which was called"triple-yang combination of diseases".Manifestations of fever,aversion to cold and pain of body were conformed to the exterior syndrome of Taiyang,as well as manifestations of fullness and discomfort in chest,vomiting and spitting and diarrhea were conformed to the syndrome of half-interior-half-exterior;And symptoms manifested as high fever,faint,and abdominal fullness and constipation were conformed to the syndrome of Yangming;But sometimes,there was cold-dampness surrounding the exterior at the beginning along with intense interior pathogenic fire.Or at the beginning,the exterior factors invaded into three Yin meridians quickly while have not been eliminated,which may lead to the syndrome of inner blocking causing collapse or Jue exhaustion.The most typical syndrome of COVID-19 was triple-yang combination of diseases,which was often seen in mild,moderate and part of severe cases.Hence"Qingfei Paidu Decoction"was prescribed especially for this kind of syndrome.Its accurate efficacy has been proved by that mild cases converting to severe cases in the mobile cabin hospital have been effectively restrained and thus the progression of the disease has blocked.Composition analysis showed that Mahuang decoction with Maxing Shigan decoction was to relieve exterior Taiyang syndrome,Xiaochaihu decoction was for harmonizing half-superficies and half-interior Shaoyang syndrome,and large dose of gypsum was used to clear interior heat of the Yangming meridian,and Shegan Mahuang decoction and Xiaoqinglong plus gypsum decoction was for lowering the adverse qi and resolving fluid,and Wuling San was for warming the triple energizer and transforming qi and draining water."Qingfei Paidu Decoction"was an syncretic innovation of classical prescriptions from Treatise on Febrile Diseases,which was not made up of herbs but multiple concordant prescriptions helping to get twice the result with half the effort,so that the"cold-wet plague"can be quickly discharged.

Clinical effect of traditional Chinese medicine Qingfei powder on Radiotherapy-related Pneumonia in patient with NSCLC

Objective： To observe the effect of traditional Chinese medicine （TCM） Qingfei powder on the radiotherapy-related pneumonia in patient with non-small-cell lung cancer （NSCLC） and explore its underlying mechanism. Methods： 120 NSCLC patients with the diagnosis of both radiotherapy-related pneumonia and deficiency of Qi and Yin were randomly divided into the treatment group and the model group. The patients in treatment group were given Qingfei power plus regular treatment and those in the model group were given the regular treatment. The period of observation is 30 days. Results： The combination of effective and markedly effective ratio in patients treated with Qingfei power was much higher than that in patients with regular treatment （70% vs 51.7%, P=0.04）. Conclusion： Qingfei power could nourish Qi and Yin as well as clear away lung-heat and dispel phlegm, leading to the relief of clinical symptom in NSCLC patients with radiotherapy-related pneumonia. It demonstrates that the deficiency of both Qi and Yin maybe the main Zheng pattern of patients with radiotherapy-related pneumonia.

Effects of Qingfei Xiaoyan pill combined with ceftriaxone and azithromycin on immune index, oxidative stress and inflammatory index in senile CAP patients

Objective: To explore the effects of Qingfei Xiaoyan pill combined with ceftriaxone and azithromycin on immune index, oxidative stress and inflammatory index in senile CAP patients. Methods: A total of 130 patients with CAP admitted to Yulin first hospital from October 2016 to December 2017 were randomly divided into control group (n = 65) and observation group (n = 65), the control group was treated with ceftriaxone combined with azithromycin, while the observation group was treated with Qingfei Xiaoyan Pill on the basis of the control group, the changes of cellular humoral immune function, oxidative stress index and inflammatory factors were compared between the two groups before and after treatment. Results: After treatment, the levels of CD4+ and CD4+/CD8+ in both groups were significantly higher than before treatment, while the level of CD8+ was significantly lower than before treatment, the levels of CD4+ and CD4+/CD8+ in the observation group were significantly higher than those in the control group, while the level of CD8+ was significantly lower than those in the control group;the levels of IgA and IgM in the observation group were significantly higher than those in the control group;the levels of MDA and SOD in the observation group were significantly lower than those in the control group, and the level of MDA in the observation group was significantly lower than that in the control group, the levels of SOD in the observation group were significantly higher than those in the control group;the levels of PCT and CRP in the two groups were significantly lower than those before treatment , and the levels of PCT and CRP in the observation group were significantly lower than those in the control group. Conclusions:Qingfei Xiaoyan pill combined with ceftriaxone and azithromycin can effectively enhance the immune function of elderly patients with CAP, enhance the body's antioxidant effect and reduce its inflammatory reaction, which is of clinical significance.

Efficacy and safety of Qingfei Huatan formula in the treatment of acute exacerbation of chronic obstructive pulmonary disease:A multi-centre,randomised,double-blind,placebo-controlled trial

Background Chronic obstructive pulmonary disease(COPD),a common respiratory disease,can be effectively treated by traditional Chinese medicine(TCM).Qingfei Huatan,a TCM formula,has been reported to effectively alleviate the clinical symptoms of COPD patients.However,there is a lack of multi-centre,randomised,double-blind,controlled clinical trials documenting the clinical efficacy and safety of this formula in the treatment of acute exacerbation of COPD(AECOPD).Objective This study evaluated the efficacy and safety of Qingfei Huatan formula in the treatment of AECOPD,thereby providing high-quality clinical evidence.Design,setting,participants and interventions A total of 276 patients with AECOPD were included in this multi-centre,randomised,double-blind,placebo-controlled trial and were randomised into treatment and control groups at a ratio of 1:1.Patients in the treatment and control groups took Qingfei Huatan granules or simulated Qingfei Huatan granules twice a day,for 14 days,in addition to Western medicine treatment.All patients were followed up for 3 months.Main outcome measures The primary outcome was time taken to symptom stabilisation.The secondary outcomes included duration of antibiotic use,clinical symptom and sign score,TCM syndrome score,dyspnoea score,and quality of life(QOL)score.Meanwhile,the safety of the formula was assessed through routine urine and stool tests,electrocardiograms,liver and kidney function tests,and the observation of adverse events throughout the trial.Results The time taken for effective stabilisation(P<0.05)and obvious stabilisation(P<0.01),and the duration of antibiotic use(P<0.05)were significantly shorter in the treatment group than in the control group.On days 6,9,12 and 14 of treatment,clinical symptom and sign score decreased in both groups,particularly in the treatment group(P<0.01).On days 9,12 and 14 of treatment,the TCM syndrome scores of both groups were reduced(P<0.01),with more significant reductions in the treatment group.At 3 months after the end of treatment,the treatment group continued to have lower clinical symptom and sign score and TCM syndrome score than the control group(P<0.01).On days 6,9,12 and 14 of treatment,dyspnoea and QOL scores were markedly reduced in the two groups(P<0.05 and P<0.01,respectively),especially in the treatment group.At 3 months after the end of treatment,dyspnoea and QOL scores were lower in the treatment group than those in the control group(P<0.01).No serious adverse events were observed in either group.Conclusion The Qingfei Huatan formula can effectively shorten the duration of AECOPD and antibiotic use,significantly relieve clinical symptoms,and increase QOL for AECOPD patients,with a favourable safety profile.These results suggest that this formula can be used as a complementary treatment for AECOPD patients.

Anti-inflammatory,anti-tussive effects and toxicity evaluation of Qingfei Dayuan granules(清肺达原颗粒)

OBJECTIVE:To study the anti-inflammatory and anti-tussive effects of Qingfei Dayuan granules(清肺达原颗粒,QFDY),and to evaluate the acute and sub-chronic toxicity of QFDY.METHODS:Anti-inflammatory effects were evaluated by murine model of xylene induced ear edema in mice.Ear swelling degree was calculated and tumor necrosis factor-α,interleukin-1βand interleukin-6 were determined.Anti-tussive evaluations were carried out in the mouse cough model induced by ammonia liquor.Latent period cough and number of cough within 3 min were counted.In acute toxicity study,the rats were randomly divided into test group and solvent control group.Body weighs,food intakes and general clinical signs were monitored.In the sub-chronic toxicity study,QFDY was administered to rats at 0,4,8 and 16 g/kg per day for 28 and 30 d of post treatment was conducted.Mortalities,clinical signs,body weight changes,food intakes,ophthalmological examinations,hematological parameters,biochemical indicators,electrolyte indicators,urinalyses and histopathological examinations were monitored.RESULTS:QFDY significantly inhibited the development of ear edema in anti-inflammatory assay and decreased cough frequency caused by ammonia liquor.The results presented a dose-effect relationship.In acute toxicity study,no abnormality exhibited at dose of 24.0 g/kg per day during the 14-d observation period.In the sub-chronic toxicity study,higher reticulocyte count,lymphocyte and lower Cl-,blood urea nitrogen were analyzed compared with the solvent control group.But the differences were considered to be incidental and not clinically toxic.Obvious dose-effect relationship of urine color was observed,and the three test groups at the end of the experiments resulted in significant increase in urobilinogen,bilirubin,ketone body and urine leukocyte.However,all the positive indicators returned to normal in the recovery period.Therefore,no toxicological changes were found during the study period.CONCLUSION:QFDY showed significant anti-inflammatory and anti-tussive effects in mice.The lethal dose(LD50)of per oral QFDY in rats was estimated to be more than 24.0 g/kg per day and the no observed adverse effect level was over 16 g/kg per day,which suggested that QFDY is relatively safe for oral medication at the present dose on rats.Our experimental results provide a reference for the further development and research of QFDY.

Long-term effects of Qingfei Paidu decoction(清肺排毒汤)in patients with coronavirus disease 2019 acute pneumonia after treatment:a protocol for systematic review and Meta-analysis

This study aims to provide evidence regarding whether Qingufei paidu decoction(清肺排毒汤,QFPD)treatment in the acute phase shows long-term benefits for coronavirus disease 2019-associated sequelae.The 10 databases will be retrieved.Every reference list of related trials and gray literature will be searched as well.Study screening,data extraction,and risk of bias evaluation will be performed by two reviewers(CUI Hanjin and FAN Rong).Data analysis will be conducted by using STATA(version 14).Statistical heterogeneity will be explored by a standardχ2 test with a significance level of P<0.10.Funnel plots,Egger’s&Begg’s test,and Trim and Fill analysis will be used for publication bias assessment.The results of the present Meta-analysis and systematic review will be disseminated via peer-review journal publication.Ethical approval is not required,as this Meta-analysis will not contain any individual patient data.This systematic review has been registered on PROSPERO(registration number:CRD42021246937)on 15 April 2021.

基于能量代谢探讨红景清肺方对PM_(2.5)诱导小鼠肺损伤的保护作用

目的探究红景清肺方对大气细颗粒物(particulate matter 2.5,PM_(2.5))诱导小鼠肺损伤的保护作用及机制。方法40只ICR雄性小鼠,随机分为空白对照组、PM_(2.5)模型组、中药等效组、中药二倍组。中药各组预给药7 d后,除空白对照组外,各组持续2 d给予0.02 mg·μL^(-1)浓度PM_(2.5)混悬液滴鼻制备小鼠肺损伤模型。末次染毒24 h后取肺组织样本,苏木素-伊红(hematoxylin-eosin,HE)染色观察肺组织形态学变化;酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测三磷酸腺苷(adenosine triphosphate,ATP)和Na^(+)-K^(+)-ATP酶(Na^(+)-K^(+)-ATPase)、Ca^(2+)-Mg^(2+)-ATP酶(Ca^(2+)-Mg^(2+)-ATPase)含量;蛋白免疫印迹法(western blot)检测腺苷酸活化蛋白激酶(AMP-activatedproteinkinase,AMPK)、过氧化物酶体增殖物激活受体1α(peroxisome proliferator-activated receptor-γcoactivator 1α,PGC-1α)及线粒体转录因子A(mitochondrial transcription factor A,TFAM)蛋白表达水平;免疫组织化学法(immunohistochemistry,IHC)检测PGC-1α、TFAM、核呼吸因子1(nuclear respiratory factor-1,Nrf1)蛋白表达。结果与空白对照组比较,PM_(2.5)模型组小鼠肺组织结构病理损伤明显,肺组织中ATP、Na^(+)-K^(+)-ATP酶、Ca^(2+)-Mg^(2+)-ATP酶含量显著降低(P<0.01),AMPK、PGC-1α、TFAM蛋白表达水平及PGC-1α、Nrf1、TFAM蛋白阳性表达率明显降低(P<0.01);与PM_(2.5)模型组比较,中药各组肺组织损伤明显改善,中药二倍组中ATP含量升高(P<0.05),Na^(+)-K^(+)-ATP酶、Ca^(2+)-Mg^(2+)-ATP酶含量显著升高(P<0.01),中药等效组三者含量有上升趋势,但差异无统计学意义(P>0.05),中药各组AMPK、PGC-1α、TFAM蛋白表达水平及PGC-1α、Nrf1、TFAM蛋白阳性表达率显著升高(P<0.01)。结论红景清肺方可提高肺组织内Na^(+)-K^(+)-ATP酶、Ca^(2+)-Mg^(2+)-ATP酶活性,上调AMPK/PGC-1α信号通路蛋白水平,减轻线粒体损伤和功能障碍,促进线粒体生物合成,有效改善肺组织能量代谢,从而减轻PM_(2.5)对肺组织的损伤。

养阴清肺汤联合中药熏蒸治疗干眼症临床观察

目的 探讨养阴清肺汤联合中药熏蒸治疗干眼症的临床效果。方法 选取中国医科大学附属盛京医院122例干眼症患者随机分为对照组和试验组,各61例。对照组予以玻璃酸钠滴眼液治疗,试验组在对照组基础上予以养阴清肺汤联合中药熏蒸治疗,均连续治疗4周。比较2组临床疗效、泪膜破裂时间(BUT)和泪液分泌量、中医症状积分及视觉相关生命质量。结果 治疗后,试验组总有效率为90.16%(55/61),高于对照组的72.13%(44/61)(P<0.05);试验组泪液分泌量、BUT高于对照组(P<0.05);试验组眼疲劳感、干涩感、异物感及烧灼感等中医症状积分低于对照组(P<0.05);试验组一般健康状况、活动障碍及视力障碍评分高于对照组(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 养阴清肺汤联合中药熏蒸治疗干眼症的临床效果显著,能明显促进泪液分泌,提高泪膜稳定性。

养阴清肺颗粒联合HRZE化疗方案治疗初治敏感肺结核的效果

目的探讨养阴清肺颗粒联合异烟肼+利福平+吡嗪酰胺+乙胺丁醇(HRZE)化疗方案治疗初治敏感肺结核的临床效果。方法回顾性收集2022年6月至2023年3月河南省胸科医院收治的95例初治敏感肺结核患者的临床资料,根据治疗方案分为对照组(47例,HRZE化疗方案治疗)和观察组(48例,HRZE化疗方案+养阴清肺颗粒治疗),均持续治疗6个月。比较两组疗效、肺功能指标(用力肺活量、呼气峰流速、第1秒用力呼气容积)、免疫功能指标,以及治疗期间不良反应发生情况。结果观察组总有效率高于对照组(P<0.05)。治疗6个月时,观察组肺功能指标、免疫功能指标均高于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论初治敏感肺结核患者采用HRZE化疗方案联合养阴清肺颗粒治疗效果显著,可改善患者免疫功能和肺功能,且不会增加不良反应。

芦根清肺颗粒制备工艺及TLC质量标准研究

本研究旨在优化和建立芦根清肺颗粒制备工艺与质量标准。本研究以提取物干浸膏得率为指标,通过单因素试验和正交试验法优选工艺参数;对处方中的芦根、桔梗、橘红、鱼腥草和枇杷叶进行薄层色谱法的定性鉴别研究。结果表明,试验最终确定的芦根清肺颗粒最佳制备工艺条件为所有药味分别加10倍和8倍量水,煎煮2次(第一次煎煮前需浸泡2 h以上),每次1.5 h,滤液浓缩至相对密度1.05~1.10(60℃),与适量的赋形剂糊精与蔗糖(质量比为1:1),制成溶解性和成型性良好的颗粒;薄层色谱法(TLC)结果显示,斑点清晰,专属性强,阴性无干扰。本品制备工艺稳定可靠。芦根、桔梗、橘红、鱼腥草和枇杷叶的薄层色谱无干扰,重复性好,专属性强。

凉血清肺散治疗玫瑰痤疮肺经血热型临床研究

目的:观察凉血清肺散治疗玫瑰痤疮肺经血热型的疗效。方法:60例按随机数字表法分为两组各30例。对照组用多西环素治疗,观察组用凉血清肺散治疗。结果:观察组总有效率高于对照组(P<0.05)。治疗后观察组临床症状评分、DLQI评分和血清TLR2、LL-37水平均低于对照组(P<0.05)。不良反应发生率两组比较差异无统计学意义(P>0.05)。结论:凉血清肺散治疗玫瑰痤疮疗效较好,不良反应较少。

清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌患者的临床疗效及对其生活质量、血清癌胚抗原、神经元特异性烯醇化酶、细胞角质素片段抗原水平的影响

目的探讨清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌患者的临床疗效及对其生活质量、血清癌胚抗原(Carcinoembryonic antigen,CEA)、神经元特异性烯醇化酶(Neuron specific enolase,NSE)、细胞角质素片段抗原(Cytokeratin 19 fragment antigen21-1,CYRAF21-1)水平的影响。方法选取2019年7月—2020年10月期间在东南大学医学院附属南京同仁医院接受治疗的非小细胞肺癌患者80例,采用随机数字表法分为对照组和观察组,每组各40例。对照组采用DP化疗方案治疗,观察组在对照组基础上联合清肺化痰汤治疗,每个疗程为21 d,连续治疗4个疗程。观察比较两组患者临床疗效、不良反应情况,治疗前后痰热郁肺证证候积分(咳嗽,咳痰、咯痰黄稠,气喘或气急,喉中痰鸣,发热,口渴)、血清肿瘤标记物(CEA、NSE、CYRAF21-1)、生命质量量表(QOL-38)评分改善情况。结果治疗后观察组总缓解率62.5%(25/40)、临床获益率85.0%(34/40)均明显高于对照组总缓解率40.0%(16/40)、临床获益率65.0%(26/40),差异有统计学意义(P<0.05)。治疗后两组患者咳嗽、咳痰、咯痰黄稠、气喘或气急、喉中痰鸣、发热、口渴评分均较治疗前降低,差异有统计学意义(P<0.01);且观察组痰热郁肺证证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清CEA、NSE及CYRAF21-1水平均较治疗前明显降低,差异有统计学意义(P<0.01);且观察组血清CEA、NSE及CYRAF21-1水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者身体状况、情绪状况、功能状况、肺癌相关症状、社会/家庭状况评分均较治疗前明显降低,总体健康状况评分较治疗前明显升高,差异有统计学意义(P<0.01);且观察组QOL-38评分改善情况明显优于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌疗效显著,能够有效降低血清CEA、NSE及CYRAF21-1水平,缓解临床症状,减轻化疗药物不良反应,提高患者生活质量。

清肺排毒汤对重症肺炎的影响

目的观察清肺排毒汤对重症肺炎(SAP)患者中医证候积分、氧合状态及炎性细胞因子水平的影响。方法选取2020年8月—2023年7月南昌市洪都中医院收治的70例SAP患者,随机分为对照组(35例)和观察组(35例),其中对照组采用西药常规治疗,观察组在对照组基础上采用清肺排毒汤治疗。比较2组患者临床疗效、中医证候积分、氧合状态、炎性因子水平及治疗期间不良反应情况。结果治疗后,观察组总有效率高于对照组(P<0.05);观察组各项中医证候积分、炎性因子水平均低于对照组(P<0.05);观察组PaO_(2)、SaO_(2)、PaO_(2)/FiO_(2)水平均高于对照组(P<0.05);2组患者治疗期间不良反应总发生率差异无统计学意义(P>0.05)。结论清肺排毒汤治疗SAP患者能提升治疗效果,降低中医证候积分,改善临床症状和氧合状态,减轻炎症反应,且具有一定安全性。

芩百清肺浓缩丸对感染后咳嗽大鼠NLRP3/Caspase-1/IL-1β信号通路的影响

目的:探讨芩百清肺浓缩丸(芩百)对感染后咳嗽(PIC)大鼠NOD样受体热蛋白结构域相关蛋白3/半胱氨酸天冬氨酸蛋白水解酶1/白细胞介素1β(NLRP3/Caspase-1/IL-1β)信号通路的调节作用。方法:40只SD大鼠随机分为正常组、模型组、阳性对照组(阿斯美)及芩百清肺浓缩丸(芩百)组,每组10只。采用烟熏联合LPS滴鼻法及辣椒素雾化吸入法构建PIC模型。于造模后第18天开始灌胃给药,芩百组给予芩百清肺浓缩丸水溶液1.65 g/kg,阳性对照组给予阿斯美25.11 mg/kg,每日1次,连续给药10 d。末次干预后,ELISA检测BALF中IL-1β含量,、Western blot检测肺组织NLRP3、Caspase-1蛋白表达。结果:与正常组相比,模型组BALF中IL-1β含量以及肺组织NLRP3、Caspase-1蛋白表达均显著升高(P<0.05);与模型组相比,阳性对照组和芩百组上述指标均显著降低(P<0.05);芩百组BALF中IL-1β水平和肺组织NLRP3蛋白表达均显著低于阳性对照组(P<0.05)。结论:芩百清肺浓缩丸能够显著减轻PIC大鼠的气道炎症和气道高反应性,其作用机制可能与抑制NLRP3/Caspase-1/IL-1β信号通路有关。

清肺化痰、降逆平喘方在慢性阻塞性肺疾病急性加重期治疗中的作用及对外周血PCT、CRP、IL-6和免疫功能的影响

目的观察清肺化痰、降逆平喘方联合常规西医治疗慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)的临床疗效,并分析该联合疗法的作用机制及其对患者外周血降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)和免疫功能的影响。方法根据纳入标准及排除标准选取2021年6月—2022年6月河北省中医院呼吸二科收治的AECOPD患者共80例,按照自愿原则将上述患者均分为两组,其中对照组40例,予以常规西医治疗方案,试验组40例,在常规西医治疗基础上给予清肺化痰、降逆平喘方治疗。比较两组患者的临床疗效以及干预前后的肺功能、免疫功能、生活质量以及血清炎症水平,并观察不良反应发生情况。结果对照组的总有效率为80.00%,试验组的总有效率95.00%,与对照组比较,试验组的总有效率明显升高(P<0.05)。两组患者干预2周后,试验组患者的第1秒用力呼气容积(FEV1)、用力肺活量(FVC)以及第1秒用力呼气容积占用力肺活量的比值(FEV1/FVC)相较于对照组均明显升高(P<0.01)。治疗前两组的圣乔治呼吸问卷(SGRQ)评分、改良英国医学研究学会呼吸困难指数(mMRC)和慢性阻塞性肺病评估测试(CAT)评分无明显差异(P>0.05)。干预2周后,试验组SGRQ评分、mMRC和CAT评分水平相较于对照组明显下降(P<0.01)。与对照组比较,试验组IL-6、CRP以及PCT水平均明显下降(P<0.01)。干预后,试验组CD_(3)^(+)、CD_(4)^(+)以及CD_(4)^(+)/CD_(8)^(+)水平相较于对照组明显升高,而CD^(+)^(8)水平相较于对照组明显下降(P<0.01)。与对照组比较,试验组的恶心、心悸、呼吸困难以及皮疹等不良反应发生率无明显差异(P>0.05)。结论清肺化痰、降逆平喘方联合西医常规药物治疗AECOPD能够提高疗效、改善患者肺功能,并对机体炎症反应和免疫功能均有调节作用,从而改善患者生活质量。