Proteomic analysis of a chronic obstructive pulmonary disease mouse model to determine the efficacy of treatment using Guben Zhike decoction

Background:Guben Zhike decoction(GBZKD)is derived from the experience of Professor Enxiang Chao,an esteemed master of Chinese medicine,while treating chronic obstructive pulmonary disease(COPD).GBZKD reinforces the healthy qi and consolidates defensive qi.This study explored the efficacy and potential mechanism of action of GBZKD in a COPD mouse model using proteomics.Methods:A COPD mouse model was established through cigarette smoke exposure and intranasal lipopolysaccharide administration.The model was verified through lung function test and lung histopathological observation.Label-free quantitative proteomics was used to detect the lung tissue proteins of mice from the GBZKD,COPD,and control groups.Results:GBZKD markedly improved the lung function and associated pathological conditions in the COPD mouse model.Proteomic analysis identified 4316 proteins,of which 3696 were quantitative proteins.We highlighted 287 and 184 proteins with significant regulatory roles in the lung tissues of COPD mice and GBZKD-treated mice,respectively.These proteins participated in multiple functions,including complement/coagulation cascade,immune response,and metabolic pathways.Conclusion:GBZKD exhibits multitarget and multipathway therapeutic effects in a COPD mouse model.

Effects of Suhuang Zhike Capsule on Pulmonary Function, Blood Gas Analysis Index, Serum PCT and CRP Expression in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

OBJECTIVE: To observe the effects of Suhuang Zhike Capsule on pulmonary function, blood gas analysis index, serum PCT and CRP expression in patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: A total of 88 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Xuancheng People's Hospital of Anhui Province from December 2014 to December 2016 were randomly divided into the observation group and the control group, with 44 cases in each group. The control group was given routine clinical treatment, and the observation group was given Suhuang Zhike Capsule on the basis of the treatment method of the control group. After 7 days' treatment, the improvement of lung function indexes were observed and evaluated before and after treatment(forced expiratory volume in one second(FEV_1), forced expiratory volume occupancy in the 1^(st) second percentage of vital capacity(FEVl/FVC), peak expiatory flow(PEF)), blood gas analysis index(Arterial oxygen partial pressure(PaO_2) and arterial blood carbon dioxide partial pressure(PaCO_2), oxygenation index(OI)) and serum cytokine levels(procalcitonin(PCT) and C reactive protein(CRP). RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(P < 0.05). The FEV_1, FEV_1/FVC and PEF in 2 groups were significantly increased after the treatment(P < 0.05), and the above lung function indexes in the observation group were significantly higher than the control group(P < 0.05). PaO_2 and OI were significantly increased after the treatment(P < 0.05), PaCO_2 was significantly decreased after the treatment(P < 0.05), and the improvement of above blood gas analysis indexes were significantly superior of the observation group than the control group(P < 0.05). The serum PCT and CRP levels in 2 groups were significantly decreased after the treatment(P < 0.05), and the improvement in the observation group were more significant than that in the control group(P < 0.05). CONCLUSION: Suhuang Zhike Capsule can inhibit serum inflammatory cytokine levels in patients with acute exacerbation of chronic obstructive pulmonary disease, improve blood gas analysis indicators, and improve lung functions.

Anti-inflammatory Effect of Wumen Zhike Gancao Decoction on Rats with Lumbar Disc Herniation Associated with Lipid Metabolic Disorder

[Objectives] To study the anti-inflammatory effect of Wumen Zhike Gancao Decoction (ZKGC) on rats with lumbar disc herniation (LDH) associated with lipid metabolic disorder.[Methods] A rat model of LDH was established by implantation of the autologous nucleus pulposus from the coccygeal vertebra of each rat tail, and histopathology, immunohistochemistry and biochemistry assays were employed to evaluate the treatment effects of ZKGC. In addition, the metabolic characteristics of LDH and ZKGC treatment were investigated with a liquid-chromatography with time-of-flight mass spectrometer (LC/Q-TOF-MS)-based metabolomics study. Nucleus pulpous tissues from rat models were collected and analyzed by metabolomics.[Results] By metabolism network analysis, lipid metabolism was up-regulated in LDH rat models and the treatment with ZKGC significantly reversed the abnormal up-regulated lipid metabolism. Meanwhile, the treatment of ZKGC also regulated the markers of neuron autophagy and inflammatory response in serum.[Conclusions] These results indicated that a complex mechanism, including abnormal lipid metabolism, associates with the progress of LDH, and multiple pathways might be involved in ZKGC s therapeutic effects on LDH.

Long-term Toxicity of Maxing Erchen Zhike Granules

[Objectives]To study the long-term toxicity of Maxing Erchen Zhike granules to rats after intragastric administration,so as to provide reference for its preclinical safety evaluation.[Methods]Total 80 rats were randomly and evenly divided into high-dose group(1.2 mL/100 g,120 g/kg),middle-dose group(96.0 g/kg),low-dose group(72.0 g/kg)and blank control group.The rats in the treatment groups were administered with corresponding doses of Maxing Erchen Zhike granules,and those in the blank control group were given with equal-amount normal saline.The administration lasted for 30 consecutive days.During the experiment,the rats'feed intake,activity,feces and other conditions and toxicity reactions were observed every day.After 24 h of the last administration,12 rats(half male and half female)were randomly selected from each group.Each of the rats was anesthetized with 10%chloral hydrate solution(0.3 mL/100 g)through intraperitoneal injection and subjected to abdominal aorta blood collection(two tubes)for hematological examination and blood biochemical examination(serum).Then,the main organs of the rats were weighed,and pathological examinations were performed.After that,the main organs were weighed and pathological examination was performed.The remaining rats in each group were discontinued and observed for 14 d.On the 15th d,they were subjected to the same treatment,and the body weight,organ coefficients,hematological indices,blood biochemical indices and pathological indices were examined.[Results]After 30 d of administration,there was no abnormality in the appearance and behavior of the animals.There was no significant difference in the daily consumption of feed among the groups,and there was no special case of weight gain.Among the blood biochemical indices,the ALB and ALT levels of each administration group were significantly different from those of the blank control group(P<0.05).The results of histopathological examination show that there was one case of interstitial pneumonia in each of the high-dose group,middle-dose group and blank control group.After 14 d that the administration was stopped,one case of focal myocarditis appeared in the high-dose group,and one case of interstitial pneumonia appeared in the middle-dose group.[Conclusions]Maxing Erchen Zhike granules are safe to be administered to rats at 100 times the clinical dose.and there should be no safety hazards clinically when used at conventional doses.

Effects of Suhuang Zhike Capsules on Pulmonary Function and Peripheral Blood Eosinophil Count and Exhaled Nitric Oxide in Patients with Acute Attack of Bronchial Asthma

OBJECTIVE: To observe the effects of Suhuang Zhike Capsules on lung function and peripheral blood eosinophil count (EOS) and exhaled nitric oxide (eNO) in patients with acute asthma attack.METHODS: A total of 80 patients with acute exacerbation of bronchial asthma admitted to Huai'an Cancer Hospital from January 2017 to January 2018 were randomly divided into an observation group and a control group,with 40 cases in each group.The control group was given conventional treatment with western medicine,and the observation group was given Suhuang Zhike Capsules on the basis of the treatment method of the control group.After 1 week of treatment,the improvement of individual symptoms (cough,wheezing,wheezing rale),lung function [1 second forced expiratory volume (FEV1),forced expiratory volume occupational capacity of vital capacity (FVC) in 1 second and peak expiratory flow (PEF)] and peripheral blood EOS and eNO levels and efficacy before and after the treatment were observed and assessed.RESULTS: The total effective rate of the observation group was 92.5%,which was significantly higher than the total effective rate of the control group (75.0%)(P < 0.05).The cough,wheezing and wheezing scores of the 2 groups were significantly decreased after treatment (P < 0.05).The scores of the above symptoms were significantly lower in the observation group than in the control group (P < 0.05).The FEV1,FVC and PEF were significantly increased after treatment (P < 0.05),and the above lung functions in the observation group were significantly higher than the control group (all P < 0.05).The EOS and eNO levels in the peripheral blood of the 2 groups were significantly decreased after treatment (P < 0.05),and the EOS and eNO levels in the peripheral blood in the observation group were significantly lower than those in the control group (P < 0.05).CONCLUSION: Suhuang Zhike Capsules can reduce the levels of EOS and eNO in peripheral blood of patients with acute asthma attack,improve the lung function of patients,relieve the clinical symptoms and improve the prognosis.

Effect of inhalant combined with Dingchuan Zhike decoction therapy on the airway remodeling, inflammation and PARC/CCL-18 pathways in patients with cough variant asthma

Objective:To study the effect of inhalant combined with Dingchuan Zhike decoction therapy on the airway remodeling, inflammation and PARC/CCL-18 pathways in patients with cough variant asthma.Methods: A total of 60 patients with cough variant asthma who were treated in our hospital between January 2014 and May 2016 were collected and divided into the control group (n=30) who received conventional inhalant treatment and the observation group (n=30) who received inhalant combined with Dingchuan Zhike decoction treatment according to single-blind randomized controlled method, and the treatment lasted for 6 months. Before treatment and after 6 months of treatment, high-resolution CT was used to determine the airway remodeling index levels, RIA method was used to detect the peripheral blood airway remodeling index contents, and enzyme-linked immunosorbent assay (ELISA) was used to detect the contents of inflammatory mediators in induced sputum and the PARC/CCL-18 in serum.Results: Before treatment, the differences in the airway remodeling degree as well as the contents of inflammatory mediators and PARC/CCL-18 were not statistically significant between the two groups. After 6 months of treatment, CT airway remodeling indexes LA and TA levels of observation group were higher than those of control group while WA level was lower than that of control group, and peripheral blood airway remodeling indexes CTGF, YKL-39, MMP-9 and TIMP-1 contents were lower tha=n those of control group;inflammatory mediators IL-5, IL-6 and IL-8 contents in induced sputum of observation group were lower than those of control group, and serum PARC/CCL-18 content was lower than that of control group.Conclusion:Inhalant combined with Dingchuan Zhike decoction can inhibit the airway remodeling and reduce the airway inflammation in patients with cough variant asthma.

Effectiveness and safety of Suhuang Zhike capsule(苏黄止咳胶囊)as adjuvant treatment for acute exacerbation of chronic obstructive pulmonary disease:a systematic review and Meta-analysis

OBJECTIVE:To evaluate the efficacy and safety of Suhuang Zhike capsule(苏黄止咳胶囊) in the adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).METHODS:The database including PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Chinese Biomedical Literature Database and Wanfang Data was searched.The retrieval time was from database establishment to May 2021.Randomized controlled trial(RCT) of Suhuang zhike capsule adjuvant treatment for AECOPD was included.The quality of the studies was independently evaluated and cross-checked by two reviewers,and Meta-analysis was performed by using RevMan5.3 software.RESULTS:Thirteen RCT results were included with a total sample number of 1195 cases,including 597 in the experimental group and 598 in the control group.The results showed that Suhuang zhike capsule adjuvant treatment of AECOPD could improve the total clinical effect rate compared with conventional treatment.Suhuang zhike capsule adjuvant treatment could improve forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC,peak expiratory flow(PEF) and other pulmonary function indexes;decrease Creactive protein(CRP),white blood cells,neutrophils and other infectious indicators;besides,the 1-year recurrence rate of the disease was decreased(all P < 0.05).CONCLUSIONS:Suhuang Zhike capsule can improve the lung function and clinical efficacy of AECOPD,thus increasing the exercise endurance,and reducing the infection and recurrence rate in AECOPD patients.

苏黄止咳胶囊联合盐酸西替利嗪片治疗感冒后咳嗽的效果

目的 探讨苏黄止咳胶囊联合盐酸西替利嗪片治疗感冒后咳嗽的效果。方法 选取2020年10月至2022年2月感冒后咳嗽患者90例,随机数字法分为3组,A组接受苏黄止咳胶囊治疗30例,B组接受盐酸西替利嗪片治疗30例,C组为上述药物联合应用治疗30例,对3组所得不同治疗结局进行分析。结果 3组治疗前咳嗽症状总评分、咳嗽视觉模拟评分、FeNO水平对比,差异无统计学意义(P>0.05);C组治疗后咳嗽总评分、咳嗽视觉模拟评分,优于A、B组(P<0.05);A、B组治疗后咳嗽总评分、咳嗽视觉模拟评分对比,差异无统计学意义(P>0.05);C组治疗后FeNO水平优于A、B组(P<0.05);A、B组治疗后FeNO水平对比,差异无统计学意义(P>0.05);C组治疗有效率,高于A、B组(P<0.05);A、B组治疗有效率差异无统计学意义(P>0.05)。A、B、C组治疗前EV1/FVC较治疗后显著偏低(P<0.05),组间EV1/FVC差异无统计学意义(P>0.05)。结论 感冒后咳嗽患者,使用苏黄止咳胶囊与盐酸西替利嗪片治疗,可有效改善患者临床咳嗽症状,提高治疗有效率,临床价值较为明显。

清肝润肺止咳露高效液相色谱特征图谱、含量测定及化学模式识别的研究

目的建立清肝润肺止咳露高效液相色谱(HPLC)特征图谱,测定其中吗啡、可待因、罂粟碱、那可丁的含量,并结合化学模式识别方法,综合评价该制剂的质量。方法采用HPLC法,以甲醇-5μmoL·L^(-1)庚烷硫酸钠溶液(用磷酸调节pH至2.6)为流动相进行梯度洗脱,流速:1.0 mL·min^(-1),柱温:20℃,检测波长:220 nm,进样量:10μL。利用指纹图谱相似度评价软件,结合聚类分析(CA)、主成分分析(PCA)和偏最小二乘法判别分析(PLS-DA)对10批清肝润肺止咳露的特征图谱进行评价。结果10批清肝润肺止咳露特征图谱共确定16个共有峰,指认了5个共有峰,分别为吗啡、可待因、蒂巴因、罂粟碱、那可丁。其中4个成分在线性范围内(吗啡0.70~8.70μg、可待因0.68~8.50μg、罂粟碱0.60~7.55μg、那可丁0.38~4.80μg)均有良好的线性关系(r≥0.9997);精密度、稳定性、重复性试验的RSD均小于3.0%;平均加样回收率在97.93%~99.43%之间(RSD<3.1%);含量测定结果:吗啡43.58~76.47μg·mL^(-1),可待因16.64~78.92μg·mL^(-1),罂粟碱29.93~41.22μg·mL^(-1),那可丁14.44~33.22μg·mL^(-1)。通过CA、PCA和PLS-DA分析,可将10批清肝润肺止咳露分为2类(S3、S4、S8、S10聚为一类,其余聚为一类),并筛选出峰2、峰4、峰13、峰11(吗啡)、峰1、峰10、峰8、峰12、峰16(那可丁)9个差异性成分。结论该研究建立的HPLC特征图谱及含量测定方法简单、准确,结合化学模式识别法,可用于清肝润肺止咳露的质量控制。

Simultaneous determination of five major components of Glycyrrhizae Radix et Rhizoma in Xiaoer Zhike Tangjiang with standardized reference extract

In this study, we developed a novel and simple HPLC-DAD method for simultaneous qualitative and quantitative determination of five major components of Glycyrrhizae Radix et Rhizoma （GRR） in Xiaoer Zhike Tangjiang （XEZKTJ） with standardized reference extract （SRE）. The five analytes （liquiritin apioside, liquiritin, isoliquiritin apioside, liquirigenin and glycyrrhizic acid） were well separated with good linearity, precision, stability and repeatability. The recovery rates ranged from 95.69% to 100.80%. The content of the five compounds in 34 batches of commercial XEZKTJ products was determined using standardized GRR extract （SRE method） and individual chemical reference standards （CRS method）. Highly similar results were obtained from the two methods, demonstrating the feasibility of the proposed SRE method. Taken together, we proposed an efficient and low-cost way to perform multi-component quality control of XEZKTJ in this study.

射干止咳胶囊体内外抗甲型H1N1流感病毒作用初探

目的初步探讨射干止咳胶囊对甲型H1N1流感病毒的体内外抗病毒作用。方法通过细胞病变效应(cytopathic effect,CPE)结合MTT法考察射干止咳胶囊体外抑制甲型H1N1流感病毒活性的作用;采用小鼠滴鼻法感染甲型H1N1流感病毒为模型,观察射干止咳胶囊对甲型H1N1流感病毒的体内抗病毒作用。结果体外抗病毒试验结果显示,射干止咳胶囊对甲型H1N1流感病毒的最高抑制率为11.86%,提示在攻毒剂量为100TCID_(50)的条件下,射干止咳胶囊在体外对甲型H1N1流感病毒的抑制作用不明显。小鼠滴鼻感染5LD_(50)的甲型H1N1流感病毒,射干止咳胶囊低、中、高剂量组小鼠的死亡率分别为30%、10%、30%,死亡保护率达50%、70%、50%,平均生存天数分别为13 d、14 d、13 d,说明各给药组对攻毒小鼠具有较好的死亡保护作用。结论射干止咳胶囊体外抗甲型H1N1流感病毒的作用不显著,但射干止咳胶囊各剂量组对甲型H1N1流感病毒攻毒致小鼠死亡却具有明显的保护作用。

“润肺止咳方”干预新型冠状病毒感染后咳嗽的回顾性分析

目的:评价2022年冬季北京大学第三医院“润肺止咳方”治疗新型冠状病毒感染后咳嗽患者的临床疗效。方法:回顾性收集2022年12月15日至2023年1月5日北京大学第三医院中医科门诊收治的新型冠状病毒感染后咳嗽患者108例,其中包括观察组68例和对照组40例。观察组给予“润肺止咳方”治疗,对照组对为未采用中医治疗的新型冠状病毒感染后咳嗽的临床患者,但可能有西医对症治疗。收集患者的基本资料、中医证候和用药情况,比较2组患者的体温复常时间、核酸转阴时间以及临床疗效。结果:与对照组比较,观察组的体温复常时间和核酸转阴时间差异无统计学意义(P=0.892,P=0.967)。观察组的临床治愈率为52.9%(36/68)、总有效率为88.2%(60/68),显著优于对照组的临床治愈率12.5%(5/40)、总有效率47.5%(19/40)(均P<0.01)。结论:北京大学第三医院“润肺止咳方”可改善新型冠状病毒感染患者的咳嗽症状,提高了中医治疗新型冠状病毒咳嗽后遗症的有效率和治愈率。

外剥内扎术加内痔柱状缝扎悬吊联合痔科生肌散治疗环状混合痔的临床研究

目的探究外剥内扎术加内痔柱状缝扎悬吊联合痔科生肌散治疗环状混合痔的临床效果和安全性。方法选取2021年1月至2022年8月江苏省无锡市中医院收治的90例环状混合痔患者,采用随机数字表法将其分为对照组(外剥内扎术加内痔柱状缝扎悬吊治疗)和试验组(外剥内扎术加内痔柱状缝扎悬吊联合痔科生肌散治疗),各45例。治疗后1、3、7 d,比较两组肛周疼痛和水肿评分,比较两组治疗前及治疗后2周肛门狭窄情况、血清炎症因子水平,记录两组不良反应发生情况。结果治疗后3、7 d,两组肛周疼痛和水肿评分均低于治疗后1 d,治疗后7 d低于治疗后3 d,试验组治疗后1、3、7 d肛周疼痛和水肿评分低于同期对照组(P<0.05)。试验组肛门狭窄率低于对照组(P<0.05)。治疗后2周,两组肛门功能评分高于治疗前,且试验组高于对照组(P<0.05)。治疗后2周,两组白细胞计数、血清降钙素原水平均低于治疗前,且试验组低于对照组(P<0.05)。试验组不良反应总发生率低于对照组(P<0.05)。结论外剥内扎术加内痔柱状缝扎悬吊联合痔科生肌散治疗环状混合痔的临床效果较好,可在临床上推广使用。

中成药治疗慢性阻塞性肺疾病稳定期的网状Meta分析

目的:采用网状Meta分析评价口服中成药治疗慢性阻塞性肺疾病(COPD)稳定期的有效性及安全性。方法:计算机检索国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、中国生物医学文献数据库(CBM)、PubMed、Embase、Web of Science、Cochrane library数据库中不同中成药治疗COPD稳定期的临床随机对照试验(RCT),检索时限为建库至2022年05月11日。采用R 4.1.1、Stata 16.0、Review manager 5.3软件进行数据分析。结果:共纳入70项RCT,包括6652例患者,涉及5种中成药。依据累计概率值排序,网状Meta分析结果显示,改善COPD自我评估测试(CAT)问卷评分方面,百令胶囊+常规治疗(>常规治疗;改善第一秒用力呼气容积占预计值百分比(FEV_(1)%)方面,百令胶囊+常规治疗>金水宝胶囊+常规治疗>补肺活血胶囊+常规治疗>玉屏风颗粒+常规治疗>常规治疗);改善六分钟步行距离(6MWD)方面,金水宝胶囊+常规治疗>补肺活血胶囊+常规治疗>百令胶囊+常规治疗>常规治疗;降低二氧化碳分压方面(PaCO_(2)),补肺活血胶囊+常规治疗>金水宝胶囊+常规治疗>百令胶囊+常规治疗>常规治疗;降低年急性发作次数方面,百令胶囊+常规治疗>常规治疗。5种中成药均未产生严重不良反应。结论:5种中成药治疗稳定期COPD均能提高临床综合疗效,但各有侧重,其中百令胶囊组综合疗效较好。

基于MAPK/NF-κB信号通路探讨调气止咳方对咳嗽变异性哮喘大鼠气道炎症的影响及机制

目的基于MAPK/NF-κB信号通路探讨调气止咳方(麻黄、苦杏仁、浙贝母、黄芩、瓜蒌子等)对咳嗽变异性哮喘大鼠气道炎症的影响及机制。方法采用卵清蛋白致敏复制咳嗽变异性哮喘大鼠模型。将SD大鼠随机分组为空白组、模型组、地塞米松组(0.5 mg·kg^(-1))、孟鲁司特组(1.0 mg·kg^(-1))及调气止咳方低、中、高剂量组(9.6、19.2、38.4 g·kg^(-1)),每组10只;灌胃给药,每日1次,连续14 d。观察大鼠一般状况并记录雾化后2 min内大鼠的咳嗽次数;采用HE染色、Masson染色法观察大鼠肺组织病理变化;ELISA法检测血清白细胞介素1β(IL-1β)、IL-6、肿瘤坏死因子α(TNF-α)含量;Western Blot法检测肺组织p38 MAPK、p-p38、NF-κB p65、p-p65蛋白表达水平;RT-qPCR法检测肺组织p38 MAPK、NF-κB p65 mRNA表达水平。结果与空白组比较,模型组大鼠的咳嗽次数显著增加(P<0.01),肺损伤病理评分及胶原纤维面积比显著升高(P<0.01);血清IL-1β、IL-6、TNF-α水平均显著升高(P<0.01);肺组织中p-p38、p-p65、p-p38/p38、p-p65/p65蛋白表达均显著上调(P<0.01),p38 MAPK、NF-κB p65 mRNA表达显著上调(P<0.01)。与模型组比较,各给药组大鼠的咳嗽次数显著减少(P<0.01),肺损伤病理评分及胶原纤维面积比显著降低(P<0.01),血清IL-1β、IL-6、TNF-α水平均显著降低(P<0.01),肺组织中p-p38、p-p65蛋白表达及p38 MAPK、NF-κB p65 mRNA表达均明显下调(P<0.05,P<0.01);调气止咳方高剂量组大鼠肺组织中p-p38/p38、p-p65/p65蛋白表达比值均显著下调(P<0.01)。与地塞米松组和孟鲁司特组比较,调气止咳方高剂量组大鼠的咳嗽次数明显减少(P<0.05);与地塞米松组比较,调气止咳方高剂量组大鼠的血清IL-1β、IL-6、TNF-α水平明显降低(P<0.01);与孟鲁司特组比较,调气止咳方高剂量组大鼠的血清IL-1β、TNF-α水平明显降低(P<0.05,P<0.01)。结论调气止咳方能够改善卵清蛋白诱导的咳嗽变异性哮喘大鼠的咳嗽症状,减轻气道炎症细胞浸润及气道重塑,降低炎症细胞因子IL-1β、IL-6、TNF-α水平,其机制可能与调控MAPK/NF-κB信号通路有关。

巴芪除痒止咳方治疗肺肾两虚兼风寒犯肺型咳嗽变异性哮喘疗效观察

目的:观察巴芪除痒止咳方治疗肺肾两虚兼风寒犯肺型咳嗽变异性哮喘的临床疗效。方法:选取门诊60名咳嗽变异性哮喘患者,随机分为两组各30例。对照组予布地奈德/福莫特罗粉吸入剂治疗,治疗组在对照组基础上予巴芪除痒止咳方治疗,疗程2周。比较两组临床疗效,VAS、CET、FeNO评分及中医证候积分变化情况。结果:治疗后,治疗组总有效率96.67%,高于对照组的80.00%,两组比较差异具有统计学意义(P﹤0.05);两组VAS、CET及FeNO评分均得到了改善(P﹤0.05),且治疗组VAS、CET评分较对照组改善更明显;治疗后治疗组咳痰、咽痒、恶风、自汗积分均小于对照组(P﹤0.05)。结论:巴芪除痒止咳方能减轻肺肾两虚兼风寒犯肺型咳嗽变异性哮喘患者气道炎症反应,缓解临床症状。

咳喘宁穴位敷贴、抗敏治咳方联合沙美特罗替卡松治疗咳嗽变异性哮喘临床研究

目的:观察咳喘宁穴位敷贴、抗敏治咳方联合沙美特罗替卡松治疗风寒型咳嗽变异性哮喘(CVA)的临床疗效。方法:将100例风寒型CVA患者按随机数字表法分为对照组和联合组各50例。对照组剔除4例,联合组剔除3例,最终纳入对照组46例、联合组47例。对照组给予沙美特罗替卡松粉吸入剂治疗8周,联合组给予沙美特罗替卡松粉吸入剂联合咳喘宁穴位敷贴治疗4周后,改予抗敏治咳方口服治疗4周。2组均随访12周。比较2组咳嗽症状积分,第1秒用力呼气容积(FEV_(1))、呼气峰值流速(PEF)、呼出气一氧化氮(FeNO)、嗜酸性粒细胞(EOS)、免疫球蛋白E (IgE)、白细胞介素-4 (IL-4)、肿瘤坏死因子-α (TNF-α)水平,以及复发率。评估治疗安全性。结果:治疗后,2组咳嗽症状积分均较治疗前降低(P<0.05);组间咳嗽症状积分比较,差异无统计学意义(P>0.05)。治疗后,2组FEV_(1)、PEF水平均较治疗前升高(P<0.05),FeNO水平均较治疗前降低(P<0.05);组间FEV_(1)、PEF水平比较,差异均无统计学意义(P>0.05);联合组FeNO水平低于对照组(P<0.05)。治疗后,2组血清EOS、IgE、IL-4、TNF-α水平均较治疗前降低(P<0.05),联合组上述4项炎症指标水平均低于对照组(P<0.05)。随访12周,联合组复发率8.51%,低于对照组23.91%(P<0.05)。治疗期间,对照组有5例、联合组有1例患者出现不良反应。结论:咳喘宁穴位敷贴、抗敏治咳方联合沙美特罗替卡松治疗风寒型CVA,可改善咳嗽症状,提升肺功能,减轻炎症状态,降低复发率。

基于国家名中医验方“参术止咳丸”院内制剂的研制

目的优选参术止咳丸的提取工艺及成型工艺,为制剂开发及试生产提供基础研究。方法采用紫外分光光度法建立参术止咳丸制剂质量检测标准。确定参术止咳丸的处方与制备工艺。以重金属、砷盐、性状、水分、重量差异、装量和微生物限量等作为考察指标,对参术止咳丸相关质量进行了检测。结果参术止咳丸在251 nm处有最大吸收峰,在0.0214~0.1824 mg/mL浓度范围内线性关系良好。所制备的参术止咳丸重金属、砷盐、性状、水分、重量差异、装量和微生物限量等各项指标均符合要求。结论本研究开发的参术止咳丸制剂优化了提取工艺及成型工艺,为制剂开发及生产提供基础研究。

宣肺化湿止咳汤联合西药治疗咳嗽变异性哮喘临床观察

目的研究宣肺化湿止咳汤治疗咳嗽变异性哮喘的临床效果及对呼出气一氧化氮(FeNO)数值的影响。方法选择2018年7月—2019年12月收治的120例咳嗽变异性哮喘患者作为研究对象,40例采用沙美特罗替卡松粉(舒利迭)吸入治疗作为西药组,40例采用宣肺化湿止咳汤治疗作为中药组,最后40例采用二者联合治疗作为联合组。观察三组治疗效果、咳嗽症状积分、FeNO水平、咳嗽生活质量以及不良反应情况。结果联合组的治疗总有效率为97.5%(39/40),明显高于西药组的80.0%(32/40)、中药组的82.5%(33/40),差异有统计学意义(P<0.05);治疗后联合组FeNO水平低于西药组和中药组,莱切斯特咳嗽问卷(LCQ)评分高于西药组和中药组,日间积分与夜间积分均低于西药组和中药组,差异均有统计学意义(P<0.05);西药组和中药组FeNO水平、LCQ评分、日间积分与夜间积分对比,差异无统计学意义(P>0.05)。结论宣肺化湿止咳汤联合西药治疗咳嗽变异性哮喘,效果较好,能明显减轻患者临床症状,提高生活质量,降低炎症反应,值得临床应用及推广。

基于cAMP/PKA/CREB信号通路探讨固本止咳方治疗慢性阻塞性肺疾病稳定期小鼠的作用机制

目的基于环磷酸腺苷(cAMP)/蛋白激酶A(PKA)/cAMP反应元件结合蛋白(CREB)信号通路探讨固本止咳方(GBZK)治疗慢性阻塞性肺疾病(COPD)稳定期小鼠的作用机制。方法60只BALB/c小鼠随机分为对照组、模型组、GBZK组、地塞米松组,除对照组外,其余组均使用烟草烟雾暴露联合脂多糖复制COPD稳定期小鼠模型。造模成功后,GBZK组予GBZK 0.2 mL/d灌胃,地塞米松组予1.0 mg/kg地塞米松注射液腹腔注射,2次/d,所有小鼠均给药28 d。观察各组小鼠一般情况,酶联免疫吸附测定法(ELISA)检测小鼠肺组织匀浆cAMP水平,利用Western blot检测小鼠肺组织匀浆中cAMP、p-PKA、CREB、p-CREB蛋白表达情况。结果与模型组比较,GBZK组小鼠的喘息气促有所改善,肺组织匀浆中cAMP含量及cAMP、p-PKA、CREB、p-CREB蛋白表达均提高(P<0.05)。结论固本止咳方可能通过激活cAMP/PKA/CREB信号通路,进而发挥对COPD稳定期小鼠的保护作用。