Objective:To explore the clinical effect of embedding thread combined with Jianpi Qushi Huayu ointment in the treatment of bronchiectasis in remission period,and to observe the effect on the level of inflammatory cyto...Objective:To explore the clinical effect of embedding thread combined with Jianpi Qushi Huayu ointment in the treatment of bronchiectasis in remission period,and to observe the effect on the level of inflammatory cytokines.Methods:150 patients with bronchiectasis in remission period were divided into three groups(50 cases in each group),western medicine group(treated with salmeterol fluticasone and low dose erythromycin),combined group(treated with Jianpi Qushi Huayu plaster),observation group(treated with western medicine+Jianpi Qushi Huayu plaster+embedding thread),and the clinical treatment of the three groups were compared.Result:before and after treatment,the improvement of TCM syndrome score,the improvement of pulmonary ventilation index,the improvement of inflammatory cytokines,and the change of adverse reactions.Results:the treatment efficiency of the observation group and the combination group was significantly higher than that of the western medicine group P The peak level of expiratory flow velocity,the maximum expiratory flow,the forced expiratory volume in one second and the ratio of forced expiratory volume in one second to vital capacity in the observation group and the combined group were significantly better than those in the western medicine group and the pre-treatment level(P<0.05),and the improvement in the observation group was better than that in the combined group After treatment,the expression of IL-13,IL-10 and IL-4 in the combined group was significantly better than that in the western medicine group and before treatment(P<0.05),and the improvement in the observation group was better than that in the combined group;there was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion:catgut embedding combined with Jianpi Qushi Huayu ointment can significantly alleviate the related clinical symptoms and signs,effectively control the further aggravation of the disease,improve the lung function of patients,regulate the level of inflammatory cytokines to reduce the degree of inflammatory reaction,and do not significantly aggravate the adverse reactions of drugs.展开更多
Bronchiectasis is usually classified as cystic fibrosis(CF) related or CF unrelated(non-CF); the latter is not considered an orphan disease any more, even in developed countries. Irrespective of the underlying etiolog...Bronchiectasis is usually classified as cystic fibrosis(CF) related or CF unrelated(non-CF); the latter is not considered an orphan disease any more, even in developed countries. Irrespective of the underlying etiology, bronchiectasis is the result of interaction between host, pathogens, and environment. Vitamin D is known to be involved in a wide spectrum of significant immunomodulatory effects such as down-regulation of pro-inflammatory cytokines and chemokines. Respiratory epithelial cells constitutively express 1α-hydroxylase leading to the local transformation of the inactive 25(OH)-vitamin D to the active 1,25(OH)_2-vitamin D. The latter through its autocrine and paracrine functions up-regulates vitamin D dependent genes with important consequences in the local immunity of lungs. Despite the scarcity of direct evidence on the involvement of vitamin D deficiency states in the development of bronchiectasis in either CF or non-CF patients, it is reasonable to postulate that vitamin D may play some role in the pathogenesis of lung diseases and especially bronchiectasis. The potential contribution of vitamin D deficiency in the process of bronchiectasis is of particular clinical importance, taking into consideration the increasing prevalence of vitamin D deficiency worldwide and the significant morbidity of bronchiectasis. Given the well-established association of vitamin D deficiency with increased inflammation, and the indicative evidence for harmful consequences in lungs, it is intriguing to speculate that the administration of vitamin D supplementation could be a reasonable and cost effective supplementary therapeutic approach for children with non-CF bronchiectasis. Regarding CF patients, maybe in the future as more data become available, we have to re-evaluate our policy on the most appropriate dosage scheme for vitamin D.展开更多
<strong>Objective:</strong><span style="font-family:Verdana;"> To determine and compare the effect of vitamin D3 supplementation on modifying the disease severity in cystic fibrosis (CF) an...<strong>Objective:</strong><span style="font-family:Verdana;"> To determine and compare the effect of vitamin D3 supplementation on modifying the disease severity in cystic fibrosis (CF) and non</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">CF bronchiectasis pediatric patients.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A randomized clinical trial evaluating the role of oral vitamin D3 supplementation for six months, was performed in forty patients with CF and non</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">CF bronchiectasis under the age of 18 years with vitamin D deficiency or insufficiency. The primary outcome was to reach the sufficient Vitamin D level, the secondary outcome was to reevaluate bronchiectasis severity by following up the frequency, severity of pulmonary exacerbations and lung function after vitamin D3 supplementation.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Results:</span></b><b><span style="font-family:""> </span></b><span style="font-family:Verdana;">Forty patients completed the trial. The percentage of improvement of vitamin D level after vitamin D3 supplementation for six months was significantly higher in CF (88.3%) than non</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">CF bronchiectasis patients (59.82%)</span><span style="font-family:""> </span><span style="font-family:Verdana;">(P =</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.03).</span><span style="font-family:""> </span><span style="font-family:Verdana;">Additionally, moderate to severe pulmonary exacerbations significantly decreased by more than 60%, 45% (P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001,</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.005) and frequent exacerbations decreased by 15%, 10% (P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.327, 0.490), while the forced expiratory volume in 1 (FEV1) significantly increased by 17% and 15% in non CF bronchiectasis and CF patients respectively (p</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.001).</span><b><span style="font-family:Verdana;"> Conclusions: </span></b><span style="font-family:Verdana;">Vitamin D3 therapy was effective in decreasing the frequency and severity of pulmonary exacerbations and preserving lung function. Thereby, improving the disease severity even more in non</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">CF bronchiectasis than CF patients.</span>展开更多
Pulmonary rehabilitation has emerged as a recommended standard of care for patients with chronic lung disease. As in chronic obstructive pulmonary disease (COPD), persons with other forms of chronic respiratory diseas...Pulmonary rehabilitation has emerged as a recommended standard of care for patients with chronic lung disease. As in chronic obstructive pulmonary disease (COPD), persons with other forms of chronic respiratory disease commonly experience deconditioning and decreased quality of life. The aim of this prospective study is to determine the effect of a 4-week pulmonary rehabilitation program (PRP) on patients diagnosed with post-pulmonary tuberculosis bronchiectasis in the Philippines. The participants were above 18 years of age, diagnosed to have stable Post-Pulmonary tuberculosis bronchiectasis with chest computerized tomography (CT) scan or chest radiograph showing bronchiectatic changes, consented to attend the PRP sessions and be included in the study. The subjects underwent PRP for 4 weeks with a total of 8 sessions and determination of Forced expiratory volume at 1 second (FEV1), forced vital capacity (FVC), quality of life determination using the Saint George Respiratory Disease Questionnaire (SGRQ), and exercise endurance using the 6-minute walking test (6 MWT), before and after the PRP. A total of fourteen patients, six males and eight females, aged from 28 - 72 years old, completed the 4-week pulmonary rehabilitation program. There were four ex-smokers and ten non-smokers with concomitant asthma and COPD in some patients. There was significant improvement in the 6-minute walk test and quality of life after 4 weeks of rehabilitation program among the subjects with p value for 6 MWT at p = 0.0001 and p = 0.008 for SGRQ. Conclusion: Pulmonary rehabilitation program led to a significant improvement in exercise capacity and health related quality of life among patients with post-pulmonary tuberculosis bronchiectasis.展开更多
Introduction: Although an increased prevalence of airway obstruction, bronchial hyperreactivity and allergic diseases such as asthma has been associated with bronchiectasis, studies investigating role of atopy in bron...Introduction: Although an increased prevalence of airway obstruction, bronchial hyperreactivity and allergic diseases such as asthma has been associated with bronchiectasis, studies investigating role of atopy in bronchiectasis are few and controversial. We have therefore studied IgE level and reversible airways obstruction in bronchiectasis which have not previously been evaluated in bronchiectasis. Patients and Methods: This study was conducted at Department of Chest Diseases of Al-Azhar University, Assiut, Egypt from January 2012 to December 2013, all consecutive patients with bronchiectasis admitted to the department were enrolled to the study. Serum IgE, pulmonary function tests (PFT) and high resolution computerized tomography (HRCT) were done to all cases. Results: Patients with high IgE (32/50) had longer disease duration and frequent history of allergic diseases. They also had significantly worse FEV1 (49.38 ± 12.65;p = 0.041) and FEV1/FVC (60.89 ± 13.52, p = 0.015) values. Mean HRCT score was significantly higher in patients with high IgE than in patients with normal (18/50) IgE (23.6 ± 10.1 and 7.83 ± 2.43 respectively). IgE showed positive correlation (r = 0.266, p = 0.015) with HRCT scores. Furthermore, the mean increase in FEV1 after inhalation of salbutamol was significantly greater (p = 0.002) in high IgE patients. Conclusions: In conclusion, IgE level is significantly high in bronchiectasis and it may lead to worse pulmonary function and more HRCT extent. Appreciable reversible airways obstruction should be sought in all cases of bronchiectasis and treated appropriately.展开更多
Objective:To study the effect of bronchoscopic ambroxol lavage on inflammatory factors in lavage fluid of patients with bronchiectasis complicated by infection.Methods:100 patients with bronchiectasis complicated by i...Objective:To study the effect of bronchoscopic ambroxol lavage on inflammatory factors in lavage fluid of patients with bronchiectasis complicated by infection.Methods:100 patients with bronchiectasis complicated by infection who were treated in our hospital between May 2012 and January 2016 were divided into the control group (n=54) who received conventional treatment and the observation group (n=46) who received intravenous anti-infection combined with bronchoscopic ambroxol lavage after the therapies were reviewed. The contents of inflammatory factors, adhesion molecules and acute phase proteins in lavage fluid were compared between the two groups.Results: Before treatment, the differences in contents of inflammatory factors, adhesion molecules and acute phase proteins in lavage fluid were not statistically significant between two groups of patients. After treatment, inflammatory factors IL-4, IL-6, IL-10 and TNF-α contents in lavage fluid of observation group were lower than those of control group;adhesion molecules sICAM-1 and VCAM-1 contents in lavage fluid were lower than those of control group;acute phase proteins CRP, AAG, HPT and CER contents in lavage fluid were lower than those of control group.Conclusion:Bronchoscopic ambroxol lavage can reduce airway inflammation in patients with bronchiectasis complicated by infection.展开更多
Hemoptysis,especially the massivehemoptysis caused by bronchiectasis is acommon,but emergent and critical diseases inclinic.Injection of Herba Houttuyniae extractinto Kongzui(LU 6)was performed to treathemoptysis acco...Hemoptysis,especially the massivehemoptysis caused by bronchiectasis is acommon,but emergent and critical diseases inclinic.Injection of Herba Houttuyniae extractinto Kongzui(LU 6)was performed to treathemoptysis according to the theory oftraditional Chinese medicine and the展开更多
基金2020 Hebei provincial research project of Chinese medicine(No.2020374)
文摘Objective:To explore the clinical effect of embedding thread combined with Jianpi Qushi Huayu ointment in the treatment of bronchiectasis in remission period,and to observe the effect on the level of inflammatory cytokines.Methods:150 patients with bronchiectasis in remission period were divided into three groups(50 cases in each group),western medicine group(treated with salmeterol fluticasone and low dose erythromycin),combined group(treated with Jianpi Qushi Huayu plaster),observation group(treated with western medicine+Jianpi Qushi Huayu plaster+embedding thread),and the clinical treatment of the three groups were compared.Result:before and after treatment,the improvement of TCM syndrome score,the improvement of pulmonary ventilation index,the improvement of inflammatory cytokines,and the change of adverse reactions.Results:the treatment efficiency of the observation group and the combination group was significantly higher than that of the western medicine group P The peak level of expiratory flow velocity,the maximum expiratory flow,the forced expiratory volume in one second and the ratio of forced expiratory volume in one second to vital capacity in the observation group and the combined group were significantly better than those in the western medicine group and the pre-treatment level(P<0.05),and the improvement in the observation group was better than that in the combined group After treatment,the expression of IL-13,IL-10 and IL-4 in the combined group was significantly better than that in the western medicine group and before treatment(P<0.05),and the improvement in the observation group was better than that in the combined group;there was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion:catgut embedding combined with Jianpi Qushi Huayu ointment can significantly alleviate the related clinical symptoms and signs,effectively control the further aggravation of the disease,improve the lung function of patients,regulate the level of inflammatory cytokines to reduce the degree of inflammatory reaction,and do not significantly aggravate the adverse reactions of drugs.
文摘Bronchiectasis is usually classified as cystic fibrosis(CF) related or CF unrelated(non-CF); the latter is not considered an orphan disease any more, even in developed countries. Irrespective of the underlying etiology, bronchiectasis is the result of interaction between host, pathogens, and environment. Vitamin D is known to be involved in a wide spectrum of significant immunomodulatory effects such as down-regulation of pro-inflammatory cytokines and chemokines. Respiratory epithelial cells constitutively express 1α-hydroxylase leading to the local transformation of the inactive 25(OH)-vitamin D to the active 1,25(OH)_2-vitamin D. The latter through its autocrine and paracrine functions up-regulates vitamin D dependent genes with important consequences in the local immunity of lungs. Despite the scarcity of direct evidence on the involvement of vitamin D deficiency states in the development of bronchiectasis in either CF or non-CF patients, it is reasonable to postulate that vitamin D may play some role in the pathogenesis of lung diseases and especially bronchiectasis. The potential contribution of vitamin D deficiency in the process of bronchiectasis is of particular clinical importance, taking into consideration the increasing prevalence of vitamin D deficiency worldwide and the significant morbidity of bronchiectasis. Given the well-established association of vitamin D deficiency with increased inflammation, and the indicative evidence for harmful consequences in lungs, it is intriguing to speculate that the administration of vitamin D supplementation could be a reasonable and cost effective supplementary therapeutic approach for children with non-CF bronchiectasis. Regarding CF patients, maybe in the future as more data become available, we have to re-evaluate our policy on the most appropriate dosage scheme for vitamin D.
文摘<strong>Objective:</strong><span style="font-family:Verdana;"> To determine and compare the effect of vitamin D3 supplementation on modifying the disease severity in cystic fibrosis (CF) and non</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">CF bronchiectasis pediatric patients.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A randomized clinical trial evaluating the role of oral vitamin D3 supplementation for six months, was performed in forty patients with CF and non</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">CF bronchiectasis under the age of 18 years with vitamin D deficiency or insufficiency. The primary outcome was to reach the sufficient Vitamin D level, the secondary outcome was to reevaluate bronchiectasis severity by following up the frequency, severity of pulmonary exacerbations and lung function after vitamin D3 supplementation.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Results:</span></b><b><span style="font-family:""> </span></b><span style="font-family:Verdana;">Forty patients completed the trial. The percentage of improvement of vitamin D level after vitamin D3 supplementation for six months was significantly higher in CF (88.3%) than non</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">CF bronchiectasis patients (59.82%)</span><span style="font-family:""> </span><span style="font-family:Verdana;">(P =</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.03).</span><span style="font-family:""> </span><span style="font-family:Verdana;">Additionally, moderate to severe pulmonary exacerbations significantly decreased by more than 60%, 45% (P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001,</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.005) and frequent exacerbations decreased by 15%, 10% (P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.327, 0.490), while the forced expiratory volume in 1 (FEV1) significantly increased by 17% and 15% in non CF bronchiectasis and CF patients respectively (p</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.001).</span><b><span style="font-family:Verdana;"> Conclusions: </span></b><span style="font-family:Verdana;">Vitamin D3 therapy was effective in decreasing the frequency and severity of pulmonary exacerbations and preserving lung function. Thereby, improving the disease severity even more in non</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">CF bronchiectasis than CF patients.</span>
文摘Pulmonary rehabilitation has emerged as a recommended standard of care for patients with chronic lung disease. As in chronic obstructive pulmonary disease (COPD), persons with other forms of chronic respiratory disease commonly experience deconditioning and decreased quality of life. The aim of this prospective study is to determine the effect of a 4-week pulmonary rehabilitation program (PRP) on patients diagnosed with post-pulmonary tuberculosis bronchiectasis in the Philippines. The participants were above 18 years of age, diagnosed to have stable Post-Pulmonary tuberculosis bronchiectasis with chest computerized tomography (CT) scan or chest radiograph showing bronchiectatic changes, consented to attend the PRP sessions and be included in the study. The subjects underwent PRP for 4 weeks with a total of 8 sessions and determination of Forced expiratory volume at 1 second (FEV1), forced vital capacity (FVC), quality of life determination using the Saint George Respiratory Disease Questionnaire (SGRQ), and exercise endurance using the 6-minute walking test (6 MWT), before and after the PRP. A total of fourteen patients, six males and eight females, aged from 28 - 72 years old, completed the 4-week pulmonary rehabilitation program. There were four ex-smokers and ten non-smokers with concomitant asthma and COPD in some patients. There was significant improvement in the 6-minute walk test and quality of life after 4 weeks of rehabilitation program among the subjects with p value for 6 MWT at p = 0.0001 and p = 0.008 for SGRQ. Conclusion: Pulmonary rehabilitation program led to a significant improvement in exercise capacity and health related quality of life among patients with post-pulmonary tuberculosis bronchiectasis.
文摘Introduction: Although an increased prevalence of airway obstruction, bronchial hyperreactivity and allergic diseases such as asthma has been associated with bronchiectasis, studies investigating role of atopy in bronchiectasis are few and controversial. We have therefore studied IgE level and reversible airways obstruction in bronchiectasis which have not previously been evaluated in bronchiectasis. Patients and Methods: This study was conducted at Department of Chest Diseases of Al-Azhar University, Assiut, Egypt from January 2012 to December 2013, all consecutive patients with bronchiectasis admitted to the department were enrolled to the study. Serum IgE, pulmonary function tests (PFT) and high resolution computerized tomography (HRCT) were done to all cases. Results: Patients with high IgE (32/50) had longer disease duration and frequent history of allergic diseases. They also had significantly worse FEV1 (49.38 ± 12.65;p = 0.041) and FEV1/FVC (60.89 ± 13.52, p = 0.015) values. Mean HRCT score was significantly higher in patients with high IgE than in patients with normal (18/50) IgE (23.6 ± 10.1 and 7.83 ± 2.43 respectively). IgE showed positive correlation (r = 0.266, p = 0.015) with HRCT scores. Furthermore, the mean increase in FEV1 after inhalation of salbutamol was significantly greater (p = 0.002) in high IgE patients. Conclusions: In conclusion, IgE level is significantly high in bronchiectasis and it may lead to worse pulmonary function and more HRCT extent. Appreciable reversible airways obstruction should be sought in all cases of bronchiectasis and treated appropriately.
文摘Objective:To study the effect of bronchoscopic ambroxol lavage on inflammatory factors in lavage fluid of patients with bronchiectasis complicated by infection.Methods:100 patients with bronchiectasis complicated by infection who were treated in our hospital between May 2012 and January 2016 were divided into the control group (n=54) who received conventional treatment and the observation group (n=46) who received intravenous anti-infection combined with bronchoscopic ambroxol lavage after the therapies were reviewed. The contents of inflammatory factors, adhesion molecules and acute phase proteins in lavage fluid were compared between the two groups.Results: Before treatment, the differences in contents of inflammatory factors, adhesion molecules and acute phase proteins in lavage fluid were not statistically significant between two groups of patients. After treatment, inflammatory factors IL-4, IL-6, IL-10 and TNF-α contents in lavage fluid of observation group were lower than those of control group;adhesion molecules sICAM-1 and VCAM-1 contents in lavage fluid were lower than those of control group;acute phase proteins CRP, AAG, HPT and CER contents in lavage fluid were lower than those of control group.Conclusion:Bronchoscopic ambroxol lavage can reduce airway inflammation in patients with bronchiectasis complicated by infection.
文摘Hemoptysis,especially the massivehemoptysis caused by bronchiectasis is acommon,but emergent and critical diseases inclinic.Injection of Herba Houttuyniae extractinto Kongzui(LU 6)was performed to treathemoptysis according to the theory oftraditional Chinese medicine and the