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TCM prevention and treatment of chronic airway inflammatory diseases
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Factors Affecting Therapeutic Effect on Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Patients with Syndrome of Phlegm-heat Obstructing Lung： A Retrospective Analysis Enhanced Publication
Abstract：ObjectiveTo analyze the factors affecting the therapeutic effect on acute exacerbation of chronic obstructive pulmonary disease （AECOPD） in the patients with the syndrome of phlegm-heat obstructing lung.MethodThe general information （gender， age， history of smoking and alcohol， and duration of COPD） of 100 AECOPD patients was collected. In addition， the data of laboratory test results， past medical history， modified Medical Research Council （mMRC） scale score， COPD assessment test （CAT） score， six-minute walk distance （6MWD）， traditional Chinese medicine （TCM） symptom scores， whether or not taking traditional Chinese medicine， and the date of disease onset were collected. The independent samples t-test， χ2 test or univariate Logistic regression analysis was performed to analyze the data， and multivariate Logistic regression analysis was employed to determine the main factors affecting the therapeutic effect.ResultA total of 100 patients were enrolled in this study， including 47 patients in the significant remission group and 53 patients in the non-significant remission group. The two groups showed differences in age， body mass index （BMI）， red blood cell count （RBC）， haemoglobin， blood urea nitrogen （BUN）， mMRC scale score， taking traditional Chinese medicine， and onset season （P<0.05）. In addition， there were significant differences in terms of the domination in circuit by element Qi， dominant Qi， and join of subordinate Qi to dominant Qi between the two groups （P<0.05）. The disease in the significant remission group mainly occurred in spring and summer. Multivariate Logistic regression showed that there were differences in the BMI， BUN， taking traditional Chinese medicine， and dominant Qi being lesser Yin and sovereign fire （relative to reverting Yin and wind-wood） between the two groups （P<0.05）.ConclusionIncreasing the BMI， lowering the BUN level， and taking traditional Chinese medicine can improve the therapeutic effect， which is better when the dominant Qi is lesser Yin and sovereign fire relative to reverting Yin and wind-wood.Keywords：acute exacerbation of chronic obstructive pulmonary disease;syndrome of phlegm-heat obstructing lung;Qingke Pingchuan granules;retrospective study;five circuits and six Qi265|210|0
<HTML><H-PDF><L-PDF>Updated：2024-07-12Constitution Distribution and Clinical Data of 252 Patients with Allergic Asthma Enhanced Publication
Abstract：ObjectiveA cross-sectional study was conducted to analyze the constitution distribution characteristics of patients with allergic asthma， aiming to provide a basis for the regulation of constitution and the treatment of allergic asthma.MethodThe patients with allergic asthma treated in the outpatient clinic from December 2021 to September 2023 were selected. The clinical data of the patients were collected by a questionnaire survey. The composite constitution distribution characteristics of the patients and the correlations of constitution with gender， age， body mass index （BMI）， comorbid allergic diseases， history of allergy， family history， keeping pets， and fractional exhaled nitric oxide （FeNO） in the patients with special constitution were analyzed.ResultA total of 252 patients with allergic asthma were included in this study， with a male-to-female ratio of 1∶1.5， and the proportion of young people was the highest. The proportion of special constitution alone was the highest， and the proportions of other constitutions combined with special constitution followed the order of Yang deficiency， Qi deficiency， Qi depression， phlegm dampness， dampness heat， Yin deficiency， and blood stasis. There were 58 patients with special constitution combined with one other constitution， of which Yang deficiency accounted for the highest proportion. There were 38 patients with special constitution combined with two other constitutions， of which Qi deficiency + Yang deficiency was the most common. Among the patients， 116， 48， and 117 patients were overweight or obese， had a family history of allergic diseases， and had a history of allergy， respectively. Seventy patients kept pets， and there was a correlation between keeping pets and allergy to cat and dog hair （P<0.05）. Other allergic diseases complicated with allergic asthma occurred in 202 patients， being dominated by allergic rhinitis， urticaria， and eczema. There were 177 patients with eosinophilic airway inflammation. The patients with allergic asthma mainly presented the syndromes of wind asthma （134， 53.17%）， heat asthma （51， 20.24%）， cold asthma （32， 12.7%）， deficiency asthma （15， 5.95%）， Qi depression asthma （14， 5.56%）， and blood stasis asthma （6， 2.38%）. The results of binary logistic regression suggested that women were more likely have Yang deficiency and Qi depression than men. Older patients were less likely to present phlegm dampness and dampness heat. BMI was positively correlated with phlegm dampness and negatively correlated with Yang deficiency （P<0.05）.ConclusionThe patients with allergic asthma mainly present special constitution and wind asthma syndrome. The combination of special constitution and other constitutions （commonly Qi deficiency and Yang deficiency） leads to repeated attacks of allergic asthma. The incidence of allergic asthma is higher in women and young people， and women are more likely to have Yang-deficiency or Qi-deficiency constitution. Obesity may be a risk factor for allergic asthma. Obese people are more likely to have phlegm-dampness and dampness-heat constitutions. Pet contact and allergic rhinitis may lead to poor control of allergic asthma.Keywords：allergic asthma;characteristics of constitution;special constitution;composite constitution;clinical data343|285|6<HTML><H-PDF><L-PDF>Updated：2024-07-12- Abstract：ObjectiveTo investigate the establishment and evaluation of a rat model of cough variant asthma （CVA， syndrome of latent wind damaging Yin）.MethodSixty rats were randomized into Blank， CVA + latent wind damaging Yin， CVA， budesonide， and Sangmei Zhike granules， with 12 rats in each group. The rats in other groups except the blank group were sensitized by intraperitoneal injection of ovalbumin and aluminum hydroxide + atomization inhalation of ovalbumin and aluminum hydroxide. The rats in the groups of CVA + latent wind damaging Yin， budesonide， and Sangmei Zhike granules were then placed in a draught and administrated with thyroxine tablets （0.15 g·kg-1） by gavage to induce latent wind damaging Yin. Days 1-15 of the experiment constituted the modeling stage while days 16-29 served as the verification stage. On day 16， the rats in the budesonide group received atomization inhalation of the drug （0.5 g·L-1）， and those in the Sangmei Zhike granules group were administrated with the granules （4.19 g·kg-1） by gavage once a day for 14 days. On days 1， 8， and 15， the body mass， water intake， anal temperature， and temperatures in the precordium and paw center were compared among the blank， CVA + latent wind damaging Yin， and CVA groups. On day 28， the body mass， water intake， anal temperature， and temperatures in the precordium and paw center were compared among five groups. On day 29， cough sensitivity was assessed based on the number of capsaicin （1 × 10-4 mol·L-1）-induced coughs within 2 min. On day 30， the pulmonary function indexes and the serum levels of inflammatory mediators ［interleukin （IL）-4， IL-5， IL-13， interferon （IFN）-γ， and total immunoglobulin E （IgE）］， cyclic adenosine monophosphate （cAMP）， and cyclic guanosine monophosphate （cGMP） were determined. Hematoxylin-eosin staining was employed to observe the pathological damage in the lung. Real-time PCR was carried out to determine the relative expression levels of cAMP， IL-4， IL-5， and IL-13 in the lung tissue.ResultOn day 15， compared with the blank and CVA groups， the CVA + latent wind damaging Yin group showcased a decrease in body mass and increases in water intake， anal temperature， and temperatures of the precordium and paw center （P<0.05）. On day 28， compared with the CVA + latent wind damaging Yin group， the budesonide and Sangmei Zhike granules groups presented reduced water intake and declined anal temperature and temperatures of precordium and paw center （P<0.05）. Compared with the budesonide group， the Sangmei Zhike granules group had a reduction in temperatures of precordium and paw center of the left and right hindlimbs. There was statistical significance （P<0.05）. Compared with blank group， the cough times within 2 min in CVA + latent wind damaging Yin and CVA groups increased （P<0.05）. Compared with CVA + latent wind damaging Yin group， the Sangmei Zhike granules group showed decreased coughs （P<0.05）. Compared with the blank group， the forced vital capacity （FVC） in the CVA + latent wind damaging Yin and CVA groups decreased （P<0.05）. Compared with CVA + latent wind damaging Yin group， the FVC in the Sangmei Zhike granules group increased （P<0.05）. Compared with the blank group， the CVA + latent wind damaging Yin and CVA groups presented elevated serum levels of total IgE， IL-4， and IL-13 （P<0.05）， and the CVA + latent wind damaging Yin group showcased elevated cAMP level and lowered cGMP and IFN-γ levels （P<0.05）. Compared with the CVA + latent wind damaging Yin group， the Sangmei Zhike granules group presented lowered IgE， IL-4， IL-13， and cAMP levels and elevated cGMP and IFN-γ levels （P<0.05）. Compared with budesonide group， the Sangmei Zhike granules group showcased a reduction in IL-13 level （P<0.05）. The lung tissue in CVA + latent wind damaging Yin and CVA groups was severely damaged， while budesonide and Sangmei Zhike granules alleviated bronchial mucosa damage， necrosis and exfoliation of airway epithelial cells， inflammatory cell infiltration， and gland hyperplasia. Compared with the blank group， CVA + latent wind damaging Yin group showed downregulated relative expression of IL-4 （P<0.05）. Compared with CVA + latent wind damaging Yin group， the relative expression of IL-4 in budesonide and Sangmei Zhike granules group were upregulated （P<0.05）.ConclusionThe CVA model prepared by intraperitoneal injection with ovalbumin and aluminum hydroxide + atomization inhalation with ovalbumin and aluminum hydroxide + wind blowing + gavage with thyroxine tablets presented the syndrome of latent wind damaging Yin.Keywords：cough variant asthma;latent wind damaging Yin;animal model;evaluation of syndromes by prescriptions;combination of disease and syndrome373|629|3<HTML><H-PDF><L-PDF>Updated：2024-07-12
Clinical Application of Theory of Latent Wind in Pulmonary Diseases Enhanced Publication
Abstract：Latent wind is either congenital or acquired. The former is related to constitution， and the latter can be classified into internal wind and external wind. As a latent pathogen， latent wind has both the pathogenic characteristics of latent pathogen and the onset pattern of wind pathogen. The deficiency of healthy Qi is a necessary condition for the formation of latent wind. External pathogen， emotional and dietary disorders， and fatigue are the common causes for the onset of latent wind， and heat stagnation damaging Yin is the inevitable outcome. The internal accumulation of latent wind and the contraction with external pathogen lead to the abnormal movement of Qi and the disorder of triple energizer， affecting the metabolism of Qi， blood， and body fluid. The intertwining of wind， phlegm， fire， and stasis becomes a cause for the lingering of latent wind. We suggest that the treatment of latent wind should follow principle of reinforcing healthy Qi to consolidate the body and ventilating wind to expel pathogen. According to the different pathogenic factors， the methods of dispersing cold， clearing heat， detoxifying， moisturizing dryness， nourishing Yin， softening liver， invigorating spleen， and replenishing kidney can be adopted. According to the nature and attribute of latent wind and the different pathogenic factors associated with latent wind， the pathogeneses of latent wind can be summarized into three types： external pathogen invasion， triple energizer disorder， and healthy Qi deficiency. According to different pathogenic factors， external pathogen invasion can be divided into wind-cold attacking lung， wind-heat invading lung， intense wind-fire， wind-dryness damaging lung， and lung-heat damaging Yin. According to the different locations in Zang-fu organs， triple energizer disorder is divided into internal stirring of liver wind， disorder of upper energizer， internal accumulation of latent wind in spleen， dysfunction of middle energizer in transportation， internal accumulation of wind in kidney， and dysfunction of lower energizer in assisting. According to the natural endowment， healthy Qi deficiency is classified into the third category. Different formulas are used to treat the patients with different syndromes. Fully understanding the theory of latent wind helps to explain the combination of external and internal pathogens， repeated attacks， and lingering of pulmonary diseases. Elaborating on the pathogenesis， treatment principle， and syndrome differentiation of latent wind enlightens the clinical treatment of pulmonary diseases.Keywords：internal accumulation of latent wind;internal wind;external wind;ventilating wind to expel pathogen;pulmonary diseases392|837|4<HTML><H-PDF><L-PDF>Updated：2024-07-12- Abstract：ObjectiveTo observe the clinical efficacy and safety of Qingke Pingchuan granules in the treatment of acute exacerbation of chronic obstructive pulmonary disease （COPD） due to phlegm-heat obstructing lung.MethodOne hundred patients with the syndrome of phlegm-heat obstructing lung during acute exacerbation of COPD were selected and assigned into a treatment group （50 cases） and a control group （50 cases） according to the random number table. The treatment group was treated with Qingke Pingchuan granules combined with conventional western medicine， and the control group was treated with conventional western medicine. The treatment course was 14 days in both groups， and the follow-up lasted for 1 month. Before and after the treatment， the traditional Chinese medicine （TCM） symptom score， COPD assessment test （CAT） score， modified Medical Research Council （mMRC） scale core， 6-minute walk distance （6MWD）， and C-reactive protein （CRP） level were determined. In addition， the TCM symptom score， CAT score， and mMRC score were recorded one month after treatment in the follow-up.ResultThe general information of the patients showed no significant difference between the two groups. The treatment group had higher comprehensive treatment efficacy than the control group， as demonstrated by the lower scores of cough， wheezing， shortness of breath， sputum volume， sputum color， sputum texture， irritability， tongue coating， and pulse manifestation and lower total TCM symptom score （P<0.05）. The treatment group outperformed the control group in terms of the total CAT score and scores of symptoms， such as cough， expectoration， and chest tightness （P<0.05）. The treatment group had lower mMRC scale score than the control group （P<0.05）， and there was no significant difference in 6MWD or CRP level between the two groups. The follow-up results showed that compared with the control group， the treatment group showcased reductions in cough， wheezing， sputum volume， chest tightness， and total TCM symptom scores （P<0.05）， total CAT score and the scores of cough， expectoration， and chest tightness （P<0.05）， and mMRC scale score （P<0.05）. During the treatment period， serious adverse reactions occurred in neither group， which indicated high safety.ConclusionQingke Pingchuan granules can mitigate the symptoms of cough， expectoration， and chest tightness and improve the quality of life of the patients with the syndrome of phlegm-heat obstructing lung during the acute exacerbation of COPD， with a long-lasting pharmacological effect and high safety， being worthy to be promoted in clinical practice.Keywords：acute exacerbation of chronic obstructive pulmonary disease;syndrome of phlegm-heat obstructing lung;Qingke Pingchuan granules;clinical efficacy;clinical randomized controlled trial355|217|1<HTML><H-PDF><L-PDF>Updated：2024-07-12
