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Objective:To observe the clinical efficacy of Qufeng Juanyin Decoction on bronchial asthma in children （syndrome of wind phlegm blocking lung） during the stage of attack， and the regulatory effect on T helper cell 17 （Th17）/regulatory T cell （Treg） and related factors. Method:One hundred and thirty patients were randomly divided into observation group （65 cases） and control group （65 cases） by random number table. In control group， 61 cases completed the treatment， including 1 fell off or lost visit， 3 was eliminated because of breach of protocol. And in observation group， 63 patients completed the treatment， including 2 cases fell off or lost visit. Both of the groups got Budesonide suspension by atomizer， 1 mg/time， 2 times/day， and severe children were added with Terbutaline Sulfate Aerosol every morning and evening， 2 sprays/time. Patients in control group got Suhuang Zhike capsules， 2 grains/time， 3 times/day. Patients in observation group got Qufeng Juanyin Decoction， 1 dose/day. The course of treatment lasted for 7 days. Onset and mitigation times of asthma were recorded. And before and after treatment， pulmonary function was evaluated， and daily variation rate of peak expiratory flow （PEF）， first second expiratory flow as a percentage of expected （FEV<sub>1</sub>%） and ratio of first second forced expiratory volume （FEV<sub>1</sub>） and forced vital capacity （FVC） were recorded， and scores of syndrome of wind phlegm blocking lung and exhaled nitric oxide were detected. At the first week after the treatment， asthma control test in children （C-ACT） was made. Levels of Th17 cells， Treg cells， interleukin-17 （IL-17）， IL-6， IL-10， IL-22 and IL-35 were also detected. And the safety was evaluated. Result:Onset and mitigation times of asthma in observation group were shorter those in control group （<italic>P</italic><0.01）. The daily variation rate of PEF in observation group was lower than that in control group （<italic>P</italic><0.01）， while levels of FEV<sub>1</sub>% and FEV<sub>1</sub>/FVC were higher than those in control group （<italic>P</italic><0.01）. Asthma control in observation group was better than that in control group （<italic>Z</italic>=2.106， <italic>P</italic><0.05）. FeNO and score of syndrome of wind phlegm blocking lung were lower than those in control group （<italic>P</italic><0.01）. Levels of Th17， Th17/Treg， IL-17， IL-6 and IL-22 were lower than those in control group （<italic>P</italic><0.01）， whereas levels of proportion of Treg cells， IL-10 and IL-35 were higher than those in control group （<italic>P</italic><0.01）. The total effective rate in observation group was 96.83% （61/63）， which was better than 85.25% （52/61） in control group （<italic>χ</italic><sup>2</sup>=5.141， <italic>P</italic><0.05）. And the total effective rate of traditional Chinese medicine （TCM） syndrome was 98.41% （62/63）， which was better than 86.89% （53/61） in control group （<italic>χ</italic><sup>2</sup>=4.525， <italic>P</italic><0.05）. And there was no adverse reaction caused by Qufeng Juanyin Decoction. Conclusion:Qufeng Juanyin Decoction can shorten the course of disease， improve the lung function， regulate the expressions of Th17/Treg cells and related factors， promote the immune balance of Th17 / Treg， reduce airway inflammation and airway hyperresponsiveness， and effectively control the attack of asthma， with a good clinical efficacy and safety on bronchial asthma in children （syndrome of wind phlegm blocking lung） during the stage of attack.
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@#AIM: To explore the effects of Nd:YAG laser peripheral iridotomy(LPI)in the treatment of drug-uncontrollable primary angle-closure glaucoma(PACG)in acute attack.<p>METHODS: A prospective study was conducted on 22 eyes of 20 patients with drug-refractory primary angle-closure glaucoma treated in the Department of Ophthalmology of Xiangyang No.1 People's Hospital from May 2019 to June 2020. All subjects underwent Nd:YAG LPI. Visual acuity, intraocular pressure, chamber angle closure range, anterior chamber angle(ACA), anterior chamber volume(ACV), central anterior chamber depth(CACD)and peripheral anterior chamber depth(PACD)were measured before and after the operation. And observe the complications of LPI.<p>RESULTS:All patients can implement LPI. All subjects' chamber angle closure range were >180° before LPI and 9 eyes(41%)were ≤180° after LPI. The intraocular pressure of 21 eyes(95%)had significantly lower than postoperative(<i>P</i><0.05). Postoperative anterior chamber parameters such as ACA, ACV and PACD were increased(<i>P</i><0.05). During the operation,15 eyes(68%)had iris cascade or silk hemorrhage and 5 eyes(23%)had corneal epithelial damage.<p>CONCLUSION: LPI has high safety and can be implemented in the acute attack stage of drug-uncontrollable PACG. It can reduce intraocular pressure effectively and relieve symptoms, which has a significant effect in the patients.
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Objective:To observe the controlling effect of addition and subtraction therapy of Xuanbi tang on knee osteoarthritis of rheumatic fever arthralgia type (KOA) at attack stage and to investigate the influence to acute inflammation factors. Method:One hundred and twenty-eight patients were randomly divided into control group and observation group (1∶1) by random number table with SAS software. The patients in both groups got celecoxib capsules, 0.2 g/time, 1 time/day, glucosamine hydrochloride capsule, 1 grain/time, 2 times/day. Patients in control group addiiontally got Simiaowan, 6 g/time, 2 times/day. Patients in observation group got addition and subtraction therapy of Xuanbitang, 1 dose/day, with a treatment course of 2 weeks in both groups. Visual analogue scale of pain (VAS) was used to discuss pain degree of knee joint, and the VAS scores during activity and resting state were recorded every day, and the time to pain relief and time to pain disappearance were also recorded. Before and after treatment, the scores of osteoarthritis index visual scale of Western Ontario and McMaster University (WOMAC), scores of swelling degree and scores of rheumatism heat arthralgia syndrome were graded. The levels of high sensitive C-reactive protein (hs CRP), interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and serum matrix metalloproteinase-3 (MMP-3) were detected before and after treatment. In addition, safety was evaluated and discussed. Result:The comprehensive total effective rate in observation group was 95.00% (57/60), higher than 83.05% (49/59) in control group (P<0.05). At the third, seventh, tenth, fourteenth day after treatment, scores of knee joint pain degree in observation group were lower than those in control group (P<0.01). Time to pain relief and time to pain disappearance were shorter than those in control group (P<0.01). Scores of WOMAC, swelling degree and rheumatism heat arthralgia syndrome were all lower than those in control group (P<0.01). Levels of hs-CRP, IL-1β, IL-6, TNF-α and MMP-3 were lower than those in control group (P<0.01). In addition, there was no adverse reaction related to Xuanbitang. Conclusion:Addition and subtraction therapy of Xuanbitang can relieve pain, swelling and other symptoms, improve knee joint function, shorten the course of disease, and control the acute inflammatory reaction, with significant clinical efficacy and safety.