ABSTRACT
Objective:To observe the clinical effects of modified Maxing Shigan Decoction combined with acupoint application of Traditional Chinese Medicine (TCM) on inflammatory indicators and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with syndrome of phlegm-heat accumulated in the lung.Methods:Prospective cohort study. Eighty AECOPD patients with syndrome of phlegm-heat accumulated in the lung, who met the inclusion criteria in our hospital from October 2020 to January 2022 were included, and randomized into two groups by random number table methods, 40 in each group. The control group received conventional therapy of Western medicine, while the treatment group received modified Maxing Shigan Decoction combined with acupoint application of TCM on the basic treatment of control group. Both groups were treated for a course of 14 days. The white blood count (WBC) and percentage of neutrophil (NE%) were detected by automatic blood cell analyzer. Levels of C-reactive protein (CRP) were measured by enzyme linked immunosorbent assay (ELISA). Pulmonary function parameters including forced expiratory volume in one second (FEV1), percentage of forced expiratory volume in one second (FEV1%), forced vital capacity (FVC) and FEV1/FVC were detected by spirometry. Meantime, the adverse reactions and clinical responsive rate were recorded in both groups.Results:The overall responsive rate was 90.0% (36/40) in treatment group, which had statistically significant difference with 70.0% (28/40) in control group (χ 2=5.00, P=0.025). After treatment, plasma WBC [(4.15±1.02)×10 9/L vs. (7.53±1.27)×10 9/L, t=13.12], NE% [(0.50±0.12)% vs. (0.65±0.13)%, t=5.36] and serum CRP [(8.12±5.58)mg/L vs. (25.15±8.50)mg/L, t=10.59] in the treatment group were significantly lower than those in the control group ( P<0.05). The FEV1 [(1.94±0.23)L vs. (1.71±0.35)L, t=3.47], FEV1% [(88.25±9.21)% vs. (74.10±8.13)%, t=7.29], FVC [(3.85±0.31)L vs. (3.12±0.23)L, t=12.29] and FEV1/FVC [(86.12±7.18)% vs. (75.30±8.32)%, t=6.23] in the treatment group were significantly higher than those in the control group ( P<0.05). The adverse reaction rate during treatment period yielded no significant difference between two groups ( P>0.05). Conclusion:Application of modified Maxing Shigan Decoction combined with acupoint application of TCM in the treatment of AECOPD with syndrome of phlegm-heat accumulated in the lung can effectively attenuate inflammation response and ameliorate the pulmonary function.
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Objective To investigate the effect of Maxing-Shigan decoction on inflammatory factors and immune function of mycoplasma pneumonia (MPP). Methods According to the random table method, 123 children with MPP who met the inclusion criteria were divided into control group (61 cases) and treatment group (62 cases). The control group was treated with azithromycin, while the treatment group was treated with Maxing-Shigan decoction on the basis of the control group. The treatment course was two weeks in two groups. The level of IL-2, IL-4, IL-6, TNF-α, CRP and CD3+, CD4+, CD8+ and CD4+/CD8+ was detected by ELISA. The recovery time of body temperature, the fading time of coughing, the fading time of crackles and rale and the time of hospitalization was observed, TCM symptoms and signs was also scored, and the clinical efficacy was evaluated. Results The total effective rate was 90.3％ (56/62) in the treatment group and 73.8％ (45/61) in the control group. There was significant difference between the two groups (χ2=5.736, P=0.017). The recovery time of body temperature, the fading time of coughing, the fading time of crackles and rale and the time of hospitalization in the treatment group was significantly lower than those in the control group (t=-6.969, -5.700,-8.226, -7.034, P<0.01). Compared with the control group after treatment, the serum level of IL-2 significantly increased, IL-4, IL-6, TNF-α and CRP significantly decreased in the treatment group (t=12.729, -6.373, -6.416,-14.482, -20.071, P<0.01), while the serum level of CD3+, CD4+, CD4+/CD8+ significantly increased and CD8+significantly decreased in the treatment group (t=2.314, 2.556, -3.866, 11.226, P<0.05). Conclusions The Maxing-Shigan decoction treats MPP by improving inflammatory factors and immune function, which not only improve the clinical symptoms, but also has high safety. It is worth promoting the application in clinic.
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Objective To evaluate the therapeutic effect of Maxing-Shigan decoction combined with salmeterol/fluticasone inhalation for acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A total of 86 patients with acute exacerbation of COPD were enrolled and randomly divided into a salmeterol/fluticasone group (41 patients) and a combined treatment group (45 patients). The salmeterol/fluticasone group was treated by salmeterol/fluticasone inhalation, and the combined treatment group by Maxing-Shigan decoction combined with salmeterol/fluticasone inhalation. Serum C-reactive protein (CRP) was detected by a immunonephelometric assay, and Toll-like receptor 9 (TLR9) in hemocytes was detected by flow cytometry. The score of the syndromes in traditional Chinese medicine (TCM), such as cough, sputum, gasping and shortness of breath, as well as pulmonary function and therapeutic effect were evaluateds. Results After the treatment, the serum C-reactive protein in the combined treatment group was significantly lower than that in the salmeterol/fluticasone group (4.3 ± 1.2 mg/L vs. 8.4 ± 2.5 mg/L;t=5.417, P<0.01), and the TLR9 expression was significantly higher (1.9 ± 0.7 vs. 1.6 ± 0.4;t=3.418, P<0.05). The scores of the syndromes in TCM, such as cough (1.7 ± 0.6 vs. 3.8 ± 1.1;t=2.859, P<0.05), sputum (1.6 ± 0.4 vs. 3.9 ± 1.2;t=3.027, P<0.05), gasping (1.2 ± 0.5 vs. 3.4 ± 1.3;t=3.416, P<0.05) and shortness of breath (1.5 ± 0.7 vs. 3.7 ± 1.6;t=3.468, P<0.05) in the combined treatment group were significantly lower than those in the salmeterol/fluticasone group. The forced expiratory volume in first second (75.4 ± 5.8 L vs. 62.8 ± 6.9 L;t=3.526, P<0.05) and the percentage of forced expiratory volume in first second to forced vital capacity (85.7%± 10.3%vs. 71.9%± 15.4%;t=5.648, P<0.01) in the combined treatment group were significantly higher than those in the salmeterol/fluticasone group. The time to symptoms alleviated (3.4 ± 0.7 d vs. 5.6 ± 1.2 d; t=3.256, P<0.05) and the use dose was (1.8 ± 0.2) ×103μg vs. (5.3 ± 0.4)×103μg, and use times of salmeterol/fluticasone (7.4 ± 1.3 vs. 16.5 ± 3.4;t=4.574, P<0.05) in the combined treatment group were significantly decreased than those in the salmeterol/fluticasone group. The total effective rate in in the combined treatment group were significantly decreased than those in the salmeterol/fluticasone group (84.4% vs. 73.2%; χ2=4.519, P<0.05). Conclusion Maxing-Shigan decoction combined with salmeterol/fluticasone inhalation can improve the pulmonary function in patients with acute exacerbation of COPD, its effiency is suppior to salmeterol/fluticasone inhalation alone.
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Objective To assess the clinical efficacy ofMaxing-Shigan decoction in patients with severe pneumonia due to phlegm-heat obstructing the lung.Methods Sixty patients with severe pneumonia in the TCM Department of Dalian Municipal Central Hospital from January to December 2013 were randomly divided into a control group and a treatment group by random number table method, 30 in each group. The control group was treated with anti-infection, fluid infusion and mechanical ventilation. On the basis of treatment in the control group, the treatment group was also givenMaxing-Shigan decoction through nasogastric gavage. The mean arterial pressure (MAP), lactic acid (Lac) and PaO2/FiO2 were compared before and after the treatment in both groups. The scores of the Clinical Pulmonary Infection Score (CPIS) and the Acute Physiology and Chronic Health Evaluation II (APACHEⅡ) were compared between the two groups.Results The total effective rate in the treatment group was significantly higher than that in the control group (80.0%vs.73.3%;χ2=4.800,P=0.029). In both groups, MAP (treatment group: 102.4 ± 11.9 mmHgvs. 70.4 ± 6.4 mmHg, t=12.972,P=0.000; control group: 101.2 ± 12.5 mmHgvs. 69.8 ± 6.6 mmHg,t=12.1672,P=0.000), PaO2/FiO2 (treatment group: 265.4 ± 19.7 mmHgvs. 78.6 ± 10.5 mmHg,t=45.833,P=0.000; control group: 124.8 ± 13.4 mmHg vs. 79.1 ± 11.1 mmHg;t=14.385,P=0.000) after the treatment were significantly higher than before the treatment, and the Lac level were significantly lower (treatment group: 1.04 ± 0.42 mmol/Lvs. 6.37 ± 2.27 mmol/L,t=12.65, P=0.000; control group: 3.88 ± 1.45 mmol/Lvs. 6.39 ± 2.32 mmol/L,t=5.025,P=0.000). The improvements in Lac (t=10.304,P=0.000) and PaO2/FiO2 (t=32.323,P=0.000) in the treatment group were superior to the control group. The scores of the CPIS (treatment group: 2.2 ± 1.5vs. 6.7 ± 1.7,t=10.872,P=0.000; control group: 4.5 ± 2.7 vs. 6.8 ± 1.8,t=3.882,P=0.000) and APACHEⅡ(treatment group: 5.3 ± 2.1vs. 13.8 ± 3.8,t=10.723,P=0.000; control group: 9.3±3.5vs. 13.7 ± 3.5,t=4.869,P=0.000) after the treatment were significantly lower than before the treatment in both groups, and the changes of CPIS (t=4.079,P=0.000) and APACHEⅡ(t=5.368,P=0.000) in the treatment group were greater than those in the control group.ConclusionsMaxing-Shigan decoction has definite therapeutic effects for severe pneumonia due to phlegm-heat obstructing the lung..