Network Meta-analysis of Efficacy of Five Classical Prescriptions for Acute Attack of Asthma in Children / 中国实验方剂学杂志

ObjectiveTo compare and evaluate the clinical efficacy of five classical prescriptions for acute attack of bronchial asthma （BA） and cough variant asthma （CVA） in children， and to further compare and assess the effect of them on cold-induced asthma or heat-induced asthma. MethodRandomized controlled trials （RCT） on the treatment of acute attack of asthma with five classical prescriptions （Sanzi Yangqintang， Maxing Shigantang， Shegan Mahuangtang， Xiao Qinglongtang， and Dingchuantang） were retrieved from China Science and Technology Journal Database （VIP）， China National Knowledge Infrastructure （CNKI）， and Wanfang Data （from establishment to August 15， 2021）. The eligible RCT were evaluated and the data were extracted for network Meta-analysis by Stata 16.0. ResultA total of eligible 47 RCT were screened out， involving 5 114 children with acute attack of asthma and 10 intervention measures. Among them， 16 RCT （1 912 children， 6 intervention measures） were about the cold-induced asthma and 10 RCT （1 054 cases， 4 intervention measures） focused on the heat-induced asthma. According to the Meta-analysis， among the 10 interventions， Maxing Shigantang + routine treatment of western medicine demonstrated the most significant effect， and the effect of the interventions was in the following order： Maxing Shigantang + routine treatment of western medicine > routine treatment of western medicine， Shegan Mahuangtang + routine treatment of western medicine> Xiao Qinglongtang + routine treatment of western medicine > Shegan Mahuangtang > Dingchuantang + routine treatment of western medicine. For the cold-induced asthma， the effect of Shegan Mahuangtang + routine treatment of western medicine was remarkable， and for the heat-induced asthma， the corresponding intervention was Dingchuantang + routine treatment of western medicine. Shegan Mahuangtang was outstanding in improving the percentage of forced expiratory volume in the first second in predicted value （FEV1%）. ConclusionThe combination of western medicine with the five prescriptions was more effective than the western medicine alone， particularly the combination with Maxing Shigantang. The combination of Shegan Mahuangtang and western medicine was outstanding in the treatment of cold-induced asthma， while the corresponding intervention for heat-induced asthma was the combination of Dingchuantang and western medicine. However， a large number of RCT with scientific design and higher quality are still needed to verify the conclusion.

Effect of Modified Dingchuantang on Airway Function, Induced Phlegm Indexes and Inflammatory Factors in Children with Cough Variant Asthma of Wind Heat Attacking Lung Syndrome / 中国实验方剂学杂志

Objective:To explore the clinical effect of the application of modified Dingchuantang in the treatment of children with cough variant asthma (CVA). Method:Totally 142 children with CVA admitted by our hospital from June 2016 to June 2018 were selected and randomly divided into observation group (71 cases) and control group (71 cases) according to the random number table method. Patients in control group were treated with inhaled budesonide powder inhalation+oral montelukast sodium chewable tablets, while patients in observation group were treated with modified Dingchuantang. All children were treated for 8 weeks. The two groups' clinical effects, changes of levels of airway function parameters[percentage of forced expiratory volume in the first second (FEV1%) and expiratory flow rate of forced expiratory in 50% and 75% vital capacity (FEF50, FEF75)], sputum induction indexes[nerve growth factor (NGF), percentage of eosinophile (EOS), substance P (SP), inflammatory factors[hypersensitivity C reactive protein (hs-CRP), interleukin (IL)-17 and IL-23], and the occurrence of adverse reactions were compared. Result:The total effective rate of observation group was 93.0% (66/71), which was significantly higher than that of control group[81.7% (58/71), PP1%, FEF50 and FEF75 of two groups were increased significantly after treatment (PPPPConclusion:Modified Dingchuantang can effectively relieve cough and other symptoms in children with CVA, reduce airway inflammation, down-regulate the expressions of inflammatory factors in blood and improve airway function, with a definite curative effect, safety and reliability.

Effect of Dingchuantang on Expression of NGF in Lung and Thymus of Asthmatic Rats / 中国中医药信息杂志

Objective To explore the effect of Dingchuantang on the expression of NGF in the lung and thymus of asthmatic rats. Methods Thirty two Wistar rats were randomly divided into control group, asthmatic group, Dingchuantang group and Beclomethasone group, 8 rats for each group. Asthmatic model was made except the control group. The change of NGF expression in the lung and thymus were observed by means of immunohistochemistry. Results The expression of NGF in the lung and thymus of asthmatic group was much higher than that of control group and that of Dingchuantang group was much lower than that of asthmatic group. Conclusion Over-expression of NGF might be involved in the pathogenesis of bronchial asthma, and inhibition of NGF expression by Dingchuantang may be one of the mechanisms in the treatment of asthma.