Objective:To explore the presence of inflammatory memory in the lung tissue of mice with cough variant asthma(CVA)and the mechanism of Wuhu decoction in preventing and treating CVA.Methods:Among the 90 SPF-grade femal...Objective:To explore the presence of inflammatory memory in the lung tissue of mice with cough variant asthma(CVA)and the mechanism of Wuhu decoction in preventing and treating CVA.Methods:Among the 90 SPF-grade female BALB/c mice,20 were randomly selected as the blank group,while the remaining 70 were sensitized by intraperitoneal injection of ovalbumin(OVA)combined with aluminum hydroxide and then exposed to OVA by nebulization to establish the CVA mouse model.From the conctrol group and the model group,10 mice were randomly selected to detect airway responsiveness using an animal ventilator.Successfully modeled mice were then randomly divided into 7 groups:a CVA model group,a CVA re-challenge group,low-,medium-,and high-dose Wuhu decoction groups,and a positive control(dexamethasone)group,with 10 mice in each group.After 30 days of rest,except for the conctrol group and the model group,mice in the other groups underwent a second OVA nebulization challenge and received corresponding drug interventions once a day for 10 consecutive days before further analysis.Pathological changes in lung tissue were observed using periodic acid-schiff(PAS)and Masson staining methods.Serum levels of tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),interferon-γ(IFN-γ),and interleukin-10(IL-10)were detected using enzyme-linked immunosorbent assay(ELISA).The expression of T-bet mRNA and GATA-3 mRNA in lung tissue was determined by real-time quantitative polymerase chain reaction(Real-time PCR).Results:The results of airway responsiveness indicated successful establishment of the model.Compared with the control group,the model group exhibited severalkey pathological changes including inflammatory cellinfiltration around the lung tissue,epithelialmetaplasia,airway collagen deposition,increased airway mucus accumulation index and airway collagen deposition index(P<0.05),elevated serum TNF-αand IL-4 expression(P<0.05),decreased IFN-γand IL-10 levels(P<0.05),decreased T-bet mRNA levels(P<0.05),increased GATA-3 mRNA levels(P<0.05),and a reduced T-bet mRNA/GATA-3 mRNA ratio(P<0.05)in lung tissue.When compared to the CVA re-challenge group,the Wuhu decoction groups and the dexamethasone group effectively alleviated pathological changes in lung tissue,reduced the airway mucus accumulation index and airway collagen deposition index(P<0.05),decreased serum TNF-αand IL-4 expression(P<0.05),increased serum IFN-γand IL-10 levels(P<0.05),upregulated T-bet mRNA levels(P<0.05),downregulated GATA-3 mRNA levels(P<0.05),and increased the T-bet mRNA/GATA-3 mRNA ratio(P<0.05)in lung tissue.Conclusion:The lung tissue of mice with cough variant asthma exhibits inflammatory memory,and Wuhu decoction may intervene in this inflammatory memory by restoring the balance between T-bet and GATA-3,thereby correcting the imbalance in Th1/Th2 immunity and exerting a preventive and therapeutic effect on cough variant asthma.展开更多
OBJECTIVE:To systematically investigate the clinical effectiveness and safety of traditional Chinese herbs(TCHs)as an alternative to conventional medicine(CM)in children with cough variant asthma(CVA).METHODS:Randomiz...OBJECTIVE:To systematically investigate the clinical effectiveness and safety of traditional Chinese herbs(TCHs)as an alternative to conventional medicine(CM)in children with cough variant asthma(CVA).METHODS:Randomized controlled trial(RCT)studies that were published from their inceptions to March 31,2020,were identified from the electronic databases of China National Knowledge Infrastructure,Wangfang,Pub Med,and Cochrane Central Library.The primary outcome of the review was the total effective rate(TER),and the secondary outcomes were immunoglobulin E(Ig E),peak expiratory flow(PEF),adverse drug reactions,and relapse rates of interventions.RESULTS:For the Meta-analysis,13 studies involving 992 children with CVA were included.In terms of TER and Ig E,the experimental interventions of TCH,when compared with the control interventions of CM,on pediatric CVA were found to be significantly effective(P<0.0001),whereas for spirometry,PEF was not significantly improved in the TCH group(P=0.48).The incident rates of adverse drug reaction and relapse were found to be significantly lower in the TCH group than those in the CM group(P=0.02 and P<0.0001,respectively).CONCLUSION:Compared with CM therapy,the effects of TCH therapy on pediatric CVA were significantly beneficial in terms of TER and Ig E,but not for PEF,and the methodological quality of included studies was poor.Therefore,the results should be interpreted with caution.More randomized controlled trials with rigorous experimental methodologies are required for objectivity in the future.展开更多
BACKGROUND Cough variant asthma(CVA)is one of the most common respiratory diseases in children,which has a serious impact on the quality of life and daily activities of children.For severe CVA,immunomodulatory drugs a...BACKGROUND Cough variant asthma(CVA)is one of the most common respiratory diseases in children,which has a serious impact on the quality of life and daily activities of children.For severe CVA,immunomodulatory drugs are needed.AIM To evaluate the efficacy of salmeterol combined with budesonide in the treatment of pediatric CVA.METHODS 130 children with CVA from January 2020 to December 2022 were prospectively selected and randomly divided into an observation group(salmeterol combined with budesonide)and a control group(budesonide combined with a placebo).Compare the clinical efficacy of two groups before and after intervention.The evaluation parameters include cough frequency score,nocturnal cough arousal,and lung function indicators.Serum inflammatory markers,immune function markers and airway anatomical indicators were also measured.RESULTS After the intervention,the total effective rate of the observation group was significantly higher than that of the control group,and the cough frequency score and the night cough wake rate of the observation group were lower than that of the control group,with a statistically significant difference.In addition,the changes of lung function indicators,serum markers and immune function markers in the observation group were better than those in the control group.CONCLUSION The clinical efficacy of salmeterol combined with Budesonide in the treatment of CVA is better than that of Budesonide alone.展开更多
Objective:This study mainly explores the clinical effect of dispelling wind,eliminating lung and relieving cough combined with western medicine in the treatment of cough variant asthma.Methods:80 children with cough v...Objective:This study mainly explores the clinical effect of dispelling wind,eliminating lung and relieving cough combined with western medicine in the treatment of cough variant asthma.Methods:80 children with cough variant asthma accepted by our hospital from January 2018 to December 2020 were randomly selected for the study and divided into two groups.One group was the reference group(40 cases)treated with procaterol hydrochloride tablets and montelukast sodium,and the other group was the research group(40 cases)・The method of eliminating wind,eliminating lung and relieving cough was combined with procaterol hydrochloride tablets and montelukast sodium to observe and compare the curative effects of the two groups.Results:There was no significant difference in TCM symptom score and eosinophil(EOS)count between the two groups before treatment(P>0.05);After treatment,the TCM symptom scores of coughs,pharyngeal itching,expectoration,nasal congestion and nasal itching in the research group were lower than those in the reference group,and the EOS count was lower than that in the reference group(P<0.05);The effective rate of research group was higher than that of reference group(P<0.05).Conclusions:For children with cough variant asthma,Qufeng Sufei cough relieving method combined with procaterol hydrochloride and montelukast sodium can improve children's symptoms and reduce eosinophil count.展开更多
Objective:To observe the effect of vitaminD3 on airway inflammation and osteopontin(OPN)expression on cough variant asthma(CVA)models.Methods:SD rats were randomly divided into blank group,model group and treatment gr...Objective:To observe the effect of vitaminD3 on airway inflammation and osteopontin(OPN)expression on cough variant asthma(CVA)models.Methods:SD rats were randomly divided into blank group,model group and treatment group,each group with 10 rats.The CVA model was induced by intraperitoneal injection combined with aerosolized ovalbumin(OVA),the treatment group was given 100 mg/ml of vitaminD330 minutes before challenge by administered orally.Airway hyperreaction were measured by airway resistance after inhalation of acetylcholine(Ach).Wright-Gimsa staining was used to observe the inflammatory cells in bronchoalveolar lavage fluid(BALF).HE and PAS were used to observe the morphological changes of lung tissue.OPN expression was detected by immunohistochemistry.Results:1)Airway hyperreaction:airway resistance after inhalation Ach in model group and treatment group were significantly higher than that in blank group(P<0.01),airway resistance in treatment group were lower than that in model group(P<0.01);2)Classification of inflammatory cells:The percentage of macrophages,lymphocytes,neutrophils,and eosinophils in the BALF of the model group and the treatment group were increased compared with the blank group(P<0.01),furthermore,the number of treatment group were lower than the model group(P<0.05);3)Morphological changes of lung tissue:a large amount of inflammatory cells and goblet cell proliferation were observed in the lung tissue of the model group,and these changes were slight in treatment group compared with model group;OPN expression in lung tissue:The expression of OPN in model and treatment group were increased compared with blank group(P<0.05),and the treatment group was lower than that of model group(P<0.05).The OPN content was positively correlated with the percentage of inflammatory cells in BALF(P<0.05).Conclusions:Vitamin D3 can reduce airway hyperreaction and airway inflammation in CVA rats.The mechanism may be related to the intervention of OPN expression in lung tissue.展开更多
Objective:To investigate the mechanism of regulation of airway neurogenic inflammation by Qiaoqin Qingfei agent in rats with cough variant asthma(CVA).Methods:48 SD rats were randomly divided into blank group,model gr...Objective:To investigate the mechanism of regulation of airway neurogenic inflammation by Qiaoqin Qingfei agent in rats with cough variant asthma(CVA).Methods:48 SD rats were randomly divided into blank group,model group,montelukast sodium group(1.05 mg/kg)and high,medium and low dose groups(26,13,6.5 g/kg),with 8 rats in each group.The rat CVA model was established by the method of ovalbumin(OVA)combined with aluminum hydroxide(Al(OH)3)sensitization and repeated stimulation.From the second day of sensitization,the rat CVA model was given by gavage for 28 days.The pathological changes of lung tissue were observed under microscope by HE staining.The content changes of nerve growth factor(NGF)and substance P(SP)in alveolar lavage fluid(BALF)were determined by double-antibody sandwich ABC-ELISA,and the protein expression levels of NGF and SP in lung tissue were detected by immunohistochemistry.Results:Pathological findings showed significant inflammatory manifestations in the model group,and the inflammatory infiltration in the high-dose,medium-dose and low-dose groups of Qiaoqin Qingfei agent and montelukast sodium groups were alleviated to varying degrees.Compared with blank group,the protein expression levels of NGF and SP in lung tissue of model group were significantly increased(P<0.01).Compared with model group,the protein expression levels of NGF and SP in lung tissue and the contents of NGF and SP in alveolar lavage fluid in high-dose,medium-dose and low-dose groups and montelukast sodium group were significantly decreased(P<0.05).Conclusion:Qiaoqin Qingfei agent may reduce airway inflammation and relieve cough variant asthma by regulating the protein expression levels of NGF and SP in airway neurogenic inflammation.展开更多
Objective:To evaluate the therapeutic effect of Glycyrrhetinic Acid on cough variant asthma(CVA)mice and to investigate the possible mechanism in reducing lung inflammation.Methods:48 young female Balb/c mice were div...Objective:To evaluate the therapeutic effect of Glycyrrhetinic Acid on cough variant asthma(CVA)mice and to investigate the possible mechanism in reducing lung inflammation.Methods:48 young female Balb/c mice were divided into Control,CVA,Prednisone Acetate,Glycyrrhetinic Acid high-dose,Glycyrrhetinic Acid middle-dose and Glycyrrhetinic Acid lowdose groups randomly,with 8 mice in each group.The CVA mice model was established by ovalbumin(OVA)sensitization and OVA challenge,the animal asthma behavior was observed after drug administration,and the index of the lung of mice were recorded.The level of OVAsIgE in the bronchoalveolar lavage fluid(BALF)was tested by ELISA.The pathological changes of the lung tissue were observed by Hematoxylin and Eosin(H&E)staining.The protein expressions of T-bet,IFN-γ,Gata3,IL-4 and IL-13 in the lung tissue were determined by Western blot.Results:Compared with the CVA group,the index of lung of mice,the OVA-sIgE level in BALF and expression levels of Th2-related factor in the lung tissue of mice in Prednisone Acetate and Glycyrrhetinic Acid groups were significantly decreased(P<0.05 or P<0.01),the infiltration of inflammatory cells in the lung tissue was reduced,while expressions of Th1-related factor in the lung tissue was significantly increased(P<0.05 or P<0.01).Conclusion:Glycyrrhetinic acid has therapeutic effect on CVA mice,the underlying mechanism of Glycyrrhetinic acid alleviating lung impairment and airway inflammation may be associated with mediating the Th1/Th2 imbalance in the lung tissue.展开更多
Objective:A comprehensive and updated systematic review is needed to evaluate the effectiveness and safety of HuangQiXiXin decoction(HQXXD)for cough variant asthma(CVA).The aim of this systematic review protocol is to...Objective:A comprehensive and updated systematic review is needed to evaluate the effectiveness and safety of HuangQiXiXin decoction(HQXXD)for cough variant asthma(CVA).The aim of this systematic review protocol is to comprehensively assess the effectiveness and safety of HQXXD for CVA.Methods:An overall search for studies in main English and Chinese electronic databases from their inception to January 2021 will be performed.Randomized controlled trials regarding HQXXD for CVA will be included.We will use RevMan 5.3 software to perform statistical analysis and meta-analysis.Results:The findings of this systematic review will be disseminated through peer-reviewed publications.Conclusion:The systematic review will provide more evidence regarding the effectiveness and safety of HQXXD for CVA.展开更多
Objective: to observe the clinical therapeutic effect of "salbutamol and phenergan" in the implementation of "children with cough variant asthma" through clinical experiments. Methods: 100 children...Objective: to observe the clinical therapeutic effect of "salbutamol and phenergan" in the implementation of "children with cough variant asthma" through clinical experiments. Methods: 100 children with cough variant asthma admitted from June 2019 to May 2020 were selected as the object of this study combined with the clinical research subjects of children with cough variant asthma, and were simultaneously divided into the control group and the observation group, and the actual records of the observation and textual research of the disease conditions of the related 100 children were well recorded. Among them, the control group mainly adopts the conventional treatment management measures, while the observation group adopts the clinical treatment implementation plan of "salbutamol and phenergan" to further analyze the optimization effect of the two groups of children in clinical treatment. Results: from the change after treatment, the maximum expiratory flow rate in the observation group was (87.8 ± 4.1) L/min;The change of high expiratory flow rate in the control group was (84.0 ± 4.2) L/min, and the comparison between the two groups was statistically significant (P < 0.05). To sum up, the clinical observation of the actual situation of the treatment of the two groups of patients, of which the maximum group's total effective rate of 94% was significantly higher than the control group of 84%;At the same time, the incidence of treatment after three months was observed, among which the incidence of observation of the other side was 96%(48/50)/ that of the control group was 84%(42/50). There were statistically significant differences between the two groups in the comparison of clinical treatment effect and incidence, P < 0.05. Conclusion: The treatment scheme of salbutamol and phenergan is beneficial to the disease control of children with cough variant asthma, which not only improves the therapeutic effect, but also can prevent the recurrence of the disease, and is worthy of further promotion and application.展开更多
Objective:To observe the clinical efficacy of modified painless suppurative moxibustion with wheat-grain sized moxa cones plus Western medication in treating cough variant asthma(CVA)due to wind-cold attacking the lun...Objective:To observe the clinical efficacy of modified painless suppurative moxibustion with wheat-grain sized moxa cones plus Western medication in treating cough variant asthma(CVA)due to wind-cold attacking the lung and its effects on pulmonary function,serum immunoglobulin(Ig)-E,hypersensitive C-reactive protein(hs-CRP),and interleukin(IL)-6.Methods:A total of 98 CVA patients were randomly divided into an observation group and a control group using the random number table method,with 49 cases in each group.The control group was treated with salmeterol xinafoate and fluticasone propionate powder for inhalation,and the observation group was treated with additional modified painless suppurative moxibustion with wheat-grain sized moxa cones.The treatment lasted for 8 weeks.The traditional Chinese medicine(TCM)symptom score of the patients in both groups was observed before treatment,after treatment,and at 1-month follow-up after treatment for its changes.The clinical efficacy after treatment and at 1-month follow-up was compared between the two groups.The pulmonary function[forced expiratory volume in the first second(FEV1),FEV1/forced vital capacity(FVC),and peak expiratory flow(PEF)]and serum IgE,hs-CRP,and IL-6 levels were compared between the two groups before and after treatment.The adverse reactions that occurred during the treatment in both groups were observed and recorded.Results:The total effective rate of the observation group after treatment and at follow-up was higher than that of the control group(P<0.05).The TCM symptom scores in both groups after treatment and at follow-up were lower compared to the baseline(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).The FEV1,FEV1/FVC,and PEF after treatment in both groups were higher compared to the baseline(P<0.05),and the levels in the observation group were higher than those in the control group(P<0.05).The serum levels of IgE,IL-6,and hs-CRP after treatment in both groups were lower than the baseline(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).There were no adverse reactions in either group during the course of the study.Conclusion:Modified painless suppurative moxibustion with wheat-grain sized moxa cones plus salmeterol xinafoate and fluticasone propionate powder for inhalation is effective in treating CVA due to wind-cold attacking the lung;it can relieve the clinical symptoms of the patients,improve their pulmonary function,and also reduce serum IgE,hs-CRP,and IL-6 levels.展开更多
Cough variant asthma(CVA)in children primarily involves the lungs but is closely related to the heart,liver,spleen,and kidneys.The pathological factors are mainly wind,cold,and phlegm,with the fundamental pathogenesis...Cough variant asthma(CVA)in children primarily involves the lungs but is closely related to the heart,liver,spleen,and kidneys.The pathological factors are mainly wind,cold,and phlegm,with the fundamental pathogenesis characterized by yang deficiency.Persistent cold,hardened phlegm,and internal stagnation are often the underlying conditions.Clinically,the disease commonly presents as cold-fluid stagnation in the lungs,phlegm obstruction due to yang deficiency,and stubborn phlegm retention in the lungs.The primary treatment approach is using Shegan Mahuang Decoction to warm yang and dissolve retained fluid.A case study is attached as supporting evidence.展开更多
To observe the clinical efficacy and the change of airway responsiveness to Chinese medicine （CM） in treating cough variant asthma （CVA）. Methods： Ninety-four patients who had confirmed the diagnosis of CVA were ...To observe the clinical efficacy and the change of airway responsiveness to Chinese medicine （CM） in treating cough variant asthma （CVA）. Methods： Ninety-four patients who had confirmed the diagnosis of CVA were selected and randomly assigned to the treatment group and the control group by the blocked randomization method. The ratio of the two groups was 2：1. The treatment group had 63 patients that were treated by CM, lost in 10 cases, 53 patients had finished the trial. The control group had 31 patients that were treated by montelukast tablets and theophylline, lost in 5 cases, 26 patients had finished the trial, two weeks as one therapeutic course. The syndrome efficacy, cough efficacy, symptom score and the airway responsiveness between two groups were observed. Results： The comparison of the syndrome efficacy： the total effective rate of the treatment group was 90.57% and the control group was 76.92%, and the two groups were significantly different （P〈0.05）. The comparison of the cough efficacy： the total effective rate of the treatment group was 98.11% and the control group was 80.77%, and the two groups were also significantly different （P〈0.05）. Syndrome scoring and cough scoring were all significantly lowered, but the airway responsiveness was not significantly lowered. Conclusions： The treatment of CM could ease the cough, improve the syndrome, and shows obvious advantages compared with the control group, which is worthy of extensive clinical application.展开更多
Objective:To observe and evaluate the clinical efficacy and safety of using pediatric Tuina(Chinese therapeutic massage),Tui-Pushing chest-back manipulation,in treating children with cough variant asthma(CVA).Methods:...Objective:To observe and evaluate the clinical efficacy and safety of using pediatric Tuina(Chinese therapeutic massage),Tui-Pushing chest-back manipulation,in treating children with cough variant asthma(CVA).Methods:Seventy-two kids with CVA were divided into two groups using the random number table method,with 36 cases in each group.The control group received the conventional Tuina treatment,and the observation group received additional Tui-Pushing chest-back manipulation.The clinical efficacy and adverse reactions were observed and recorded for the two groups.Results:After three treatment courses,compared with the control group,the observation group showed advantages in the total effective rate,reducing the number and intensity of cough and improving the nature of cough(P<0.05).However,at the one-month follow-up,there were no significant differences between the two groups in these parameters(P>0.05).Regarding the adverse reaction rate,there was no significant between-group difference(P>0.05).Conclusion:It is effective and safe to use pediatric Tuina,Tui-Pushing chest-back manipulation,plus the conventional treatment protocol to treat CVA in children.展开更多
目的观察咳喘镇定汤在小儿咳嗽变异性哮喘治疗中的作用及对患儿嗜酸性粒细胞计数(eosinophil count,EOS)、白介素-23(interleukin-23,IL-23)/辅助性T细胞17(helper T cells17,Th17)轴的影响。方法选取2020年8月—2023年2月收治的小儿咳...目的观察咳喘镇定汤在小儿咳嗽变异性哮喘治疗中的作用及对患儿嗜酸性粒细胞计数(eosinophil count,EOS)、白介素-23(interleukin-23,IL-23)/辅助性T细胞17(helper T cells17,Th17)轴的影响。方法选取2020年8月—2023年2月收治的小儿咳嗽变异性哮喘患儿104例,将患儿采用简单随机法分为两组。常规组给予止咳化痰、抗炎、平喘等常规治疗,咳喘镇定汤组在常规组基础上采用咳喘镇定汤辅助治疗。检测组间及组内T淋巴亚群、EOS、巨噬细胞炎症蛋白-1α(macrophage inflammatory protein-1α,MIP-1α)、Clara细胞分泌蛋白16(clara cell secreted protein 16,CC-16)、嗜酸细胞活化趋化因子(Eotaxin)、IL-23/Th17轴、小气道功能水平。评估组间及组内咳嗽症状评分、中医证候评分差异。统计组间疗效和不良反应。结果治疗前T淋巴亚群、CC-16、Eotaxin等差异无统计学意义(P>0.05)。两组治疗后CD_(8)^(+)、EOS、MIP-1α、Eotaxin降低,CC-16、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)升高,咳喘镇定汤组治疗后CD_(8)^(+)、EOS、MIP-1α、Eotaxin低于常规组,CC-16、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)高于常规组(P<0.05)。治疗前比较IL-23/Th17轴差异无统计学意义(P>0.05)。两组治疗后IL-23、Th17、白介素-17(interleukin-17,IL-17)降低,咳喘镇定汤组治疗后IL-23/Th17轴低于常规组(P<0.05)。治疗前相关评分无差异(P>0.05)。两组治疗后咳嗽症状评分、中医证候评分降低,咳喘镇定汤组治疗后咳嗽症状评分、中医症候评分低于常规组(P<0.05)。治疗前小气道功能无差异(P>0.05)。两组治疗后小气道功能升高,咳喘镇定汤组治疗后小气道功能高于常规组(P<0.05)。咳喘镇定汤组治愈13例,显效和有效共35例,总有效率92.31%高于常规组,差异有统计学意义(P<0.05)。结论咳喘镇定汤可通过调控小儿咳嗽变异性哮喘患儿IL-23/Th17轴,改善T淋巴亚群和小气道功能,减轻咳嗽症状,提高疗效。展开更多
文摘Objective:To explore the presence of inflammatory memory in the lung tissue of mice with cough variant asthma(CVA)and the mechanism of Wuhu decoction in preventing and treating CVA.Methods:Among the 90 SPF-grade female BALB/c mice,20 were randomly selected as the blank group,while the remaining 70 were sensitized by intraperitoneal injection of ovalbumin(OVA)combined with aluminum hydroxide and then exposed to OVA by nebulization to establish the CVA mouse model.From the conctrol group and the model group,10 mice were randomly selected to detect airway responsiveness using an animal ventilator.Successfully modeled mice were then randomly divided into 7 groups:a CVA model group,a CVA re-challenge group,low-,medium-,and high-dose Wuhu decoction groups,and a positive control(dexamethasone)group,with 10 mice in each group.After 30 days of rest,except for the conctrol group and the model group,mice in the other groups underwent a second OVA nebulization challenge and received corresponding drug interventions once a day for 10 consecutive days before further analysis.Pathological changes in lung tissue were observed using periodic acid-schiff(PAS)and Masson staining methods.Serum levels of tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),interferon-γ(IFN-γ),and interleukin-10(IL-10)were detected using enzyme-linked immunosorbent assay(ELISA).The expression of T-bet mRNA and GATA-3 mRNA in lung tissue was determined by real-time quantitative polymerase chain reaction(Real-time PCR).Results:The results of airway responsiveness indicated successful establishment of the model.Compared with the control group,the model group exhibited severalkey pathological changes including inflammatory cellinfiltration around the lung tissue,epithelialmetaplasia,airway collagen deposition,increased airway mucus accumulation index and airway collagen deposition index(P<0.05),elevated serum TNF-αand IL-4 expression(P<0.05),decreased IFN-γand IL-10 levels(P<0.05),decreased T-bet mRNA levels(P<0.05),increased GATA-3 mRNA levels(P<0.05),and a reduced T-bet mRNA/GATA-3 mRNA ratio(P<0.05)in lung tissue.When compared to the CVA re-challenge group,the Wuhu decoction groups and the dexamethasone group effectively alleviated pathological changes in lung tissue,reduced the airway mucus accumulation index and airway collagen deposition index(P<0.05),decreased serum TNF-αand IL-4 expression(P<0.05),increased serum IFN-γand IL-10 levels(P<0.05),upregulated T-bet mRNA levels(P<0.05),downregulated GATA-3 mRNA levels(P<0.05),and increased the T-bet mRNA/GATA-3 mRNA ratio(P<0.05)in lung tissue.Conclusion:The lung tissue of mice with cough variant asthma exhibits inflammatory memory,and Wuhu decoction may intervene in this inflammatory memory by restoring the balance between T-bet and GATA-3,thereby correcting the imbalance in Th1/Th2 immunity and exerting a preventive and therapeutic effect on cough variant asthma.
文摘OBJECTIVE:To systematically investigate the clinical effectiveness and safety of traditional Chinese herbs(TCHs)as an alternative to conventional medicine(CM)in children with cough variant asthma(CVA).METHODS:Randomized controlled trial(RCT)studies that were published from their inceptions to March 31,2020,were identified from the electronic databases of China National Knowledge Infrastructure,Wangfang,Pub Med,and Cochrane Central Library.The primary outcome of the review was the total effective rate(TER),and the secondary outcomes were immunoglobulin E(Ig E),peak expiratory flow(PEF),adverse drug reactions,and relapse rates of interventions.RESULTS:For the Meta-analysis,13 studies involving 992 children with CVA were included.In terms of TER and Ig E,the experimental interventions of TCH,when compared with the control interventions of CM,on pediatric CVA were found to be significantly effective(P<0.0001),whereas for spirometry,PEF was not significantly improved in the TCH group(P=0.48).The incident rates of adverse drug reaction and relapse were found to be significantly lower in the TCH group than those in the CM group(P=0.02 and P<0.0001,respectively).CONCLUSION:Compared with CM therapy,the effects of TCH therapy on pediatric CVA were significantly beneficial in terms of TER and Ig E,but not for PEF,and the methodological quality of included studies was poor.Therefore,the results should be interpreted with caution.More randomized controlled trials with rigorous experimental methodologies are required for objectivity in the future.
文摘BACKGROUND Cough variant asthma(CVA)is one of the most common respiratory diseases in children,which has a serious impact on the quality of life and daily activities of children.For severe CVA,immunomodulatory drugs are needed.AIM To evaluate the efficacy of salmeterol combined with budesonide in the treatment of pediatric CVA.METHODS 130 children with CVA from January 2020 to December 2022 were prospectively selected and randomly divided into an observation group(salmeterol combined with budesonide)and a control group(budesonide combined with a placebo).Compare the clinical efficacy of two groups before and after intervention.The evaluation parameters include cough frequency score,nocturnal cough arousal,and lung function indicators.Serum inflammatory markers,immune function markers and airway anatomical indicators were also measured.RESULTS After the intervention,the total effective rate of the observation group was significantly higher than that of the control group,and the cough frequency score and the night cough wake rate of the observation group were lower than that of the control group,with a statistically significant difference.In addition,the changes of lung function indicators,serum markers and immune function markers in the observation group were better than those in the control group.CONCLUSION The clinical efficacy of salmeterol combined with Budesonide in the treatment of CVA is better than that of Budesonide alone.
文摘Objective:This study mainly explores the clinical effect of dispelling wind,eliminating lung and relieving cough combined with western medicine in the treatment of cough variant asthma.Methods:80 children with cough variant asthma accepted by our hospital from January 2018 to December 2020 were randomly selected for the study and divided into two groups.One group was the reference group(40 cases)treated with procaterol hydrochloride tablets and montelukast sodium,and the other group was the research group(40 cases)・The method of eliminating wind,eliminating lung and relieving cough was combined with procaterol hydrochloride tablets and montelukast sodium to observe and compare the curative effects of the two groups.Results:There was no significant difference in TCM symptom score and eosinophil(EOS)count between the two groups before treatment(P>0.05);After treatment,the TCM symptom scores of coughs,pharyngeal itching,expectoration,nasal congestion and nasal itching in the research group were lower than those in the reference group,and the EOS count was lower than that in the reference group(P<0.05);The effective rate of research group was higher than that of reference group(P<0.05).Conclusions:For children with cough variant asthma,Qufeng Sufei cough relieving method combined with procaterol hydrochloride and montelukast sodium can improve children's symptoms and reduce eosinophil count.
基金Sichuan provincial cadre health-care project(2017-1601)Nanchong municipal strategic cooperation projects in science and technology(18SXHZ0301,18SXHZ0300)
文摘Objective:To observe the effect of vitaminD3 on airway inflammation and osteopontin(OPN)expression on cough variant asthma(CVA)models.Methods:SD rats were randomly divided into blank group,model group and treatment group,each group with 10 rats.The CVA model was induced by intraperitoneal injection combined with aerosolized ovalbumin(OVA),the treatment group was given 100 mg/ml of vitaminD330 minutes before challenge by administered orally.Airway hyperreaction were measured by airway resistance after inhalation of acetylcholine(Ach).Wright-Gimsa staining was used to observe the inflammatory cells in bronchoalveolar lavage fluid(BALF).HE and PAS were used to observe the morphological changes of lung tissue.OPN expression was detected by immunohistochemistry.Results:1)Airway hyperreaction:airway resistance after inhalation Ach in model group and treatment group were significantly higher than that in blank group(P<0.01),airway resistance in treatment group were lower than that in model group(P<0.01);2)Classification of inflammatory cells:The percentage of macrophages,lymphocytes,neutrophils,and eosinophils in the BALF of the model group and the treatment group were increased compared with the blank group(P<0.01),furthermore,the number of treatment group were lower than the model group(P<0.05);3)Morphological changes of lung tissue:a large amount of inflammatory cells and goblet cell proliferation were observed in the lung tissue of the model group,and these changes were slight in treatment group compared with model group;OPN expression in lung tissue:The expression of OPN in model and treatment group were increased compared with blank group(P<0.05),and the treatment group was lower than that of model group(P<0.05).The OPN content was positively correlated with the percentage of inflammatory cells in BALF(P<0.05).Conclusions:Vitamin D3 can reduce airway hyperreaction and airway inflammation in CVA rats.The mechanism may be related to the intervention of OPN expression in lung tissue.
基金Research Project of Guangdong Provincial Bureau of Traditional Chinese Medicine(No.20222183,20221320)Guangzhou Traditional Chinese Medicine and Integrated Traditional Chinese and Western Medicine Technology Project(No.20222A010020)。
文摘Objective:To investigate the mechanism of regulation of airway neurogenic inflammation by Qiaoqin Qingfei agent in rats with cough variant asthma(CVA).Methods:48 SD rats were randomly divided into blank group,model group,montelukast sodium group(1.05 mg/kg)and high,medium and low dose groups(26,13,6.5 g/kg),with 8 rats in each group.The rat CVA model was established by the method of ovalbumin(OVA)combined with aluminum hydroxide(Al(OH)3)sensitization and repeated stimulation.From the second day of sensitization,the rat CVA model was given by gavage for 28 days.The pathological changes of lung tissue were observed under microscope by HE staining.The content changes of nerve growth factor(NGF)and substance P(SP)in alveolar lavage fluid(BALF)were determined by double-antibody sandwich ABC-ELISA,and the protein expression levels of NGF and SP in lung tissue were detected by immunohistochemistry.Results:Pathological findings showed significant inflammatory manifestations in the model group,and the inflammatory infiltration in the high-dose,medium-dose and low-dose groups of Qiaoqin Qingfei agent and montelukast sodium groups were alleviated to varying degrees.Compared with blank group,the protein expression levels of NGF and SP in lung tissue of model group were significantly increased(P<0.01).Compared with model group,the protein expression levels of NGF and SP in lung tissue and the contents of NGF and SP in alveolar lavage fluid in high-dose,medium-dose and low-dose groups and montelukast sodium group were significantly decreased(P<0.05).Conclusion:Qiaoqin Qingfei agent may reduce airway inflammation and relieve cough variant asthma by regulating the protein expression levels of NGF and SP in airway neurogenic inflammation.
基金National Natural Science Foundation of China (No.81960887)Innovation Project of Guangxi Graduate Education (No.YCXJ2021119)。
文摘Objective:To evaluate the therapeutic effect of Glycyrrhetinic Acid on cough variant asthma(CVA)mice and to investigate the possible mechanism in reducing lung inflammation.Methods:48 young female Balb/c mice were divided into Control,CVA,Prednisone Acetate,Glycyrrhetinic Acid high-dose,Glycyrrhetinic Acid middle-dose and Glycyrrhetinic Acid lowdose groups randomly,with 8 mice in each group.The CVA mice model was established by ovalbumin(OVA)sensitization and OVA challenge,the animal asthma behavior was observed after drug administration,and the index of the lung of mice were recorded.The level of OVAsIgE in the bronchoalveolar lavage fluid(BALF)was tested by ELISA.The pathological changes of the lung tissue were observed by Hematoxylin and Eosin(H&E)staining.The protein expressions of T-bet,IFN-γ,Gata3,IL-4 and IL-13 in the lung tissue were determined by Western blot.Results:Compared with the CVA group,the index of lung of mice,the OVA-sIgE level in BALF and expression levels of Th2-related factor in the lung tissue of mice in Prednisone Acetate and Glycyrrhetinic Acid groups were significantly decreased(P<0.05 or P<0.01),the infiltration of inflammatory cells in the lung tissue was reduced,while expressions of Th1-related factor in the lung tissue was significantly increased(P<0.05 or P<0.01).Conclusion:Glycyrrhetinic acid has therapeutic effect on CVA mice,the underlying mechanism of Glycyrrhetinic acid alleviating lung impairment and airway inflammation may be associated with mediating the Th1/Th2 imbalance in the lung tissue.
基金supported by the Scientific Research Project from the Health Commission of Wuxi(No.Q202055)Project of Clinical Research and Preparation in Jiangyin Hospital of Traditional Chinese Medicine(No.Z202109).
文摘Objective:A comprehensive and updated systematic review is needed to evaluate the effectiveness and safety of HuangQiXiXin decoction(HQXXD)for cough variant asthma(CVA).The aim of this systematic review protocol is to comprehensively assess the effectiveness and safety of HQXXD for CVA.Methods:An overall search for studies in main English and Chinese electronic databases from their inception to January 2021 will be performed.Randomized controlled trials regarding HQXXD for CVA will be included.We will use RevMan 5.3 software to perform statistical analysis and meta-analysis.Results:The findings of this systematic review will be disseminated through peer-reviewed publications.Conclusion:The systematic review will provide more evidence regarding the effectiveness and safety of HQXXD for CVA.
文摘Objective: to observe the clinical therapeutic effect of "salbutamol and phenergan" in the implementation of "children with cough variant asthma" through clinical experiments. Methods: 100 children with cough variant asthma admitted from June 2019 to May 2020 were selected as the object of this study combined with the clinical research subjects of children with cough variant asthma, and were simultaneously divided into the control group and the observation group, and the actual records of the observation and textual research of the disease conditions of the related 100 children were well recorded. Among them, the control group mainly adopts the conventional treatment management measures, while the observation group adopts the clinical treatment implementation plan of "salbutamol and phenergan" to further analyze the optimization effect of the two groups of children in clinical treatment. Results: from the change after treatment, the maximum expiratory flow rate in the observation group was (87.8 ± 4.1) L/min;The change of high expiratory flow rate in the control group was (84.0 ± 4.2) L/min, and the comparison between the two groups was statistically significant (P < 0.05). To sum up, the clinical observation of the actual situation of the treatment of the two groups of patients, of which the maximum group's total effective rate of 94% was significantly higher than the control group of 84%;At the same time, the incidence of treatment after three months was observed, among which the incidence of observation of the other side was 96%(48/50)/ that of the control group was 84%(42/50). There were statistically significant differences between the two groups in the comparison of clinical treatment effect and incidence, P < 0.05. Conclusion: The treatment scheme of salbutamol and phenergan is beneficial to the disease control of children with cough variant asthma, which not only improves the therapeutic effect, but also can prevent the recurrence of the disease, and is worthy of further promotion and application.
文摘Objective:To observe the clinical efficacy of modified painless suppurative moxibustion with wheat-grain sized moxa cones plus Western medication in treating cough variant asthma(CVA)due to wind-cold attacking the lung and its effects on pulmonary function,serum immunoglobulin(Ig)-E,hypersensitive C-reactive protein(hs-CRP),and interleukin(IL)-6.Methods:A total of 98 CVA patients were randomly divided into an observation group and a control group using the random number table method,with 49 cases in each group.The control group was treated with salmeterol xinafoate and fluticasone propionate powder for inhalation,and the observation group was treated with additional modified painless suppurative moxibustion with wheat-grain sized moxa cones.The treatment lasted for 8 weeks.The traditional Chinese medicine(TCM)symptom score of the patients in both groups was observed before treatment,after treatment,and at 1-month follow-up after treatment for its changes.The clinical efficacy after treatment and at 1-month follow-up was compared between the two groups.The pulmonary function[forced expiratory volume in the first second(FEV1),FEV1/forced vital capacity(FVC),and peak expiratory flow(PEF)]and serum IgE,hs-CRP,and IL-6 levels were compared between the two groups before and after treatment.The adverse reactions that occurred during the treatment in both groups were observed and recorded.Results:The total effective rate of the observation group after treatment and at follow-up was higher than that of the control group(P<0.05).The TCM symptom scores in both groups after treatment and at follow-up were lower compared to the baseline(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).The FEV1,FEV1/FVC,and PEF after treatment in both groups were higher compared to the baseline(P<0.05),and the levels in the observation group were higher than those in the control group(P<0.05).The serum levels of IgE,IL-6,and hs-CRP after treatment in both groups were lower than the baseline(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).There were no adverse reactions in either group during the course of the study.Conclusion:Modified painless suppurative moxibustion with wheat-grain sized moxa cones plus salmeterol xinafoate and fluticasone propionate powder for inhalation is effective in treating CVA due to wind-cold attacking the lung;it can relieve the clinical symptoms of the patients,improve their pulmonary function,and also reduce serum IgE,hs-CRP,and IL-6 levels.
基金supported by the Henan Traditional Chinese Medicine Elite Talent Project(Yu Wei Traditional Chinese Medicine Letter[2021]No.15).
文摘Cough variant asthma(CVA)in children primarily involves the lungs but is closely related to the heart,liver,spleen,and kidneys.The pathological factors are mainly wind,cold,and phlegm,with the fundamental pathogenesis characterized by yang deficiency.Persistent cold,hardened phlegm,and internal stagnation are often the underlying conditions.Clinically,the disease commonly presents as cold-fluid stagnation in the lungs,phlegm obstruction due to yang deficiency,and stubborn phlegm retention in the lungs.The primary treatment approach is using Shegan Mahuang Decoction to warm yang and dissolve retained fluid.A case study is attached as supporting evidence.
基金Supported by the Third Advantage Project of Xiyuan Hospital of China Academy of Chinese Medical Sciences(No. CACMS08Y0033)
文摘To observe the clinical efficacy and the change of airway responsiveness to Chinese medicine （CM） in treating cough variant asthma （CVA）. Methods： Ninety-four patients who had confirmed the diagnosis of CVA were selected and randomly assigned to the treatment group and the control group by the blocked randomization method. The ratio of the two groups was 2：1. The treatment group had 63 patients that were treated by CM, lost in 10 cases, 53 patients had finished the trial. The control group had 31 patients that were treated by montelukast tablets and theophylline, lost in 5 cases, 26 patients had finished the trial, two weeks as one therapeutic course. The syndrome efficacy, cough efficacy, symptom score and the airway responsiveness between two groups were observed. Results： The comparison of the syndrome efficacy： the total effective rate of the treatment group was 90.57% and the control group was 76.92%, and the two groups were significantly different （P〈0.05）. The comparison of the cough efficacy： the total effective rate of the treatment group was 98.11% and the control group was 80.77%, and the two groups were also significantly different （P〈0.05）. Syndrome scoring and cough scoring were all significantly lowered, but the airway responsiveness was not significantly lowered. Conclusions： The treatment of CM could ease the cough, improve the syndrome, and shows obvious advantages compared with the control group, which is worthy of extensive clinical application.
文摘Objective:To observe and evaluate the clinical efficacy and safety of using pediatric Tuina(Chinese therapeutic massage),Tui-Pushing chest-back manipulation,in treating children with cough variant asthma(CVA).Methods:Seventy-two kids with CVA were divided into two groups using the random number table method,with 36 cases in each group.The control group received the conventional Tuina treatment,and the observation group received additional Tui-Pushing chest-back manipulation.The clinical efficacy and adverse reactions were observed and recorded for the two groups.Results:After three treatment courses,compared with the control group,the observation group showed advantages in the total effective rate,reducing the number and intensity of cough and improving the nature of cough(P<0.05).However,at the one-month follow-up,there were no significant differences between the two groups in these parameters(P>0.05).Regarding the adverse reaction rate,there was no significant between-group difference(P>0.05).Conclusion:It is effective and safe to use pediatric Tuina,Tui-Pushing chest-back manipulation,plus the conventional treatment protocol to treat CVA in children.
文摘目的观察咳喘镇定汤在小儿咳嗽变异性哮喘治疗中的作用及对患儿嗜酸性粒细胞计数(eosinophil count,EOS)、白介素-23(interleukin-23,IL-23)/辅助性T细胞17(helper T cells17,Th17)轴的影响。方法选取2020年8月—2023年2月收治的小儿咳嗽变异性哮喘患儿104例,将患儿采用简单随机法分为两组。常规组给予止咳化痰、抗炎、平喘等常规治疗,咳喘镇定汤组在常规组基础上采用咳喘镇定汤辅助治疗。检测组间及组内T淋巴亚群、EOS、巨噬细胞炎症蛋白-1α(macrophage inflammatory protein-1α,MIP-1α)、Clara细胞分泌蛋白16(clara cell secreted protein 16,CC-16)、嗜酸细胞活化趋化因子(Eotaxin)、IL-23/Th17轴、小气道功能水平。评估组间及组内咳嗽症状评分、中医证候评分差异。统计组间疗效和不良反应。结果治疗前T淋巴亚群、CC-16、Eotaxin等差异无统计学意义(P>0.05)。两组治疗后CD_(8)^(+)、EOS、MIP-1α、Eotaxin降低,CC-16、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)升高,咳喘镇定汤组治疗后CD_(8)^(+)、EOS、MIP-1α、Eotaxin低于常规组,CC-16、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)高于常规组(P<0.05)。治疗前比较IL-23/Th17轴差异无统计学意义(P>0.05)。两组治疗后IL-23、Th17、白介素-17(interleukin-17,IL-17)降低,咳喘镇定汤组治疗后IL-23/Th17轴低于常规组(P<0.05)。治疗前相关评分无差异(P>0.05)。两组治疗后咳嗽症状评分、中医证候评分降低,咳喘镇定汤组治疗后咳嗽症状评分、中医症候评分低于常规组(P<0.05)。治疗前小气道功能无差异(P>0.05)。两组治疗后小气道功能升高,咳喘镇定汤组治疗后小气道功能高于常规组(P<0.05)。咳喘镇定汤组治愈13例,显效和有效共35例,总有效率92.31%高于常规组,差异有统计学意义(P<0.05)。结论咳喘镇定汤可通过调控小儿咳嗽变异性哮喘患儿IL-23/Th17轴,改善T淋巴亚群和小气道功能,减轻咳嗽症状,提高疗效。
