Clinical Efficacy and Mechanism of Quyu Qingjintang on Stroke Complicated with Lung Infection with Phlegm-heat Accumulation Lung Syndrome and Blood Stasis Syndrome / 中国实验方剂学杂志

Objective:To explore the clinical efficacy and mechanism of Quyu Qingjintang in the treatment of stroke complicated with lung infection （SCLI） with phlegm-heat accumulation lung syndrome and blood stasis syndrome. Method:The 60 patients with SCLI with phlegm-heat accumulation lung syndrome and blood stasis syndrome were selected and divided into control group （30 cases） and observation group （30 cases）. The patients in both groups received basic treatments such as thrombolysis and anticoagulation， and were injected with imipenem cilastatin sodium and ambroxol hydrochloride. The patients in control group additionally received Tanreqing capsule on the basis of the conventional treatment while those in observation group were additionally treated with Quyu Qingjintang on the basis of the conventional treatment. The clinical efficacy， lung function， inflammatory factor levels， time to symptoms disappearance， haptoglobin （HPT） and amyloid A （SAA） levels， T lymphocyte subset level and safety index were compared between two groups. Result:The total effective rate was 93.33% （28/30） in observation group， significantly higher than 70.00% （21/30） in control group （<italic>χ²=</italic>5.450， <italic>P</italic><0.05）. After treatment， the symptoms of both groups were improved （<italic>P</italic><0.05）. The scores of fever， cough， wheezing， and expectoration in observation group were lower than those in control group （<italic>P</italic><0.05）. The levels of interleukin-6（IL-6）， white blood cell（WBC）， procalcitonin（PCT）， C-reactive protein（CRP）， HPT， and SAA in observation group were significantly lower than those in control group （<italic>P</italic><0.05）. The forced expiratory volume in one second （FEV₁）， forced vital capacity （FVC） and peak expiratory flow rate （PEF） in observation group were better than those in control group （<italic>P</italic><0.05）. The levels of CD3⁺， CD4⁺， CD4⁺/CD8⁺ in observation group were significantly higher than those in control group （<italic>P</italic><0.05）. The recovery time of WBC count， hospitalization time， lung rales， the time to fever and cough disappearance in observation group were lower than those in control group （<italic>P</italic><0.05）， no serious adverse reactions occurred in two groups. Conclusion:Quyu Qingjintang in the treatment of stroke complicated with lung infection with phlegm-heat accumulation lung syndrome and blood stasis syndrome can significantly improve the treatment efficiency， improve the symptoms of pulmonary infection， reduce the level of inflammatory factors， and improve lung function， with less adverse reactions and high safety， so it is worthy of clinical application.

Clinical Efficacy of Modified Qingjin Huatan Tang on Bronchiectasis with Syndrome of Phlegm-heat Accumulating Lung at Acute Exacerbation / 中国实验方剂学杂志

<b>Objective::To observe the clinical efficacy of modified Qingjin Huatan Tang on bronchiectasis with syndrome of phlegm-heat accumulating lung at acute exacerbation and its inhibitory effect on pro-inflammatory factors and proteolytic activity. <b>Method::One hundred and thirty patients were randomly divided into control group and observation group by random number table. Patients in control group got tazobactam sodium and piperacillin sodium for injection, 3.375 g/time, 1 time/6 hours, and the types of antibiotics were regulated according to the bacterial culture results. And patients in control group also got Ambroxol Hydrochloride injection, 30 mg/time, 2 time/days, and postural drainage. In addition to the therapy of control group, patients in observation group were also given modified Qingjin Huatan Tang, 1 dose/day. Before and after treatment, symptoms and signs were scored. And levels of white blood cell count (WBC), neutrophile granulocyte (GRAN), C-reactive protein (CRP), procalcitonin (PCT) were detected. And scores of forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), peak expiratory flow rate (PEFR) and BODE were graded. And levels of tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), interleukin-4 (IL-4), IL-6 and IL-8 in sputum, peripheral neutrophil elastase (NE) and cathepsin G were detected. <b>Result::By rank sum test, the clinical efficacy in observation group was better than that in control group (Z=2.086, <italic>P</italic><0.05), while scores of symptoms and signs in observation group were lower than those in control group (<italic>P</italic><0.01). WBC, GRAN, CRP, PCT, airflow limitation (O), dyspnea (D), motor ability (E) score, BODE index, TNF-<italic>α</italic>, IL-4, IL-6, IL-8, plasma NE and cathepsin G were all lower than those in control group (<italic>P</italic><0.01). And levels of FEV₁, FVC, PEF and FEV₁/FVC were higher than those in control group (<italic>P</italic><0.01). <b>Conclusion::In addition to routine anti-infection and expectoration western medicine therapy, modified Qingjin Huatan Tang can be added to control symptoms and signs, alleviate the degree of illness, improve pulmonary function and the quality of life of patients, and inhibit expression of airway pro-inflammatory factor and proteolysis, with a better clinical efficacy than pure western medicine.

Effect of Yuebi Jia Banxiatang on Inflammatory Markers and Prognosis of Patients with Community Acquired Pneumonia in Old People / 中国实验方剂学杂志

Objective:To observe the efficacy of Yuebi Jia Banxiatang on old patients with community acquired pneumonia （CAP） combined with syndrome of phlegm heat damming lung， and observe effect on inflammatory markers and prognosis. Method:A total of 120 patients with CAP were randomly divided into control group （60 cases） and observation group （60 cases） by random number table. In control group， 55 patients finished the therapy （3 patients fell off or were lost to follow-up， 2 were eliminated）， 55 patients in observation group completed the therapy （5 patients fell off or were lost to follow-up）. Both groups' patients got anti-infection and other comprehensive therapies. Patients in control group got Feilike mixture， 20 mL/time， 3 times/day. Patients in observation group obtained Yuebi Jia Banxiatang， 1 dose/day. The course of treatment for the two groups continued for 10 days. Antipyretic time and antipyretic rate at the 5th day after treatment， relief time of cough， expectoration and lung rale were recorded. And clinical pulmonary infection score （CPSI）， time （CPSI<6） and time to stop antibiotics were recorded. Before and after treatment， syndrome of phlegm heat damming lung was scored， and failure of initial treatment was also recorded. Levels of procalcitonin （PCT）， red blood cell volume distribution wid （RDW）， D-dimer （D-D） and synpeptin， high sensitivity C-reactive protein （hs-CRP）， tumor necrosis factor-α （TNF-α）， interleukin （IL-1β） and IL-6 were measured. Recurrence rate of chest radiograph was recorded， and safety was evaluated. Result:Relief time of antipyretic， cough， expectoration and lung rale in observation group were less than those in control group （P<0.01）. Antipyretic rate at the 5th day after treatment， antibiotic discontinuation rate， recurrence rate of chest radiograph were 85.45% （47/55）， 94.55% （52/55） and 90.91% （50/55）， which were higher than 65.45% （36/55）， 81.82% （45/55） and 74.55% （45/55） in control group. And initial treatment failure rate was 5.54% （3/55）， which was lower than 20.00% （11/55） in control group （P<0.05）. Scores of CPSI and syndrome of phlegm heat damming lung were less than those in control group （P<0.01）. And levels of PCT， RDW， D-D， peptide， hs-CRP， TNF-α， IL-1β and IL-6 were all below the level in control group （P<0.01）. Total effective rate of traditional Chinese medicine （TCM） syndrome was 96.36% （53/55）， which was higher than 83.64% （46/55） in control group （χ2=4.949， P<0.05）. And there was no adverse reactions relating to traditional Chinese medicine. Conclusion:In addition to anti-infection and other comprehensive therapies， Yuebi Jia Banxiatang can control the clinical symptoms， reduce the degree of pulmonary infection and disease， control the inflammatory reaction， shorten the course of disease and improve the prognosis， with a significant effect and safety in clinical use.