CN109646605B - Traditional Chinese medicine composition for treating pulmonary interstitial fibrosis, traditional Chinese medicine decoction-free granules and application - Google Patents

Traditional Chinese medicine composition for treating pulmonary interstitial fibrosis, traditional Chinese medicine decoction-free granules and application Download PDF

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CN109646605B
CN109646605B CN201910092959.5A CN201910092959A CN109646605B CN 109646605 B CN109646605 B CN 109646605B CN 201910092959 A CN201910092959 A CN 201910092959A CN 109646605 B CN109646605 B CN 109646605B
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interstitial fibrosis
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李猛
马战平
王志梅
黄刚
山萌
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Shaanxi Traditional Chinese Medicine Hospital
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Abstract

The invention relates to a traditional Chinese medicine composition for treating pulmonary interstitial fibrosis, traditional Chinese medicine decoction-free granules and application, and belongs to the technical field of traditional Chinese medicines. The traditional Chinese medicine composition is prepared from the following raw material medicines in parts by weight: 9-30 parts of raw astragalus, 9-15 parts of codonopsis pilosula, 6-12 parts of radix ophiopogonis, 10-15 parts of white gourd seed, 10-15 parts of reed rhizome, 9-30 parts of raw coix seed, 5-10 parts of peach kernel, 6-15 parts of honeysuckle, 6-15 parts of angelica and 2-6 parts of raw liquorice. The traditional Chinese medicine decoction-free granules consist of single traditional Chinese medicine formula granules in parts by weight. Application of Chinese medicinal composition and Chinese medicinal decoction-free granule in preparing medicine for treating pulmonary interstitial fibrosis is provided. The invention has the following advantages: replenishing qi, nourishing yin, eliminating phlegm, and removing blood stasis; has antiinflammatory, antioxidant, anti-angiogenesis, anticoagulant, antithrombotic, and platelet aggregation inhibiting effects; has the function of regulating the immunity of the organism.

Description

Traditional Chinese medicine composition for treating pulmonary interstitial fibrosis, traditional Chinese medicine decoction-free granules and application
Technical Field
The invention belongs to the technical field of traditional Chinese medicines, and particularly relates to a traditional Chinese medicine composition for treating pulmonary interstitial fibrosis, a traditional Chinese medicine decoction-free granule and application thereof.
Background
Pulmonary Interstitial Fibrosis (PIF) is a fatal diffuse lung disease that involves progressive exacerbation of pulmonary interstitium, alveoli and/or bronchioles, and is clinically characterized by imaging diffuse lung lesions, hypoxemia, lung function-restricted ventilation disorder and diffuse function reduction, and clinically manifested by progressive dyspnea, shortness of breath, dry cough and the like, and finally patients die due to respiratory failure. The pulmonary interstitial fibrosis is divided into two main categories, namely Idiopathic Pulmonary Fibrosis (IPF) is the most common clinical one, and the etiology and pathogenesis are not clear; secondary pulmonary fibrosis is usually secondary to immune system diseases such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma, sicca syndrome and the like. The patient has unbalanced blood coagulation-fibrinolysis system, and the high coagulation state and the continuous fibrin deposition are important factors for the disease formation. Various effector cells are stimulated to release a plurality of inflammatory mediators after the body is infected and wounded, excessive inflammatory reaction is generated, the lung vascular endothelial cells and the alveolar epithelium are widely damaged to cause lung injury, the tissue factor expression can be up-regulated, and an extrinsic coagulation mechanism is activated; the alveolar epithelial cell necrosis can down-regulate the expression of thrombomodulin, inhibit the activation of Protein C (PC) and Protein S (PS) systems, lead the coagulation factor IXa-Xa to be incapable of degrading and promote the formation of a PC pathway hypercoagulative state; the blood coagulation factor VIIa-Xa complex on the surface of the abnormally activated alveolar epithelial cells can not only induce thrombin formation, but also activate and activate differentiation into fibroblasts to generate a profibrotic effect. In addition, a large number of fibroblast growth factors and growth factors, such as transforming growth factor beta 1 (TGF-beta 1), platelet-derived growth factor, vascular endothelial growth factor, etc., can cause fibroblast proliferation and differentiation, ultimately leading to chronic lung interstitial fibrosis.
The Western medicine for treating the pulmonary interstitial fibrosis recommends the use of pirfenidone, nintedanib and antacid medicines, and can also be used for treating by methods such as oxygen therapy, mechanical ventilation, lung rehabilitation, lung transplantation and the like, but the clinical curative effect, safety, adaptation symptoms and the like of the Western medicine need to be further evaluated, and the Western medicine is high in price and is easy to have adverse reactions such as liver enzyme rise, light allergy, skin rash, weakness, osteoporosis, gastrointestinal disorder and the like. The western medicine treatment is summarized as follows: the medicine is basically unavailable.
Disclosure of Invention
The pulmonary interstitial fibrosis belongs to the categories of 'consumptive lung disease', 'pulmonary paralysis', 'asthma syndrome', 'cough' and the like in the traditional Chinese medicine, the disease position is mainly in the lung, is related to the spleen, reaches the kidney for a long time, is mostly generated in the old or people with weak constitution, and can not be driven out by pathogenic factors after being infected, so that the pathogenic factors are interwoven, lingering and difficult to heal, and phlegm and blood stasis are combined to cause continuous pathological damage. The struggle between vital qi and pathogens to lose lung qi and lung yin, which may lead to the development of yin deficiency with effulgent fire or qi and yin deficiency; or lung dryness and fluid consumption, which leads to lung withering and withering. Therefore, "deficiency of both qi and yin and accumulation of phlegm-dampness and blood stasis" are the basic pathogenesis of the disease. The disease is caused by deficiency of the essence and excess of the essence, the deficiency of the lung, spleen and kidney, the turbid phlegm and blood stasis as the symptoms, and the blood stasis and phlegm as both pathological products and important pathogenic factors, so the clinical treatment needs to combine deficiency tonifying with blood circulation promoting and phlegm resolving. A large number of researches show that the traditional Chinese medicine has the effects of integrally thinking and dialectically treating, tonifying qi, nourishing yin, strengthening spleen, reducing phlegm, tonifying kidney, promoting blood circulation, removing blood stasis, dredging collaterals and the like, can effectively improve the clinical symptoms of patients, improve the living quality of the patients, delay the progress of diseases and reduce the death rate of the diseases.
The invention aims to disclose a traditional Chinese medicine composition for treating pulmonary interstitial fibrosis.
The second purpose of the invention is to disclose the application of the traditional Chinese medicine composition.
The third purpose of the invention is to disclose a traditional Chinese medicine decoction-free granule for treating pulmonary interstitial fibrosis.
The fourth purpose of the invention is to disclose the application of the Chinese medicinal decoction-free granules.
The purpose of the invention is realized by the following technical scheme:
a traditional Chinese medicine composition for treating pulmonary interstitial fibrosis is prepared from the following raw material medicines in parts by weight: 9-30 parts of raw astragalus, 9-15 parts of codonopsis pilosula, 6-12 parts of radix ophiopogonis, 10-15 parts of white gourd seed, 10-15 parts of reed rhizome, 9-30 parts of raw coix seed, 5-10 parts of peach kernel, 6-15 parts of honeysuckle, 6-15 parts of angelica and 2-6 parts of raw liquorice.
The traditional Chinese medicine composition of the technical scheme is characterized in that the traditional Chinese medicine composition comprises the following raw material medicines in parts by weight: 30 parts of raw astragalus, 15 parts of codonopsis pilosula, 12 parts of dwarf lilyturf tuber, 15 parts of white gourd seed, 15 parts of reed rhizome, 30 parts of raw coix seed, 10 parts of peach kernel, 15 parts of honeysuckle, 15 parts of angelica and 6 parts of raw liquorice.
The application of the traditional Chinese medicine composition in the technical scheme in preparing the medicine for treating the pulmonary interstitial fibrosis.
A traditional Chinese medicine decoction-free granule for treating pulmonary interstitial fibrosis is prepared from the following single traditional Chinese medicine formula granules in parts by weight: 9-30 parts of raw astragalus, 9-15 parts of codonopsis pilosula, 6-12 parts of radix ophiopogonis, 10-15 parts of white gourd seed, 10-15 parts of reed rhizome, 9-30 parts of raw coix seed, 5-10 parts of peach kernel, 6-15 parts of honeysuckle, 6-15 parts of angelica and 2-6 parts of raw liquorice.
The traditional Chinese medicine decoction-free granules in the technical scheme are prepared from the following single traditional Chinese medicine formula granules in parts by weight: 30 parts of raw astragalus, 15 parts of codonopsis pilosula, 12 parts of dwarf lilyturf tuber, 15 parts of white gourd seed, 15 parts of reed rhizome, 30 parts of raw coix seed, 10 parts of peach kernel, 15 parts of honeysuckle, 15 parts of angelica and 6 parts of raw liquorice.
The application of the traditional Chinese medicine decoction-free granules in the technical scheme in preparing the medicine for treating pulmonary interstitial fibrosis.
Aiming at the fact that 'deficiency of qi and yin and phlegm-dampness and blood stasis' are basic pathogenesis of pulmonary interstitial fibrosis, the invention adopts a treatment method of 'supplementing qi and nourishing yin, and resolving phlegm and removing blood stasis', and the traditional Chinese medicine treatment mechanism of the invention is as follows:
the raw astragalus and the codonopsis pilosula are monarch drugs, the astragalus is sweet and slightly warm in taste, enters spleen and lung channels, has the effects of tonifying spleen and middle-jiao, raising yang and lifting sinking, tonifying defensive qi and consolidating superficial resistance, and removing toxin and promoting tissue regeneration, and the astragalus can tonify qi, promote blood circulation, tonify qi of lung and spleen, activate qi and blood, promote generation of nutrient and blood, and promote blood circulation and circulation of channels and collaterals; the codonopsis pilosula is sweet and neutral, enters spleen and lung channels, has the effects of tonifying spleen and lung qi, enriching blood and promoting fluid production, and the four organs are all vigorous when lung qi is vigorous; the two medicines are monarch medicines together, namely, strengthening defensive qi, tonifying middle-jiao energy, strengthening yang and yin, and strengthening exterior and interior, and are mutually used to treat the root;
the ministerial drug radix ophiopogonis is sweet, slightly bitter and slightly cold, has the effects of nourishing yin, promoting the production of body fluid, moistening lung and clearing heart, is combined with radix codonopsis to achieve the effects of supplementing qi, nourishing yin, promoting the production of body fluid and quenching thirst, and can restore qi, promote the production of body fluid, stop sweating, stop yin existence and achieve qi-filling pulse. Rhizoma Phragmitis is sweet and cold, has effects of clearing heat-fire, promoting fluid production to quench thirst, relieving restlessness, and relieving vomit, and is good at clearing lung heat; the white gourd seed is sweet and cool, can clear lung heat, resolve phlegm, eliminate carbuncle, discharge pus and promote diuresis, can clear the upper part and the lower part, can descend lung qi, and can enhance the effects of clearing lung heat, dispersing obstruction, removing phlegm and discharging pus by matching the two medicines; raw coix seed is sweet, bland and cool, induces diuresis to alleviate edema, excretes dampness, strengthens spleen, removes arthralgia, clears heat and pus, clears lung heat and pus, purges intestines and stomach and excretes dampness. Peach kernel, semen Persicae is bitter, sweet and neutral, has effects of promoting blood circulation, removing blood stasis, loosening bowel to relieve constipation, relieving cough and asthma, and enhancing carbuncle eliminating;
the honeysuckle flower, flos lonicerae, sweet and cold in adjuvant drugs, has the effects of clearing heat, removing toxicity, dispelling wind and heat, is used together with the astragalus root, has sweet and cold properties and mild smell, and can strengthen the effect of promoting blood circulation; when used together with Dang Gui, it can promote blood circulation, nourish blood without stagnation, and activate blood without blood flowing. The angelica sinensis is sweet and pungent, is warm, can enrich blood, regulate menstruation, promote blood circulation, relieve pain, moisten intestines and relieve constipation, can replenish blood and harmonize nutrient, can promote yang to grow yin, can invigorate qi, promote blood generation, can consolidate blood by aeration, and can calm yin and yang, and can be used together with the astragalus membranaceus for tonifying qi and blood, dredging lung and collaterals, and playing the roles of promoting blood circulation and nourishing blood;
guiding the drug to generate the liquorice, the effects are three: radix astragali is added to supplement qi; the composition can be used together with flos Lonicerae for improving heat and toxic materials clearing away effect; harmonizing the raw materials and relieving the property of the medicines;
the formula of the invention is in favor of the pathogenesis, has precise and appropriate compatibility and concentrated drug efficacy, and the compatibility of the medicines can dissipate phlegm stasis pathogen, help deficiency vital qi and achieve the effects of reducing phlegm, removing stasis and strengthening body resistance.
The single traditional Chinese medicine formula granules used in the traditional Chinese medicine decoction-free granules are pure traditional Chinese medicine product series which are prepared by taking traditional Chinese medicine decoction pieces which meet processing specifications as raw materials and carrying out extraction, concentration, separation, drying, granulation and packaging refining by modern pharmaceutical technology. The purpose of pushing the product is to be used as a substitute of the traditional Chinese medicine decoction piece for clinical formula. The product has the advantages of completely consistent effective components, taste, channel tropism, indication and efficacy with those of traditional Chinese medicine decoction pieces. Therefore, the traditional Chinese medicine decoction piece not only keeps all the characteristics of the original traditional Chinese medicine decoction pieces, namely can meet the requirements of doctors on treatment based on syndrome differentiation, can be added or subtracted according to the symptoms, has strong medicine property and high medicine effect, but also has the advantages of no need of decoction, direct taking, small dosage, rapid action, complete components, exact curative effect, safety, sanitation, convenience in carrying and storage, easiness in dispensing, suitability for industrial production and the like. The single Chinese medicinal formula granule is separated from the traditional Chinese medicinal decoction pieces, and has more superiority than the traditional Chinese medicinal decoction pieces.
The chemical components of Chinese medicine are the material basis of the pharmacological action of Chinese medicine. The traditional Chinese medicine decoction-free granules for treating pulmonary interstitial fibrosis (hereinafter referred to as lung tonifying and flaccidity removing granules) have the main effects of tonifying qi and nourishing yin, and reducing phlegm and removing blood stasis, and are used for treating basic pathogenesis of pulmonary interstitial fibrosis such as deficiency of qi and yin and phlegm-dampness and blood stasis. Modern pharmacological research proves that the components of the medicine have certain functions of resisting inflammation, resisting oxidation, resisting angiogenesis, resisting coagulation, resisting thrombus, resisting platelet aggregation and regulating the immunologic function of the organism. Modern pharmacological research data show that:
the functions of reducing phlegm and removing blood stasis are related to anti-inflammation, antioxidation, antiangiogenesis, anticoagulation, antithrombotic and antiplatelet aggregation;
the second, qi-tonifying and yin-nourishing function lies in the function of traditional Chinese medicine in regulating the immune function of the organism.
The traditional Chinese medicine composition and the traditional Chinese medicine decoction-free granules respectively have the following effects aiming at the two points:
the functions of reducing phlegm and removing blood stasis are related to anti-inflammation, antioxidation, antiangiogenesis, anticoagulation, antithrombotic and antiplatelet aggregation:
1. anti-inflammatory and antioxidant effects:
the pulmonary injury is caused by various reasons, so that the pulmonary tissue is subjected to repeated hypoxia and reoxygenation to generate excessive oxygen free radicals, the balance of an oxidation system and an antioxidation system is damaged, the oxidative stress is caused, the occurrence of alveolitis is started by the imbalance of oxidation/antioxidation of the organism, and neutrophilic granulocytes, alveolar macrophages and lymphocytes are infiltrated, so that the oxidative injury is aggravated on one hand, and various fibroblast forming factors are released on the other hand to stimulate the formation of pulmonary fibrosis. Research proves that the phlegm-reducing and stasis-removing medicines can improve the permeability of capillary vessels, relieve inflammatory reaction, and promote the regression and absorption of inflammation by relieving oxidative stress injury; can reduce the generation of free radicals and increase the clearance of the free radicals, reduce the airway remodeling and the alveolar damage through oxidation resistance, relieve the dyspnea symptom and delay or block the pulmonary fibrosis process.
(1) The Astragalus polysaccharides has protective effect on ultrastructure of pulmonary fibrosis rat pulmonary alveolus type II epithelial cells, can intervene inflammation of rat pulmonary alveolus, and can regulate Th1/Th2The balance of cell factors, TNF-alpha content and NO metabolism, thereby achieving the function of anti-fibrosis; can also increase superoxide dismutase (SOD) activity, reduce Malondialdehyde (MDA) content, and reduceFree radical production and increased free radical clearance, and reduction of airway remodeling and alveolar damage through oxidation resistance.
(2) Radix Codonopsis can significantly reduce pathological deposition of total collagen and collagen types I, III, and IV in lung tissue of rat, significantly reduce collagen content, and inhibit transforming growth factor beta-1 (transforming growth factor-beta)1，TGF-β1) The expression of (3) promotes the expression of interstitial collagenase and reduces the production of extracellular matrix such as collagen. The radix codonopsitis water extract can correct the oxidation/oxidation resistance imbalance of the rats with pulmonary fibrosis, improve the airway remodeling of the rats and inhibit the angiogenesis of the rats with pulmonary fibrosis, thereby delaying or inhibiting the development of pulmonary fibrosis.
(3) Radix Ophiopogonis can inhibit production of proinflammatory cytokine MCP-1, and regulate TH1/TH2The network balance of the cell factors promotes the repair of the normal lung tissue structure, inhibits the activation of the hyperplastic fibroblasts and inhibits the synthesis of collagen to play the role of anti-fibrosis. The radix ophiopogonis has a certain relieving effect on the occurrence and development of the pulmonary fibrosis through mechanisms of activating superoxide dismutase, inhibiting and eliminating free radicals, improving the balance of oxidation and antioxidation, relieving the damage of lung tissue cell membranes, weakening inflammatory reaction and the like.
(4) White gourd kernel capable of inhibiting TGF-beta in pulmonary tissue of rat with pulmonary fibrosis1And the expression level of TNF-alpha, slow down the proliferation of lung fibroblasts, reduce the synthesis of collagen and effectively relieve the formation of pulmonary fibrosis. The water extract of semen Benincasae (also known as semen Benincasae) has effects in scavenging hydroxy free radical and superoxide free radical, inhibiting lipid peroxidation, and resisting oxidation.
(5) The semen Persicae water decoction has antiinflammatory and repercussive effects, the semen Persicae water extract can strongly inhibit edema of semen Persicae protein PR-A, PR-BB, has obvious inhibitory effect on vascular hyperpermeability caused by inflammation, and has certain antiinflammatory effect, and polysaccharide in semen Persicae has OH-pair effect—And O2－Has a certain removing effect. The peach kernel ethanol extract can obviously reduce the activity of SOD and glutathione peroxidase (GSH-Px) in mouse brain tissues, obviously increase the content of MDA, and has the functions of scavenging oxygen free radicals and resisting oxidation.
(6) The flos Lonicerae extract can improve IL-10 secretion by inhibiting expression levels of TNF-alpha, IL-6 and IL-8, and has certain therapeutic effect on inflammation; can increase total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-Px) and SOD content in rat plasma, and significantly increase MDA content and OH content—And O2－The free radicals have certain scavenging capacity, inhibit the oxidation of grease and play a role in oxidation resistance.
(7) The angelicae polysaccharide can relieve cell edema, inflammatory exudation, capillary congestion, maintain normal structure of alveoli and alveolar parenchyma structure, and resist fibroblast proliferation and collagen fiber proliferation. Research shows that angelica can resist inflammatory injury, improve lung function and reduce TGF-beta by regulating the expression of TNF-alpha1The expression of mRNA inhibits extracellular matrix remodeling, thereby protecting the lung from damage. The active ingredient ferulic acid of angelica has good antioxidation, can effectively remove free radicals, can relieve acute pulmonary alveolitis inflammation, delay pulmonary fibrosis process and reduce lung collagen fiber deposition.
(8) The compound glycyrrhizin can inhibit the synthesis of inflammatory chemotactic factors to a certain extent and relieve alveolitis, thereby playing a role in relieving pulmonary fibrosis. Research shows that diammonium glycyrrhizinate can down-regulate the expression of IL-4 and TGF-1 and up-regulate the expression of IFN-gamma in lung tissue of rat with pulmonary fibrosis, so that serum IL-4 and TGF-beta1Reduce IFN-gamma content and increase IFN-gamma content, thereby reducing pulmonary fibrosis degree. Glycyrrhizin has strong nonspecific oxidation resistance to pulmonary fibrosis, and can inhibit proliferation of lung fibroblast and collagen secretion, thereby relieving alveolitis and pulmonary fibrosis.
(9 rhizoma Phragmitis polysaccharide and Coicis semen extract can scavenge hydroxy free radical, inhibit lipid peroxide generation, and exert antioxidant activity.
2. Anti-angiogenic, anticoagulant, antithrombotic, anti-platelet aggregation:
the stagnation of phlegm and blood in the collaterals throughout the development of pulmonary interstitial fibrosis is the key to the development of pulmonary interstitial fibrosis. Modern pharmacological research proves that the blood-activating and stasis-resolving medicine has the effects of resisting angiogenesis, improving blood circulation, particularly microcirculation and promoting recovery of pathological changes; has anticoagulant effect, and can be used for preventing thrombosis and arteriosclerosis plaque; can improve metabolism function of organism, and promote repair of damaged tissue.
(1) The astragalus can effectively reduce the activation degree of platelets, inhibit the activity and aggregation of the platelets, inhibit the release and synthesis of hydroxytryptamine and effectively relieve the hypercoagulable state of blood of patients.
(2) The Codonopsis lanceolata ethanol extract can obviously reduce the levels of LPA and PA in vivo after cerebral thrombosis embolism of rats and inhibit the aggregation of platelets.
(3) Radix Ophiopogonis can inhibit Thrombi (TXA)2) And ET-1 is generated, and through inhibiting the activation of platelets, the pulmonary alveolitis is relieved, the release of a proliferation promoting factor is reduced, the proliferation of fibroblasts is inhibited, and the effect of resisting pulmonary fibrosis is achieved. The radix Ophiopogonis extract can reduce platelet aggregation rate of rat, improve microcirculation, and increase alveolar oxygen ventilation.
(4) The peach kernel has the effects of anticoagulation, platelet aggregation inhibition and thrombosis resistance, and has obvious improvement effect on the activity of heart and cerebral vessels. The peach kernel extract can obviously inhibit the synthesis of collagen of rats with silicosis and reduce ceruloplasmin in serum, and has the function of delaying the pulmonary fibrosis.
(5) Radix Angelicae sinensis can improve microcirculation in lung, reduce blood hypercoagulability in pulmonary interstitial fibrosis caused by hormone, and reduce TXB2Increase of Prostacyclin (PGI)2) The biological activity of the compound can inhibit the activation and aggregation of blood platelets and prevent the formation of pulmonary embolism.
(6) Flos Lonicerae can inhibit Adenosine Diphosphate (ADP), induce platelet activation, and inhibit platelet aggregation. Glycyrrhizic acid can inhibit neutrophil from adhering to endothelial cell, is favorable for blocking thrombus formation, does not reduce blood coagulation capacity, and avoids increasing potential bleeding risk.
The qi-tonifying and yin-nourishing effects are the effects of the traditional Chinese medicine on regulating the immune function of the organism:
the pulmonary interstitial fibrosis is a chronic complex disease with the symptoms of lung qi and yin deficiency and collateral stasis as the basis and blood stasis and turbid phlegm as the targets, and the intermingled deficiency and excess run through the course of the disease. The lung collaterals are deep in the body, the vital qi is insufficient, the viscera are healed, and the qi deficiency is weak to direct the blood, so that the blood stasis is difficult to attack; the body fails to nourish yin and fluids, and fails to exert normal physiological functions, and new blood fails to grow if stagnant blood is not removed; only if the healthy qi is sufficient and the blood is smooth, the normal qi transformation function of the five zang-organs and six fu-organs can be recovered. Therefore, the qi-tonifying and yin-nourishing traditional Chinese medicine can help healthy qi, promote blood circulation and achieve the treatment effect by improving the immune function of the organism.
(1) The astragalus can obviously increase the number of leucocytes and multinucleate cells in blood, promote the phagocytic function and the bactericidal capability of neutrophils and macrophages, can restore the body in the state of hyperfimmunity to be normal, and restore the body from the state of low immune function to play a role in bidirectional immunoregulation.
(2) The Codonopsis pilosula polysaccharide can promote mouse B lymphocyte proliferation, improve phagocytic function of macrophage, enhance activity of Natural Killer (NK) cell and play a role in immunoregulation. Research proves that the codonopsis pilosula water extract can obviously improve the pathological score of a fibrosis rat and improve the organism immunity of the rat.
(3) The ophiopogonpolysaccharide can obviously increase the weight of thymus and spleen of mice, enhance the phagocytic capacity of reticuloendothelial system of the mice, increase the content of hemolysin in serum and has good immune enhancement and stimulation effects; can enhance immunity by regulating the expression of monoamine oxidase B (MAO-B), IL-2, TNF-alpha, IL-6, IFN-gamma and IL-10 mRNA.
(4) The peach kernel total protein can promote the generation of antibody forming cells and the generation of serum hemolysin, and improve the humoral immunity function of the organism; correctable CD4 +/CD8 +The ratio of cells is unbalanced, so that the body can recover a normal immune state; can promote the secretion of IL-2 and IL-4, stimulate the immune function and correct maladjustment.
(5) The glycyrrhiza polysaccharide can enhance the body resistance by stimulating the proliferation of T lymphocytes, can activate the endothelial system, induce the generation of human immunoglobulin, and has the effect of anticomplementary activity; can directly stimulate B lymphocyte proliferation, and induce interferon to enhance the ability of body to kill cell.
(6) The coix seed polysaccharide can obviously improve the phagocytic percentage and the phagocytic index of abdominal macrophages of immunocompromised mice, promote the formation of hemolysin and hemolytic plaques, and promote the lymphocyte transformation. The rhizoma Phragmitis polysaccharide has immunity promoting effect, and can be used for treating mouse cell plaque formation and lymphocyte transformation.
(7) The flos Lonicerae can remarkably improve phagocytosis rate and phagocytosis index of macrophage, enhance lymphocyte transformation rate of organism, and enhance THIThe cell secretes lL-2, IFN-gamma and TNF-alpha, and the immune function of the organism is obviously enhanced.
(8) Radix Angelicae sinensis can enhance phagocytic ability of macrophage and transformation ability of lymphocyte, induce production of interferon, stimulate production of IL-2, and enhance immunity.
The invention has the following beneficial effects:
1. has effects of invigorating qi, nourishing yin, eliminating phlegm, and removing blood stasis.
2. Has antiinflammatory, antioxidant, anti-angiogenesis, anticoagulant, antithrombotic, and platelet aggregation inhibiting effects.
3. Has the function of regulating the immunity of the organism.
The specific implementation mode is as follows:
in order to facilitate understanding of the technical scheme of the invention, the following will further describe the traditional Chinese medicine composition, the traditional Chinese medicine decoction-free granule and the application thereof for treating the pulmonary interstitial fibrosis in combination with specific test examples.
Example 1:the preparation of the traditional Chinese medicine composition comprises the following steps:
weighing 9g of raw astragalus, 9g of codonopsis pilosula, 6g of dwarf lilyturf tuber, 10g of white gourd seed, 10g of reed rhizome, 9g of raw coix seed, 5g of peach seed, 6g of honeysuckle flower, 6g of Chinese angelica and 2g of raw liquorice.
Example 2:the preparation of the traditional Chinese medicine composition comprises the following steps:
weighing 20g of raw astragalus membranaceus, 12g of codonopsis pilosula, 9g of radix ophiopogonis, 12g of white gourd seed, 12g of rhizoma phragmitis, 20g of raw coix seed, 8g of peach kernel, 10g of honeysuckle, 10g of angelica sinensis and 4g of raw liquorice.
Example 3:the preparation of the traditional Chinese medicine composition comprises the following steps:
weighing 30g of raw astragalus, 15g of codonopsis pilosula, 12g of dwarf lilyturf tuber, 15g of white gourd seed, 15g of reed rhizome, 30g of raw coix seed, 10g of peach seed, 15g of honeysuckle, 15g of Chinese angelica and 6g of raw liquorice.
Example 4:the preparation of the traditional Chinese medicine decoction-free granules:
weighing the following single traditional Chinese medicine formula granules by weight: 9g of raw astragalus, 9g of codonopsis pilosula, 6g of dwarf lilyturf tuber, 10g of white gourd seed, 10g of reed rhizome, 9g of raw coix seed, 5g of peach seed, 6g of honeysuckle flower, 6g of Chinese angelica and 2g of raw liquorice.
The single traditional Chinese medicine formula granule in the embodiment is purchased from Jiangyin Tianjiang pharmaceutical industry Co.
Example 5:the preparation of the traditional Chinese medicine decoction-free granules:
weighing the following single traditional Chinese medicine formula granules by weight: 20g of raw astragalus, 12g of codonopsis pilosula, 9g of dwarf lilyturf tuber, 12g of white gourd seed, 12g of reed rhizome, 20g of raw coix seed, 8g of peach seed, 10g of honeysuckle flower, 10g of Chinese angelica and 4g of raw liquorice.
The single traditional Chinese medicine formula granule in the embodiment is purchased from Jiangyin Tianjiang pharmaceutical industry Co.
Example 6:the preparation of the traditional Chinese medicine decoction-free granules:
weighing the following single traditional Chinese medicine formula granules by weight: 30g of raw astragalus, 15g of codonopsis pilosula, 12g of dwarf lilyturf tuber, 15g of white gourd seed, 15g of reed rhizome, 30g of raw coix seed, 10g of peach kernel, 15g of honeysuckle flower, 15g of Chinese angelica and 6g of raw liquorice.
The single traditional Chinese medicine formula granule in the embodiment is purchased from Jiangyin Tianjiang pharmaceutical industry Co.
The beneficial effects of the traditional Chinese medicine decoction-free granules (hereinafter referred to as lung-tonifying and flaccidity-removing granules) for treating pulmonary interstitial fibrosis are illustrated by specific test examples.
Test example 1:the lung-tonifying and flaccidity-eliminating granules are clinically applied:
the diagnosis standard of the drug treatment is adopted for the pulmonary interstitial fibrosis:
western diagnostic criteria: reference is made to "2018 assessment and management recommendation for idiopathic pulmonary fibrosis".
Traditional Chinese medicine diagnosis standard for consumptive lung disease: refer to "consensus opinion of consumptive lung disease diagnosis and treatment experts (Jiangxi province)": clinically, the primary symptoms are progressive dyspnea accompanied by light cough or paroxysmal cough. The shortness of breath aggravates after exercise, with no or little or white sticky sputum. ② there is usually the general condition of pale complexion, dark complexion, purple lips, emaciation, lassitude, dizziness or chills and fever. Thirdly, the patient mostly has no hemoptysis, no wheezing and wheezing, can lie flat at night, and the like.
(II) treatment effect evaluation standard: reference is made to the efficacy assessment criteria recommended by the national association of thoracic sciences in 2000 for the international consensus on IPF diagnosis and treatment.
The improvement is as follows: at least 2 conditions are met, namely, the symptom is improved, and particularly, the activity is improved; the pulmonary interstitial lesion on the X-ray chest film or the HRCT is reduced; (iii) at least 2 of the following: a. the total lung volume (TLC) or Vital Capacity (VC) is increased by more than or equal to 10 percent or increased by more than or equal to 200 mL; b. the carbon monoxide Dispersion (DLCO) of the lung is increased by more than or equal to 15 percent or increased by more than or equal to 3mL/(min mm Hg); c. arterial oxygen saturation in cardiopulmonary exercise test (SaO)2) The increase is more than or equal to 4 percent or the alveolar gas-arterial oxygen partial pressure difference [ P (A-a) O ]2]The increase is more than or equal to 4mm Hg.
And (3) stabilizing: at least 2 conditions are met, namely, change of TLC or VC is less than 10% or change is less than 200 mL; ② DLCO changes less than 15% or changes less than 3mL/(min mm Hg); ③ SaO in the test of cardio-pulmonary movement2Variation < 4%, P (A-a) O2The variation was < 4mm Hg.
Weighting: exacerbation of symptoms, in particular of dyspnea or cough; x-ray chest radiograph or HRCT shows that the pulmonary interstitial lesion is aggravated, especially the honeycomb lung or pulmonary artery high pressure symptom appears; (iii) when at least 2 of the following are met: the reduction of TLC or VC is more than or equal to 10 percent or more than or equal to 200 mL; DLCO is reduced by more than or equal to 15 percent or is reduced by more than or equal to 3mL/(min mm Hg); c. SaO in cardiopulmonary exercise testing2The reduction is more than or equal to 4 percent or P (A-a) O2The increase is more than or equal to 4mm Hg.
(III) the lung tonifying and impotence eliminating granules are used for treating effective cases of pulmonary interstitial fibrosis:
case one:one of hu, man, 58 years old, heart-wind man in Bao Ji city, clinic number: 1701221036
Initial diagnosis time: year 2017, 3 month 5 day.
The main complaints are: intermittent cough with short breath for 2 years and aggravation for 1 week.
The current medical history: after the patient is cooled 2 years ago, the patient has cough, a little white and sticky sputum, chest distress, short breath and aggravation after activity, and no fever at that time, the patient is diagnosed in a central hospital of a chicken city, and the chest CT shows that: the basement is changed like ground glass after the two lower lungs, has inflammatory exudation, is diagnosed as 'pulmonary interstitial fibrosis' by combining clinical symptoms, and provides symptomatic treatment for resisting infection, relieving cough, reducing sputum, relieving asthma and the like, and relieving symptoms for discharge. After that, the symptoms are repeatedly attacked every time the cold catches a cold and in autumn and winter, the local hospital is intermittently visited to take the symptomatic medicine, and the disease condition is generally controlled. Cough and qi shortness aggravate after the patient catches a cold before 1 week, and the symptoms are not relieved by taking anti-infection, cough-relieving and phlegm-reducing medicines (not detailed) by self, and the patient is treated by seeking the traditional Chinese medicine treatment. The symptoms are as follows: dry cough with little phlegm, short breath, marked movement, lassitude, dry mouth, dark lips, normal appetite, poor appetite, easy conditioning, pale and dark tongue with little coating, tortuous and tortuous sublingual collaterals, and deep and thready pulse.
History of the past: it is good for health.
Traditional Chinese medicine diagnosis: consumptive lung disease refers to the syndrome of deficiency of qi and yin and accumulation of phlegm-dampness and blood stasis.
And (3) Western diagnosis: fibrosis of lung interstitium.
Therapeutic method: to replenish qi, nourish yin, resolve phlegm and remove blood stasis.
The traditional Chinese medicine comprises the following components: the lung-tonifying and paralysis-eliminating granules comprise the following specific medicines: 30g of raw astragalus, 15g of codonopsis pilosula, 12g of dwarf lilyturf tuber, 15g of white gourd seed, 15g of reed rhizome, 30g of raw coix seed, 10g of peach kernel, 15g of honeysuckle flower, 15g of Chinese angelica and 6g of raw liquorice. 7 doses of the medicine are taken with water, and one dose is taken every day in two times.
The time of the return visit: 3, 12 months in 2017
After the patient complains of 7 doses of the medicine, the symptoms of cough and shortness of breath are obviously relieved, the symptoms of hypodynamia and dry mouth are relieved, the patient generally takes the medicine, the night is improved, the patient is convenient to adjust, the tongue is pale and dark, the coating is less, the sublingual collaterals are tortuous, and the pulse is deep and thin.
The traditional Chinese medicine comprises the following components: the lung-tonifying and paralysis-eliminating granules comprise the following specific medicines: 30g of raw astragalus, 15g of codonopsis pilosula, 12g of dwarf lilyturf tuber, 15g of white gourd seed, 15g of reed rhizome, 30g of raw coix seed, 10g of peach kernel, 15g of honeysuckle flower, 15g of Chinese angelica and 6g of raw liquorice. 14 doses are taken with water, and one dose is taken every day in two times.
And (3) return visit: patients complain of 14 doses of the above medicines, basically disappear symptoms such as cough, shortness of breath, hypodynamia and the like, are occasionally coughed when encountering cold, and are rechecked after 1 month of treatment to mostly absorb the inflammatory exudation of the double lungs in the chest CT.
Case two:one of li, man, 62 years old, glaring state person, wakawa, clinic number: 1406141026
Initial diagnosis time: 9, 15 days 2014.
The main complaints are: repeated cough with short breath for 3 years and aggravation for 1 month.
The current medical history: the patient has cough and expectoration with short breath and hypodynamia after being cooled for 3 years, is diagnosed in local hospitals, is diagnosed as diffuse pulmonary interstitial fibrosis by combining with related examination, is subjected to symptomatic treatment for resisting infection, relieving cough, reducing sputum, relieving asthma and the like, and is discharged. After that, the symptoms are repeatedly attacked in cold and autumn and winter, the symptomatic medicine is intermittently taken, the system diagnosis and treatment are not performed, and the disease condition is gradually worsened. Cough and aggravation of short breath after a patient is cooled 1 month ago, the patient is in a local hospital, and the chest CT is checked: the two lungs are in diffuse distribution, and are in the form of ground glass shadow and grid shadow, and the honeycomb pattern is changed, mainly including subpleurum and two lower lungs. When the methylprednisolone (120mg three days, 80mg three days and 40mg three days) is orally taken for treatment, cough and shortness of breath still occur, CT change is not obvious after half a month check, and the symptoms are still not relieved when the acetylcysteine effervescent tablets, the Jinshuibao capsules and other medicines are orally taken, so that the patients are diagnosed by asking for traditional Chinese medicine treatment. The symptoms are as follows: cough, cough with little white and sticky phlegm, shortness of breath, aggravation after exercise, fatigue, dry mouth, cyanosis of the lips, poor appetite, gastrectasia, general night rest, convenient adjustment, pale and dark tongue with little coating, tortuous sublingual collaterals, and deep and thready pulse.
History of the past: it is good for health.
Traditional Chinese medicine diagnosis: consumptive lung disease refers to the syndrome of deficiency of qi and yin and accumulation of phlegm-dampness and blood stasis.
And (3) Western diagnosis: diffuse pulmonary interstitial fibrosis.
Therapeutic method: to replenish qi, nourish yin, resolve phlegm and remove blood stasis.
The traditional Chinese medicine comprises the following components: the lung-tonifying and paralysis-eliminating granules comprise the following specific medicines: 30g of raw astragalus, 15g of codonopsis pilosula, 12g of dwarf lilyturf tuber, 15g of white gourd seed, 15g of reed rhizome, 30g of raw coix seed, 10g of peach kernel, 15g of honeysuckle flower, 15g of Chinese angelica and 6g of raw liquorice. 14 doses are taken with water, and one dose is taken every day in two times.
The time of the return visit: 9 and 29 days 2014
After the patient takes 14 doses of the medicine, the symptoms of cough and shortness of breath are relieved, the dry mouth and the hypodynamia are relieved, the appetite is improved, the patient is general at night, the patient can adjust the appetite, the tongue is pale and dark, the coating is less, the sublingual collaterals are tortuous, and the pulse is deep and thin.
The traditional Chinese medicine comprises the following components: the lung-tonifying and paralysis-eliminating granules comprise the following specific medicines: 30g of raw astragalus, 15g of codonopsis pilosula, 12g of dwarf lilyturf tuber, 15g of white gourd seed, 15g of reed rhizome, 30g of raw coix seed, 10g of peach kernel, 15g of honeysuckle flower, 15g of Chinese angelica and 6g of raw liquorice. 14 doses are taken with water, and one dose is taken every day in two times.
And (3) return visit: the patient complains about 14 doses of the above medicines to obviously relieve the symptoms of cough, shortness of breath, hypodynamia and the like, rechecks the CT in the chest and absorbs the inflammatory exudation. When the patient suffers from short breath and aggravates, the traditional Chinese medicine decoction is taken intermittently for more than half a year by taking local medicines according to the reserved prescription every time, except taking thymosin enteric-coated tablets, acetylcysteine effervescent tablets and other medicines, no hormone or other western medicines are used. After 1 year, the CT is reviewed in a hospital to show that the fibrosis degree of the two lung interstitium is obviously reduced.
Case three:wang a certain woman, age 76, kaiki city in south of Henan province, hospital number: 196831
Initial diagnosis time: 2016, 5 months and 23 days.
The main complaints are: cough and expectoration are interrupted for 6 years, qi shortness is 1 year, and aggravation is 5 days.
The current medical history: cough and expectoration appear after the patient is cooled 6 years ago, no shortness of breath exists at that time, the patient is treated in Tang hospital, and chest CT is examined to prompt interstitial pneumonia between both lungs, which is not taken into consideration and is not systematically diagnosed and treated. After that, the symptoms are repeatedly attacked in cold and autumn and winter, the symptomatic medicine is intermittently taken, the system diagnosis and treatment are not performed, and the disease condition is gradually worsened. The patient had no obvious reasons for cough and expectoration before 1 year, has short breath and aggravation after activity, and is diagnosed in the Xijing hospital, and the chest CT shows that: the two lungs are changed like ground glass, the periphery is changed like honeycomb and grid, the basal lamina hindensis segments of the two lungs are taken as the major, the diffuse interstitial pulmonary fibrosis is diagnosed by combining symptoms, and the symptom is relieved after symptomatic treatment such as administration of acetylcysteine effervescent tablets. Cough and aggravation of short breath appear after the patient catches a cold before 5 days, and the patient is treated by seeking the treatment of the traditional Chinese medicine. The symptoms are as follows: cough, a small amount of white and sticky sputum, good expectoration, shortness of breath, aggravation after exercise, fatigue, weakness, dry mouth, appetite, poor appetite, small convenient stool, light and dark tongue, little coating, tortuous sublingual collaterals, and thready and unsmooth pulse.
History of the past: the patient has a history of coronary heart disease for 16 years, and the patient does not take the medicine regularly; the patient has a 'hypertension' history for 6 years, the highest blood pressure is 170/90mmHg, telmisartan dispersible tablets, nitrendipine tablets and hydrochlorothiazide tablets are regularly taken, and the blood pressure is not controlled in detail; the patient has the history of type 2 diabetes for 5 years, and the patient does not take the medicine regularly, so that the blood sugar is not controlled in detail; the disease history of the liver cyst and the prostate hyperplasia is 1 year.
Traditional Chinese medicine diagnosis: consumptive lung disease refers to the syndrome of deficiency of qi and yin and accumulation of phlegm-dampness and blood stasis.
And (3) Western diagnosis: 1. diffuse pulmonary interstitial fibrosis; 2. coronary heart disease heart function grade II; 3. hypertension class 2 (very high risk); 4. type 2 diabetes; 5. hepatic cyst; 6. hyperplasia of prostate gland.
Therapeutic method: to replenish qi, nourish yin, resolve phlegm and remove blood stasis.
The traditional Chinese medicine comprises the following components: the lung-tonifying and paralysis-eliminating granules comprise the following specific medicines: 30g of raw astragalus, 15g of codonopsis pilosula, 12g of dwarf lilyturf tuber, 15g of white gourd seed, 15g of reed rhizome, 30g of raw coix seed, 10g of peach kernel, 15g of honeysuckle flower, 15g of Chinese angelica and 6g of raw liquorice. 3 doses are taken with water, and one dose is taken every day in two times.
The time of the return visit: 2016, 5 months and 26 days
After patients complain of 3 doses of the medicine, the symptoms of cough, shortness of breath, hypodynamia and dry mouth are relieved, patients can take the medicine, the symptoms are improved at night, and the patients can feel big, small and convenient to adjust, the tongue is pale and dark, the coating is little, the sublingual collaterals are tortuous, and the pulse is thready and unsmooth.
The traditional Chinese medicine comprises the following components: the lung-tonifying and paralysis-eliminating granules comprise the following specific medicines: 30g of raw astragalus, 15g of codonopsis pilosula, 12g of dwarf lilyturf tuber, 15g of white gourd seed, 15g of reed rhizome, 30g of raw coix seed, 10g of peach kernel, 15g of honeysuckle flower, 15g of Chinese angelica and 6g of raw liquorice. 7 doses of the medicine are taken with water, and one dose is taken every day in two times.
And (3) return visit: patients complain of the upper 14 doses of the prescription to obviously relieve symptoms of cough, shortness of breath, hypodynamia and the like, take the upper part after activities, and review chest CT after 3 months of treatment: the degree of fibrosis of the lung and the interstitium is obviously reduced, and the inflammatory exudation is absorbed earlier.
While the invention has been described with reference to a preferred embodiment, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims; meanwhile, any equivalent changes, modifications and variations of the above embodiments according to the essential technology of the present invention are within the scope of the technical solution of the present invention.

Claims (6)

1. The traditional Chinese medicine composition for treating pulmonary interstitial fibrosis is characterized by comprising the following raw material medicines in parts by weight: 9-30 parts of raw astragalus, 9-15 parts of codonopsis pilosula, 6-12 parts of radix ophiopogonis, 10-15 parts of white gourd seed, 10-15 parts of reed rhizome, 9-30 parts of raw coix seed, 5-10 parts of peach kernel, 6-15 parts of honeysuckle, 6-15 parts of angelica and 2-6 parts of raw liquorice.
2. The traditional Chinese medicine composition according to claim 1, wherein the raw materials are in parts by weight: 30 parts of raw astragalus, 15 parts of codonopsis pilosula, 12 parts of dwarf lilyturf tuber, 15 parts of white gourd seed, 15 parts of reed rhizome, 30 parts of raw coix seed, 10 parts of peach kernel, 15 parts of honeysuckle, 15 parts of angelica and 6 parts of raw liquorice.
3. The use of the Chinese medicinal composition of claim 1 or 2 in the preparation of a medicament for the treatment of pulmonary interstitial fibrosis.
4. The traditional Chinese medicine decoction-free granules for treating pulmonary interstitial fibrosis are characterized by consisting of the following single traditional Chinese medicine formula granules in parts by weight: 9-30 parts of raw astragalus, 9-15 parts of codonopsis pilosula, 6-12 parts of radix ophiopogonis, 10-15 parts of white gourd seed, 10-15 parts of reed rhizome, 9-30 parts of raw coix seed, 5-10 parts of peach kernel, 6-15 parts of honeysuckle, 6-15 parts of angelica and 2-6 parts of raw liquorice.
5. The decoction-free Chinese medicinal granule according to claim 4, wherein the single Chinese medicinal granules comprise the following raw materials in parts by weight: 30 parts of raw astragalus, 15 parts of codonopsis pilosula, 12 parts of dwarf lilyturf tuber, 15 parts of white gourd seed, 15 parts of reed rhizome, 30 parts of raw coix seed, 10 parts of peach kernel, 15 parts of honeysuckle, 15 parts of angelica and 6 parts of raw liquorice.
6. The use of the decoction-free Chinese medicinal granule of claim 4 or 5 in the preparation of a medicament for treating pulmonary interstitial fibrosis.
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