CN112386671B - Traditional Chinese medicine composition for treating interstitial lung disease and application thereof - Google Patents

Traditional Chinese medicine composition for treating interstitial lung disease and application thereof Download PDF

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CN112386671B
CN112386671B CN201910746184.9A CN201910746184A CN112386671B CN 112386671 B CN112386671 B CN 112386671B CN 201910746184 A CN201910746184 A CN 201910746184A CN 112386671 B CN112386671 B CN 112386671B
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CN112386671A (en
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李友林
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China Japan Friendship Hospital
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/48Fabaceae or Leguminosae (Pea or Legume family); Caesalpiniaceae; Mimosaceae; Papilionaceae
    • A61K36/481Astragalus (milkvetch)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/25Araliaceae (Ginseng family), e.g. ivy, aralia, schefflera or tetrapanax
    • A61K36/258Panax (ginseng)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/46Eucommiaceae (Eucommia family), e.g. hardy rubber tree
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/48Fabaceae or Leguminosae (Pea or Legume family); Caesalpiniaceae; Mimosaceae; Papilionaceae
    • A61K36/484Glycyrrhiza (licorice)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/54Lauraceae (Laurel family), e.g. cinnamon or sassafras
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/57Magnoliaceae (Magnolia family)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/65Paeoniaceae (Peony family), e.g. Chinese peony
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/71Ranunculaceae (Buttercup family), e.g. larkspur, hepatica, hydrastis, columbine or goldenseal
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/71Ranunculaceae (Buttercup family), e.g. larkspur, hepatica, hydrastis, columbine or goldenseal
    • A61K36/714Aconitum (monkshood)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/79Schisandraceae (Schisandra family)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/88Liliopsida (monocotyledons)
    • A61K36/906Zingiberaceae (Ginger family)
    • A61K36/9068Zingiber, e.g. garden ginger
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00Drugs for disorders of the respiratory system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]

Abstract

The invention provides an application of a traditional Chinese medicine composition in treating interstitial lung diseases, wherein the traditional Chinese medicine composition is prepared from the following raw material medicines: 8-35 parts of astragalus membranaceus, 8-35 parts of cassia twig, 6-30 parts of eucommia ulmoides, 5-25 parts of dried ginger, 4-22 parts of monkshood, 4-22 parts of radix paeoniae alba, 3-16 parts of schisandra chinensis, 3-16 parts of pseudo-ginseng and 3-16 parts of liquorice. The traditional Chinese medicine composition has better clinical curative effect on interstitial lung diseases, the main and secondary curative effect indexes after treatment are better than those before treatment, and the total effective rate reaches 76.72 percent.

Description

Traditional Chinese medicine composition for treating interstitial lung disease and application thereof
Technical Field
The invention relates to a traditional Chinese medicine composition and application thereof, in particular to a traditional Chinese medicine composition for treating interstitial lung diseases and application thereof.
Background
Interstitial Lung Disease (ILD) belongs to the category of consumptive lung Disease in traditional Chinese medicine, and has the main clinical manifestations of cough, chest distress and dyspnea. Traditional Chinese medicine considers that ILD is a disease which takes the lung and spleen as the core to take the dysfunction of viscera and the overall decline of the body function state as basic pathological changes. The lung lobes of ILD patients are withered due to consumption of body fluids and dryness of the lung, which is caused by consumption of body fluids and qi, and the lung lobes are dry when dry, but weak when not used. The abundance of lung qi depends on the distribution of spleen qi, while the deficiency of spleen qi leads to the deficiency of lung qi. The root of qi is in the kidney, kidney deficiency makes it impossible to take the food, qi fails to return to original, and yang, qi, yin and body fluids are easy to dissipate. The disease is manifested in the lung, but its pathological changes are closely related to the spleen, stomach and kidney. The lung governs qi and the spleen is the source of qi and blood. The spleen and stomach transporting and transforming food essence can nourish lung qi, the spleen qi is weak, and the transportation and transformation cannot be performed, which results in lung qi deficiency and qi failing to transform body fluids, resulting in lung malnutrition and lung atrophy and atrophy.
The pathogenesis essence of interstitial lung diseases is deficient, excessive, cold and heat mixed, and the syndrome characteristics are mainly the deficiency of both lung and spleen, and relate to the function deficiency of a plurality of internal organs, so that the interstitial lung diseases can be essentially treated only by carrying out the integral differentiation of the internal organs with the lung and the spleen as the core and applying the treatment principle of 'warm-moistening and pungent-gold banking up root'.
Disclosure of Invention
In order to solve the problems in the prior art, the application provides a traditional Chinese medicine composition for treating interstitial lung diseases and application thereof.
As one aspect of the present application, the present application provides a Chinese medicinal composition for treating interstitial lung diseases, which is prepared from the following raw material medicines: astragalus root, cassia twig, eucommia bark, dried ginger, aconite root, white peony root, schisandra fruit, notoginseng and licorice root.
In a specific embodiment, the traditional Chinese medicine composition is prepared from the following raw material medicines in parts by weight: 8-35 parts of astragalus membranaceus, 8-35 parts of cassia twig, 6-30 parts of eucommia ulmoides, 5-25 parts of dried ginger, 4-22 parts of monkshood, 4-22 parts of radix paeoniae alba, 3-16 parts of schisandra chinensis, 3-16 parts of pseudo-ginseng and 3-16 parts of liquorice.
In a preferred embodiment, the traditional Chinese medicine composition is prepared from the following raw medicines in parts by weight: 10-28 parts of astragalus membranaceus, 10-28 parts of cassia twig, 8-25 parts of eucommia ulmoides, 7-22 parts of dried ginger, 5-20 parts of monkshood, 5-20 parts of radix paeoniae alba, 4-14 parts of schisandra chinensis, 4-14 parts of pseudo-ginseng and 4-14 parts of liquorice.
In a further preferred embodiment, the traditional Chinese medicine composition is prepared from the following raw material medicines in parts by weight: 15-24 parts of astragalus membranaceus, 15-24 parts of cassia twig, 12-19 parts of eucommia ulmoides, 10-16 parts of dried ginger, 7-14 parts of monkshood, 7-14 parts of radix paeoniae alba, 5-9 parts of schisandra chinensis, 5-9 parts of pseudo-ginseng and 5-9 parts of liquorice.
In the most preferred embodiment, the traditional Chinese medicine composition is prepared from the following raw material medicines in parts by weight:
18 parts of astragalus membranaceus, 18 parts of cassia twig, 15 parts of eucommia ulmoides, 12 parts of dried ginger, 9 parts of monkshood, 9 parts of radix paeoniae alba, 6 parts of schisandra chinensis, 6 parts of pseudo-ginseng and 6 parts of liquorice;
or 16 parts of astragalus, 22 parts of cassia twig, 13 parts of eucommia bark, 14 parts of dried ginger, 8 parts of monkshood, 13 parts of white paeony root, 6 parts of Chinese magnoliavine fruit, 8 parts of pseudo-ginseng and 6 parts of liquorice;
or 22 parts of astragalus membranaceus, 16 parts of cassia twig, 18 parts of eucommia ulmoides, 11 parts of dried ginger, 13 parts of monkshood, 8 parts of radix paeoniae alba, 8 parts of schisandra chinensis, 6 parts of pseudo-ginseng and 8 parts of liquorice.
In a preferred embodiment, the astragalus is raw astragalus; the monkshood is prepared monkshood; the licorice is raw licorice.
The traditional Chinese medicine composition can be a composition formed by crushing and mixing raw material medicines, can also be an extract obtained by mixing or extracting the raw material medicines independently, or an effective part obtained by further refining and purifying the extract, and can also be a conventional preparation form prepared by adding pharmaceutically acceptable auxiliary materials.
Wherein the extraction method comprises decocting extraction, reflux extraction, immersion extraction, ultrasonic extraction, percolation extraction, microwave extraction, etc.; the purification method comprises water extraction and alcohol precipitation, alkali dissolution and acid precipitation and various column chromatography purification methods, such as a macroporous resin column, a silica gel column, a reversed phase column and the like; the conventional dosage forms include but are not limited to injections, capsules, tablets, granules, gels, sustained release agents, oral liquids, dropping pills or nano preparations; the pharmaceutically acceptable auxiliary materials comprise: bulking agent, disintegrating agent, lubricant, suspending agent, binder, sweetener, correctant, antiseptic, matrix, etc. The filler comprises: starch, pregelatinized starch, lactose, mannitol, chitin, microcrystalline cellulose, sucrose, etc.; the disintegrating agent comprises: starch, pregelatinized starch, microcrystalline cellulose, sodium carboxymethyl starch, crospolyvinylpyrrolidone, low-substituted hydroxypropylcellulose, croscarmellose sodium, etc.; the lubricant comprises: magnesium stearate, sodium lauryl sulfate, talc, silica, and the like; the suspending agent comprises: polyvinylpyrrolidone, microcrystalline cellulose, sucrose, agar, hydroxypropyl methylcellulose, and the like; the binder includes starch slurry, polyvinylpyrrolidone, hydroxypropyl methylcellulose, etc.
In addition to the above raw materials, the Chinese medicinal composition of the present invention may also be administered in the form of an extract (effective fraction), and therefore, as another aspect of the present invention, the present invention further discloses a Chinese medicinal composition for treating interstitial lung diseases, wherein the Chinese medicinal composition is prepared from the following raw materials by weight:
8-35 parts of astragalus extract, 8-35 parts of cassia twig extract, 6-30 parts of eucommia bark extract, 5-25 parts of dried ginger extract, 4-22 parts of monkshood extract, 4-22 parts of white peony root extract, 3-16 parts of schisandra extract, 3-16 parts of pseudo-ginseng extract and 3-16 parts of liquorice extract.
In a specific embodiment, the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight:
10-28 parts of astragalus extract, 10-28 parts of cassia twig extract, 8-25 parts of eucommia bark extract, 7-22 parts of dried ginger extract, 5-20 parts of monkshood extract, 5-20 parts of white peony root extract, 4-14 parts of schisandra chinensis extract, 4-14 parts of pseudo-ginseng extract and 4-14 parts of liquorice extract.
In a preferred embodiment, the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight:
15-24 parts of astragalus extract, 15-24 parts of cassia twig extract, 12-19 parts of eucommia bark extract, 10-16 parts of dried ginger extract, 7-14 parts of monkshood extract, 7-14 parts of white peony root extract, 5-9 parts of schisandra extract, 5-9 parts of pseudo-ginseng extract and 5-9 parts of liquorice extract.
In a further preferred embodiment, the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight:
18 parts of astragalus extract, 18 parts of cassia twig extract, 15 parts of eucommia bark extract, 12 parts of dried ginger extract, 9 parts of monkshood extract, 9 parts of white paeony root extract, 6 parts of Chinese magnoliavine fruit extract, 6 parts of pseudo-ginseng extract and 6 parts of liquorice extract.
The above extract can be obtained by extracting with conventional method, or can be effective components obtained by further purifying and refining; the conventional extraction method comprises one or more of decoction extraction, reflux extraction, soaking extraction, ultrasonic extraction or percolation extraction; the extraction solvent is water or an organic solvent mutually soluble with water; further one or more of methanol, ethanol and acetone; more preferably 50-90% ethanol; even more preferably 60-80% ethanol; the purification and refining method comprises water extraction and alcohol precipitation, extraction or purification through a macroporous resin column, a silica gel column and the like. Preferably the water extract of each raw material medicine.
As a second aspect of the invention, the invention also provides application of the traditional Chinese medicine composition in preparing a medicine for treating interstitial lung diseases.
The interstitial lung diseases include interstitial lung diseases, pulmonary interstitial fibrosis, interstitial pneumonia and organizing pneumonia.
As a third aspect of the invention, the invention also provides application of the traditional Chinese medicine composition in preparing medicines with anti-inflammatory effects.
As a fourth aspect of the invention, the invention also provides application of the traditional Chinese medicine composition in preparing a medicine with an anti-fibrosis effect.
The astragalus root in the formula of the invention is a monarch drug for tonifying qi, strengthening exterior, strengthening spleen and benefiting lung; the cassia twig warms and unblocks the meridians and collaterals, assists yang and regulates qi, the eucommia bark tonifies the liver and kidney, the dried ginger warms the middle-jiao and dispels cold, returns yang and unblocks the collaterals, the cassia twig, the eucommia bark and the dried ginger serve as ministerial drugs, and the monarch drug is used for tonifying the spleen, benefiting the lung and tonifying the kidney; radix Aconiti lateralis warms up kidney yang, radix Notoginseng activates blood and nourishes blood, fructus Schisandrae chinensis astringes and astringes, benefits qi and promotes fluid production, radix Paeoniae alba nourishes blood and regulates menstruation, coordinates Ying and Wei, the four are used as adjuvant drugs; licorice root, radix Glycyrrhizae is a guiding drug for tonifying the spleen and replenishing qi, and harmonizing the effects of the other drugs in the recipe. The whole formula has the effects of tonifying qi, warming yang, dredging collaterals and generating lung, and is suitable for treating traditional Chinese medicine consumptive lung disease caused by multiple organ deficiency of lung, spleen and kidney, with symptoms of dyspnea after progressive activity and interstitial lung disease.
According to the invention, through the comparison clinical research and observation of 116 cases of ILD patients treated by the traditional Chinese medicine composition, the traditional Chinese medicine composition has a good clinical curative effect on ILD treatment, the main curative effect index and the secondary curative effect index after the treatment are both superior to those before the treatment, and the total effective rate reaches 76.72%; fully inherits the holistic concept and the zang-fu organ syndrome differentiation theory of the traditional Chinese medicine, and reflects the essential problems of the zang-fu organ dysfunction and the integral decline of the body function state of the ILD patient with the lung and the spleen as the core; the Chinese patent medicine overcomes the defects that the prior Chinese patent medicine mostly starts from excess syndrome, mainly removes pathogenic excess, slightly strengthens the body resistance and totally protects the body resistance from gas-solid.
Drawings
Figure 1 is rat HE stained lung tissue section.
FIG. 2 is a section of rat Masson stained lung tissue.
Detailed Description
Example 1
The formula is as follows: 18g of astragalus membranaceus, 18g of cassia twig, 15g of eucommia ulmoides, 12g of dried ginger, 9g of monkshood, 9g of radix paeoniae alba, 6g of schisandra chinensis, 6g of pseudo-ginseng and 6g of liquorice;
the preparation method comprises the following steps: the raw materials are taken according to the proportion and decocted and extracted by water to obtain the traditional Chinese medicine composition decoction.
Example 2
The formula is as follows: 16g of astragalus, 22g of cassia twig, 13g of eucommia bark, 14g of dried ginger, 8g of monkshood, 13g of white paeony root, 6g of Chinese magnoliavine fruit, 8g of pseudo-ginseng and 6g of liquorice;
the preparation method comprises the following steps: the raw materials are taken according to the proportion and decocted and extracted by water to obtain the decoction of the traditional Chinese medicine composition.
Example 3
The formula is as follows: 22g of astragalus, 16g of cassia twig, 18g of eucommia bark, 11g of dried ginger, 13g of monkshood, 8g of white paeony root, 8g of Chinese magnoliavine fruit, 6g of pseudo-ginseng and 8g of liquorice;
the preparation method comprises the following steps: the raw materials are taken according to the proportion and decocted and extracted by water to obtain the traditional Chinese medicine composition decoction.
Example 4
The formula is as follows: 20g of astragalus membranaceus, 17g of cassia twig, 17g of eucommia ulmoides, 12g of dried ginger, 11g of monkshood, 9g of radix paeoniae alba, 7g of schisandra chinensis, 5g of pseudo-ginseng and 7g of liquorice;
the preparation method comprises the following steps: taking the bulk drugs according to the prescription amount, adding 70 percent ethanol with the amount of 10 times of the bulk drugs, and carrying out reflux extraction for 2 times, wherein each time lasts for 1.5 hours; mixing extractive solutions, filtering, recovering ethanol, and concentrating; drying the concentrated solution under reduced pressure, pulverizing into fine powder, adding starch, mixing, granulating, adding magnesium stearate, mixing, and tabletting to obtain tablet.
Example 5
The formula is as follows: 17g of astragalus, 20g of cassia twig, 14g of eucommia bark, 15g of dried ginger, 9g of monkshood, 11g of white paeony root, 5g of Chinese magnoliavine fruit, 7g of pseudo-ginseng and 5g of liquorice;
the preparation method comprises the following steps: taking the bulk drugs according to the prescription amount, adding 10 times of 80% ethanol, carrying out ultrasonic extraction for 3 times, 40min for the first time, 20min for each of the 2 nd and 3 rd times, combining the extracting solutions, filtering, and concentrating under reduced pressure; drying the concentrated solution under reduced pressure, pulverizing into fine powder, adding conventional adjuvants, and mixing; dry pressing, granulating, and making into capsule.
Example 6
The formula is as follows: 12g of astragalus, 25g of cassia twig, 11g of eucommia bark, 18g of dried ginger, 6g of monkshood, 16g of white paeony root, 4g of Chinese magnoliavine fruit, 12g of pseudo-ginseng and 4g of liquorice;
the preparation method comprises the following steps: taking the bulk drugs according to the prescription amount, adding 8 times of water to soak for 6h, percolating for 24h, and enabling the flow rate to be 2L/h. Collecting percolate, centrifuging, loading onto macroporous adsorbent resin column, eluting with water and then 60% ethanol, collecting ethanol eluate, concentrating the filtrate, drying, pulverizing into fine powder, adding pharmaceutically acceptable adjuvants, and making into dripping pill according to conventional method of preparation in the art.
Example 7
The formula is as follows: 25g of astragalus membranaceus, 12g of cassia twig, 22g of eucommia ulmoides, 8g of dried ginger, 16g of monkshood, 6g of radix paeoniae alba, 12g of schisandra chinensis, 4g of pseudo-ginseng and 12g of liquorice;
the preparation method comprises the following steps: decocting the bulk drugs according to the prescription amount in water for 2 times, the first time lasts for 2 hours, the second time lasts for 1.5 hours, combining the decoctions, filtering, concentrating the filtrate, adding ethanol into the concentrated solution until the ethanol content reaches 70%, standing, filtering, recovering ethanol from the filtrate until the ethanol smell does not exist, concentrating until the relative density reaches 1.15 (60 ℃), adding water to 1000ml, filtering, heating, boiling and sterilizing to obtain the oral liquid of the composition.
Example 8
The formula is as follows: 14g of astragalus, 27g of cassia twig, 9g of eucommia bark, 20g of dried ginger, 7g of monkshood, 18g of white paeony root, 5g of Chinese magnoliavine fruit, 13g of pseudo-ginseng and 5g of liquorice.
Example 9
The formula is as follows: 27g of astragalus, 14g of cassia twig, 24g of eucommia bark, 10g of dried ginger, 18g of monkshood, 7g of white paeony root, 13g of Chinese magnoliavine fruit, 5g of pseudo-ginseng and 13g of liquorice.
Example 10
The formula is as follows: 9g of astragalus, 30g of cassia twig, 7g of eucommia bark, 24g of dried ginger, 5g of monkshood, 22g of white paeony root, 3g of Chinese magnoliavine fruit, 15g of pseudo-ginseng and 3g of liquorice.
Example 11
The formula is as follows: 30g of astragalus, 9g of cassia twig, 27g of eucommia bark, 6g of dried ginger, 22g of monkshood, 5g of white paeony root, 15g of Chinese magnoliavine fruit, 3g of pseudo-ginseng and 15g of liquorice.
Example 12
The formula is as follows: 18g of astragalus extract, 18g of cassia twig extract, 15g of eucommia bark extract, 12g of dried ginger extract, 9g of monkshood extract, 9g of white paeony root extract, 6g of Chinese magnoliavine fruit extract, 6g of pseudo-ginseng extract and 6g of liquorice extract.
Example 13
The formula is as follows: 16g of astragalus extract, 22g of cassia twig extract, 13g of eucommia bark extract, 14g of dried ginger extract, 8g of monkshood extract, 13g of white paeony root extract, 6g of Chinese magnoliavine fruit extract, 8g of pseudo-ginseng extract and 6g of liquorice extract.
Example 14
The formula is as follows: 22g of astragalus extract, 16g of cassia twig extract, 18g of eucommia bark extract, 11g of dried ginger extract, 13g of monkshood extract, 8g of white paeony root extract, 8g of Chinese magnoliavine fruit extract, 6g of pseudo-ginseng extract and 8g of liquorice extract.
Example 15
The formula is as follows: 20g of astragalus extract, 17g of cassia twig extract, 17g of eucommia bark extract, 12g of dried ginger extract, 11g of monkshood extract, 9g of white paeony root extract, 7g of Chinese magnoliavine fruit extract, 5g of pseudo-ginseng extract and 7g of liquorice extract.
Example 16
The formula is as follows: 17g of astragalus extract, 20g of cassia twig extract, 14g of eucommia bark extract, 15g of dried ginger extract, 9g of monkshood extract, 11g of white paeony root extract, 5g of Chinese magnoliavine fruit extract, 7g of pseudo-ginseng extract and 5g of liquorice extract.
Example 17
The formula is as follows: 12g of astragalus extract, 25g of cassia twig extract, 11g of eucommia bark extract, 18g of dried ginger extract, 6g of monkshood extract, 16g of white paeony root extract, 4g of Chinese magnoliavine fruit extract, 12g of pseudo-ginseng extract and 4g of liquorice extract.
Example 18
The formula is as follows: 25g of astragalus extract, 12g of cassia twig extract, 22g of eucommia bark extract, 8g of dried ginger extract, 16g of monkshood extract, 6g of white paeony root extract, 12g of Chinese magnoliavine fruit extract, 4g of pseudo-ginseng extract and 12g of liquorice extract.
Example 19
The formula is as follows: 14g of astragalus extract, 27g of cassia twig extract, 9g of eucommia bark extract, 20g of dried ginger extract, 7g of monkshood extract, 18g of white paeony root extract, 5g of Chinese magnoliavine fruit extract, 13g of pseudo-ginseng extract and 5g of liquorice extract.
Example 20
The formula is as follows: 27g of astragalus extract, 14g of cassia twig extract, 24g of eucommia bark extract, 10g of dried ginger extract, 18g of monkshood extract, 7g of white paeony root extract, 13g of Chinese magnoliavine fruit extract, 5g of pseudo-ginseng extract and 13g of liquorice extract.
The extracts described in examples 12-20 are aqueous extracts of the respective bulk drugs.
EXAMPLE 21 clinical trial
1 data and method
1.1. General data
116 cases of patients with lung diseases of Chinese medicine of China friendly hospital, which are diagnosed in 15 months to 2018 months in 2015, are selected, and the patients are aged (65.06 +/-11.08) years old, wherein 56 cases are male and 60 cases are female, and the patients are diagnosed according with interstitial lung diseases (interstitial lung diseases, interstitial fibrosis of lung, interstitial pneumonia and organizing pneumonia).
1.2. Inclusion criteria
(1) Patients diagnosed with interstitial lung diseases (interstitial lung diseases, interstitial fibrosis of lung, interstitial pneumonia and organizing pneumonia) by HRCT or pathological biopsy result are selected to have at least one examination of CT and lung function at the initial diagnosis; (2) the age is more than or equal to 18 years old, and the nature is not limited; (3) clear mind, normal thinking and ability of language communication.
1.3. Exclusion criteria
(1) Pregnant or lactating women; (2) patients with other severe disease; (3) patients with comorbid mental disease or severe neurosis; (4) those who do not express subjective discomfort symptoms; (5) while receiving inhaled corticosteroid therapy, or other thoracic abnormalities that may interfere with efficacy assessments; (6) specific types of interstitial lung diseases are diagnosed, such as allergic alveolitis, sarcoidosis, and pulmonary lymphangioleiomyomatosis.
1.4. Index of therapeutic effect
1.4.1 Main therapeutic index
1.4.1.1 major associated symptom score
The physician records the patient's score of the primary associated symptoms, the score criteria of primary associated symptoms: see table 1.
TABLE 1 score criteria for major relevant symptoms
Figure BDA0002165650150000091
1.4.1.2 doubling correlation symptom integration
Doctors record clinical symptoms except dyspnea and cough of patients, and possible clinical symptoms comprise wheezing, chest distress, breath holding, shortness of breath, expectoration, abnormal stool, abnormal urine, bitter taste, dry mouth, poor sleep, hypodynamia, sweating, anorexia, abdominal distension, cold hands and feet, rash, arthralgia, discomfort of eyes and the like. All the integration points of the complications are added to form the total integration point of the treatment.
1.4.2 Secondary efficacy index
Examination of pulmonary function
Comparison of pulmonary function before and after treatment (FVC, FEV1, PEF, DLCO-SB).
1.4.3 therapeutic efficacy criteria
According to the guiding principle of clinical research of new traditional Chinese medicine, 2002 edition: the clinical cure is as follows: clinical symptoms and physical signs disappear or basically disappear, and the syndrome score is reduced by more than or equal to 95 percent; the effect is shown: the clinical symptoms and physical signs are obviously improved, and the syndrome integral is reduced by more than or equal to 70 percent but less than 95 percent; the method has the following advantages: the clinical symptoms and physical signs are improved, and the syndrome integral is reduced by more than or equal to 30 percent but less than 70 percent; and (4) invalidation: clinical symptoms and physical signs are not obviously improved or even aggravated, and the syndrome score is reduced by less than 30%.
Syndrome integral calculation formula (nimodipine method) = [ integral before treatment-integral after treatment ] ÷ integral before treatment × 100%.
1.5 methods
1.5.1 Experimental drugs
The decoction prepared in example 1 is taken in 2 times with one dose per day, 7 days is 1 treatment course, and 14 days are taken continuously for 2 treatment courses.
1.5.2 statistical methods
Using SPSS25.0 to make statistics and analysis on various data, and using various parameters to make statistics
Figure BDA0002165650150000104
The result shows that the difference is statistically significant by using a paired Wilcoxon symbolic rank sum test, and P is less than 0.05.
2 results of
2.1 clinical efficacy
Of the 116 patients, 29 patients showed significant effect, accounting for 25.00%; 60 effective cases account for 51.72 percent; invalid 27 cases account for 23.28%; the total effective rate is 76.72%.
2.2 integral comparison of symptom signs before and after treatment
The results are shown in Table 2. The total score of symptoms, the dyspnea of the main symptoms and the cough after treatment are all obviously lower than those before treatment, and the difference has statistical significance (P is less than 0.01).
TABLE 2 integral comparison of signs before and after treatment for 116 patients: (
Figure BDA0002165650150000101
Minute)
Item Before treatment After treatment
General points of the symptoms 24.76±3.95 12.47±5.68**
Dyspnea 1.93±0.64 1.06±0.61**
Cough with a symptom of the lung 2.15±0.75 1.00±0.69**
Note: p <0.01 compared to pre-treatment. The following table is the same.
2.3 comparison of Lung function FVC, FEV1, PEF, DLCO-SB before and after treatment see Table 3. After treatment, FVC, FEV1 and DLCO-SB are all obviously lower than before treatment, and the difference has statistical significance (P is less than 0.01).
TABLE 3 comparison of pulmonary function before and after treatment in 116 patients: (
Figure BDA0002165650150000102
Minute)
Figure BDA0002165650150000103
Figure BDA0002165650150000111
According to the invention, through the front-back contrast clinical research and observation of 116 ILD patients treated by the traditional Chinese medicine composition, the traditional Chinese medicine composition has better clinical curative effect on ILD treatment, the main and secondary curative effect indexes after treatment are better than those before treatment, and the total effective rate reaches 76.72%.
According to the traditional Chinese medicine, the basic pathogenesis of pulmonary fibrosis is mainly deficiency and excess, the deficiency and excess are mixed, the excess is mainly blood stasis, phlegm dampness and heat toxin, and the clinical treatment is mostly performed by methods of tonifying deficiency and reducing excess, treating both symptoms and root causes, tonifying qi and enriching blood, activating blood and dissolving stasis and the like. The commonly used traditional Chinese medicines include: qi tonics: astragalus root, ginseng, american ginseng, white atractylodes rhizome, chinese date and licorice; interior-warming herbs: rhizoma Zingiberis, radix Aconiti lateralis Preparata; yang tonics: gecko, cortex Eucommiae, and Cordyceps; and (3) yin tonifying drugs: radix Ophiopogonis, fructus Ligustri Lucidi; blood-tonifying agent: radix Paeoniae alba, radix rehmanniae Preparata, radix Angelicae sinensis, and rhizoma Ligustici Chuanxiong; cough-relieving and phlegm-resolving herbs: aster, fritillaria, exocarpium citri rubrum, ginkgo leaf, platycodon grandiflorum, trichosanthes kirilowii maxim and inula flower; collaterals-unblocking, wind-extinguishing and spasm-stopping herbs: lumbricus, scorpio, and spina Gleditsiae; blood-activating stasis-resolving herbs: saviae Miltiorrhizae radix, semen Persicae, notoginseng radix, hirudo, and Curcuma rhizome; heat-clearing and blood-cooling medicine: radix Paeoniae Rubra, radix scrophulariae, radix Arnebiae, and cortex moutan; wind-cold-dispersing herbs: ramulus Cinnamomi, radix Saposhnikoviae, radix Angelicae Dahuricae, and herba asari; astringency inducing: schisandra fruit, dogwood fruit, myrobalan fruit, dark plum fruit and the like.
Before the invention, the inventor screens the common traditional Chinese medicines, establishes different compositions according to different compatibility principles, and is inferior to the compositions of the invention in effective rate by inspection:
the formula 1 is as follows: 10g of astragalus membranaceus, 3g of American ginseng, 6g of bighead atractylodes rhizome, 9g of radix ophiopogonis, 4g of bulbus fritillariae cirrhosae, 12g of radix paeoniae rubra, 9g of radix scrophulariae, 3g of exocarpium citri rubrum, 9g of salvia miltiorrhiza, 9g of peach kernel, 5g of radix saposhnikoviae, 6g of glossy privet fruit, 3g of gecko and 2g of liquorice. After 3 months of treatment, the treatment group has 3 improved patients, 21 stable patients and 10 ineffective patients, and the total effective rate reaches 70.59%;
and (2) formula: 15g of American ginseng, 3g of pseudo-ginseng, 15g of dogwood, 15g of schisandra chinensis, 15g of aster, 15g of radix ophiopogonis, 10g of ginkgo leaves and 10g of honey-fried licorice roots, and the decoction is decocted with water, 100mL of the decoction is taken each time, 2 times a day and 2 months as a treatment course. The total effective rate of 61 patients in the treatment group is 62.3%.
The astragalus root in the formula of the invention is a monarch drug for tonifying qi, strengthening exterior, strengthening spleen and benefiting lung; the cassia twig warms and unblocks the meridians and collaterals, assists yang and regulates qi, the eucommia bark tonifies the liver and kidney, the dried ginger warms the middle-jiao and dispels cold, returns yang and unblocks the collaterals, the cassia twig, the eucommia bark and the dried ginger serve as ministerial drugs, and the monarch drug is used for tonifying the spleen, benefiting the lung and tonifying the kidney; radix Aconiti lateralis warms up kidney yang, radix Notoginseng activates blood and nourishes blood, fructus Schisandrae chinensis astringes and astringes, benefits qi and promotes fluid production, radix Paeoniae alba nourishes blood and regulates menstruation, coordinates Ying and Wei, the four are used as adjuvant drugs; licorice root, radix Glycyrrhizae is a guiding drug for tonifying the spleen and replenishing qi, and harmonizing the effects of the other drugs in the recipe. The whole formula has the effects of tonifying qi, warming yang, dredging collaterals and generating lung, and is suitable for consumptive lung disease in traditional Chinese medicine caused by multiple organ deficiency of lung, spleen and kidney. Compared with other compositions, the composition has obvious compatibility effect.
Example 22 Effect of the Chinese medicinal composition of the present invention on pulmonary fibrosis in rats caused by bleomycin
1 materials and methods
1.1 materials
1.1.1 animals
The SPF grade SD male rats are 90, and the body mass is 200 +/-20 g (Beijing Witongliwa experiment animal technology Co., ltd., the animal license number is SCXK (Jing) 2012-0001). The animal room is clean, the environment humidity is 22 +/-2 ℃, the relative humidity is 60-80%, the common special feed is used for feeding, noise and other interference are avoided, the animal room is cleaned in each day, the drinking water of the rat is replaced, the feed is added, and the cage for the laboratory rat is replaced every other day. The test is carried out after the test is adapted to the environment for 1 week and no abnormality occurs in activities, feces and the like.
1.1.2 drugs and reagents
1.1.2.1 Experimental drugs
The tested drugs are: 18g of raw astragalus, 18g of cassia twig, 15g of eucommia bark, 12g of dried ginger, 9g of prepared aconite root, 9g of white paeony root, 6g of Chinese magnoliavine fruit, 6g of pseudo-ginseng and 6g of raw liquorice. According to the standard of 2010 Chinese pharmacopoeia, the medicines are purchased and identified from Beijing Tongrentang Chinese herbal piece Limited liability company at one time, 8 times of water is added after the original prescription is combined, the mixture is soaked for 30min, the time is sequentially 2h according to 12 ℃,3 times of extracting solution is filtered, concentrated at 80 ℃, and stored in a refrigerator at 4 ℃ for standby;
positive control drug: prednisone acetate tablets (Tianjin Lisheng pharmaceutical products, ltd., batch No. 1705021 of the national standard H12020122);
1.1.2.2 Experimental reagents
See table 4.
TABLE 4 test reagents
Figure BDA0002165650150000121
Figure BDA0002165650150000131
1.1.2.3 Experimental apparatus
See table 5.
TABLE 5 Experimental apparatus
Instrument for measuring the position of a moving object Company(s)
ASP300 takes off full-automatic multi-functional ELIASA MULTISKAN MK3 (Thermo Co., ltd.)
High-speed refrigerated centrifuge Shanghai Luxiang instrument centrifuge instruments ltd
Microscope Olympus, japan Ltd
Image analysis software MIAS
Picture-taking software Nikon NIS-Elements D3.2 Nikon Japan Co Ltd
BX51 water machine Leica, germany
EG1150H embedding machine Leica, germany
RM2235 slicer Leica, germany
H I1 210 sheet spreading machine Leica, germany
1.2 Experimental methods
1.2.1 animal groups
90 SD male rats, classified by the stochastic numerical notation: a normal control group, a model control group, a prednisone acetate group (6 mg/kg), a large (20 g crude drug/kg), a medium (10 g crude drug/kg) and a small dose group (5 g crude drug/kg) of the composition, and 15 of the compositions are respectively used.
1.2.2 model building
After the rats were acclimatized for 1 week, 5mg/kg of bleomycin physiological saline solution (3 mg/mL) was injected intratracheally into each of the groups except the normal control group. Normal control group was infused with equal amount of normal saline intratracheally. Immediately after injection, the rats were stood upright and rotated so that the drug was uniformly distributed in the lungs of the rats. Rats were fed ad libitum after waking.
1.2.3 administration
The next day of model establishment, each administration group began to administer the drug by gavage 1 time a day for 28 consecutive days, and the normal control group and the model control group were administered with normal saline.
1.2.4 specimen Collection and processing
Taking materials at 28d after molding, wherein the specific method comprises the following steps: the rats were anesthetized by intraperitoneal injection of 2% pentobarbital, the anesthetized rats were positioned on the operating table in a supine position, the abdominal cavity was cut open, and arterial blood was taken from the abdominal aorta. And then cutting the chest upwards to expose the two lungs, clamping the mouth of the right lung by using a hemostatic dislocation treated by RNase, taking down the right lung, placing the upper lobe of the right lung in a pre-marked cryopreservation tube, and placing the cryopreservation tube in liquid nitrogen for storage so as to extract RNA. The right lung lobes were washed rapidly with blood in pre-cooled saline, the connective tissue was removed, and placed in 4% poly formic acid to prepare pathological sections. The neck skin of the rat is cut open, the trachea is separated and exposed, a transverse incision is rapidly made on the lower section of the trachea, the trachea is intubated, 2ml of normal saline is injected by a 5ml syringe, the normal saline is slowly pumped back after the normal saline is reserved for 2 minutes, and the normal saline is collected in a 10ml centrifuge tube. Repeating the steps for 3 times, wherein the total volume is 6ml, the recovery rate is more than 85%, the alveolar lavage fluid (BALF) in a centrifuge tube is centrifuged for 5 minutes, and the extracted supernatant is subpackaged in an EP tube and stored in a refrigerator at the temperature of-80 ℃ for inflammatory cytokine detection.
1.2.5 detection index and method
1.2.5.1 general case
The mental activities, the weight changes, the ingestion, the drinking, the hair color, the respiration and the reaction conditions to external stimulation of the rats in each group during the experiment period are observed every day, the death condition and the death time of the rats are recorded, and the death reason is analyzed in time.
1.2.5.2 airway resistance and dynamic compliance detection
On the 28 th day of administration, 1 hour after administration, rats in each group were anesthetized with pentobarbital sodium injection (2%, 60 mg/kg), fixed on the back, the neck skin was cut open to expose the trachea, T-shaped scissors were cut, the trachea was cannulated, placed in an obturator scanning box, assisted ventilation was performed with a ventilator, 20 μ L (0 mg/mL, 3.125mg/mL, 6.25mg/mL, 12.5mg/mL, 25 mg/mL) of methacholine at increasing concentrations was sequentially nebulized after the baseline of airway resistance in rats was stabilized, and airway Resistance (RL) and dynamic compliance (Cdyn) were examined.
1.2.5.3 bronchoalveolar lavage fluid (BALF) cell count
The rat lungs were lavaged with 5mL of saline to obtain BALF, centrifuged, smeared, stained by HE, and the microscopic alveolar macrophages, neutrophils, and lymphocytes were counted (%).
1.2.5.4 Lung weight and Lung coefficient
And taking out the lung, removing the extrapulmonary trachea, weighing by an electronic balance, and calculating the lung coefficient.
1.2.5.5 histopathological Observation
The lung of a rat is taken, fixed by neutral formaldehyde, embedded by paraffin, sliced conventionally, and subjected to HE staining and Masson staining respectively, and pathological changes (alveolar structure, inflammatory cell infiltration, fibrosis and the like) are observed under a light microscope.
1.2.5.5.1HE staining
The 10% neutral formalin-fixed specimen was dehydrated with normal alcohol, xylene-treated, paraffin-embedded, 3 μm-sectioned continuously, and baked for use. Dewaxing the xylene I and the xylene II for l5min. The method comprises the steps of hydrating absolute ethyl alcohol I, absolute ethyl alcohol II, 95% ethyl alcohol and 80% ethyl alcohol for 2min respectively, washing with running water, dyeing with hematoxylin for 10min, washing with water for 3min, washing with color separation liquid for 10s, washing with water for 3 times, washing with 0.25% bluing liquid for 40s, washing with water for 3 times, dyeing with l% eosin for 1min, and washing with water for 3 times. Dehydrating 95% ethanol I and 95% ethanol II step by step for 1min, dehydrating anhydrous ethanol I and II step by step for 2min, xylene I for 2min, and xylene II and III are transparent for 5min, and sealing with neutral gum.
1.2.5.5.2Masson staining
Masson staining procedure: slicing, dewaxing, dewatering, and dip-dyeing with hematoxylin at room temperature for 1-2min; washing with running water for 3-5min, returning blue, and washing with distilled water; dyeing Masson's acid red re-reddening solution for 5min, and washing with 1% phosphomolybdic acid water solution for 1-2s; dyeing with aniline blue or light green liquor for 5min; soaking and washing with 0.2% glacial acetic acid for 1-2s; after drying, sealing the neutral gum into a piece; the collagen fibers are observed by an optical microscope, and the positive result shows blue-green.
1.2.5.5.3 the degree of alveolitis and pulmonary fibrosis was determined with reference to the grading criteria of station Szapiel.
Grading and integration criteria for pulmonary interstitial fibrosis (Masson staining) and alveolitis (HE staining) are shown in Table 6.
TABLE 6 pulmonary alveolitis and pulmonary fibrosis grading and integration criteria
Figure BDA0002165650150000151
Figure BDA0002165650150000161
1.2.5.6 detection of Lung tissue homogenate related indicators
Taking lung tissue, homogenizing, and detecting the content of Hydroxyproline (HYP), basic fibroblast growth factor (bFGF), type III procollagen, type IV collagen, TIMP-1, monocyte chemotactic protein-1 (MCP-1), TGF-beta 1, IL-6 and TNF-alpha.
1.3 statistical methods
All data are expressed by means of standard deviation +/-s, are processed by SPSS25.0 statistical software, are subjected to single-factor variance analysis when subjected to normal distribution, are subjected to LSD (least squares) test when compared pairwise, are subjected to nonparametric test when not subjected to normal distribution or irregular variance, and have statistical significance when P <0.05 or P <0.01 is used as difference.
2. Results of the experiment
2.1 general State description of rats
A total of 5 rats died during the experiment. Among them, 4 model groups and 1 prednisone acetate group were considered to be related to the cytotoxicity of BLM, and the correlation between the cause of death and factors such as the constitution of rats and the tolerance to toxicity was not excluded.
During the test period, 26 rats died, wherein 7 rats in the model group, 3 rats in the prednisone group, 5 rats in the traditional Chinese medicine low dose group, 4 rats in the traditional Chinese medicine medium dose group and 7 rats in the traditional Chinese medicine high dose group. After the dead rats are dissected, the lung congestion and swelling of different degrees are found, and pleural effusion is seen in some cases. The cause of death was considered to be related to bleomycin cytotoxicity.
The rats in the normal group have sensitive reaction, good spirit, stable respiration, strong body, good drinking and eating, bright hair color and gradually increased weight; the rats in the model group showed listlessness, rapid respiration, slow movement, bows, knees, loose fur, lusterless fur, even filthy fasciculation, decreased intake of water, rapid weight loss after model building, and slow body weight increase after two weeks. The rats in each administration group generally have better conditions than those in the model group, the body weight of the rats rapidly decreases after the model is built, and the body weight increases to different degrees after one week.
2.2 airway resistance and dynamic compliance detection
Compared with the normal group, the lung compliance of rats in each group is reduced (P is less than 0.05), and the airway resistance of rats in each dose group with low, medium and high composition in the model group is increased (P is less than 0.05); compared with the model group, the rats in each group show an upward trend in compliance and a downward trend in airway resistance, but have no meaning (P > 0.05), and the results are shown in Table 7.
TABLE 7 airway resistance and dynamic compliance in various groups of rats
Group of n CDYN RL
Normal group 15 0.40±0.09 0.29±0.04
Model set 8 0.20±0.12 ** 0.52±0.40 *
Prednisone group 12 0.26±0.10 ** 0.36±0.13
Composition low dose group 10 0.23±0.08 ** 0.39±0.06 **
Dosage group in composition 11 0.29±0.08 * 0.42±0.14 **
High dose compositions 8 0.24±0.12 ** 0.42±0.11 **
Note: in comparison with the normal group, * P<0.05, ** p is less than 0.01; in comparison to the set of models, P<0.05, ▲▲ P<0.01
2.3 bronchoalveolar lavage fluid (BALF) cell count
Compared with the normal group, the prednisone group has the advantages that the macrophage proportion in the bronchoalveolar lavage fluid is increased (P is less than 0.01), the lymphocyte proportion is obviously reduced (P is less than 0.01), and the neutrophil proportion is obviously increased (P is less than 0.01); the macrophage proportion of the low-dose group is increased (P is less than 0.05), and the lymphocyte proportion is reduced (P is less than 0.05); the model group, the Chinese medicine medium dosage group and the Chinese medicine high dosage group have no obvious difference (P is more than 0.05). Compared with the model group, the prednisone group has the advantages that the macrophage proportion in the bronchoalveolar lavage fluid is increased (P is less than 0.05), and the lymphocyte proportion is obviously reduced (P is less than 0.05). Compared with prednisone, the macrophage proportion of each Chinese medicinal composition is reduced (P is less than 0.05), the lymphocyte proportion is increased (P is less than 0.05), and the neutrophil proportion of the Chinese medicinal composition in the dosage group is remarkably reduced (P is less than 0.01). The prednisone group is suggested to have low immune function and inflammatory cell infiltration, and is considered to be possibly related to the low immune function caused by long-term application of the hormone, which is shown in table 8.
TABLE 8 bronchoalveolar lavage fluid (BALF) cell counts
Group of Macrophage (%) Lymphocyte (%) Neutral cell (%)
Normal group 14.09±6.64 82.27±7.86 3.64±2.34
Model set 22.50±9.87 74.17±9.70 3.33±2.58
Prednisone group 43.18±7.51 **▲ 49.55±7.57 **▲ 7.27±3.44 **▲
Composition low dose group 24.00±8.43 *△ 70.50±9.56 *△ 5.50±1.58
Composition medium dosage group 11.50±5.80 ▲△△ 86.50±7.09 ▲△△## 2.00±2.58 △△##
High dose compositions 17.14±6.36 △△ 77.14±5.67 △△ 5.71±1.89 &
Note: in comparison with the normal group, * P<0.05, ** p is less than 0.01; in comparison to the set of models, P<0.05, ▲▲ p is less than 0.01; in comparison to the prednisone group, P<0.05, △△ P<0.01; compared with the group with low dosage of the traditional Chinese medicine, # P<0.05, ## P<0.01; compared with the traditional Chinese medicine medium dosage group, & P<0.05, && P<0.01
2.4 Lung weight and Lung factor
2.4.1 Effect of Chinese medicinal composition on Lung weight of rat
After the administration is finished, the lung weight of each group is in a rising trend compared with the lung weight of a normal group, wherein the lung weight of a model group and a low-medium dosage group of the traditional Chinese medicine composition is obviously increased (P is less than 0.05); compared with the model group, the weight of the lung of the prednisone group is obviously reduced (P is less than 0.05); compared with prednisone, the lung weight of the low-dose group of the traditional Chinese medicine is obviously increased (P is less than 0.05), and the middle-dose group and the high-dose group of the traditional Chinese medicine are in an increasing trend without statistical difference (P is more than 0.05), which is shown in Table 9.
TABLE 9 Lung weights of rats after dosing
Figure BDA0002165650150000181
Figure BDA0002165650150000182
Figure BDA0002165650150000191
Note: in comparison with the normal group, * P<0.05, ** P<0.01; in comparison to the set of models, P<0.05, ▲▲ P<0.01; in comparison to the prednisone group, P<0.05, △△ P<0.01
2.4.2 pulmonary factor changes in groups of rats after drug administration
The lung coefficients of the rats in each group have no obvious difference (P is more than 0.05), and are shown in a table 10.
TABLE 10 pulmonary factor of rats after dosing
Figure BDA0002165650150000192
Figure BDA0002165650150000193
Note: as compared with the normal group, the test results, * P<0.05, ** P<0.01
2.5 histopathological Observation
2.5.1 anatomical Observation
The normal group had pink lungs, smooth surface and good elasticity. The model group has pale lung, poor elasticity, reduced volume and increased hardness. The remaining treatment groups were lighter than the model group, and the prednisone group was roughly equivalent to the model group.
2.5.2HE and Masson staining
The lung tissue structure of the rats in the normal group is clear, the alveolar wall is not thickened, and the alveolar epithelial cell structure is complete. The alveolar space of the model group is obviously widened, fibroblasts are proliferated, and inflammatory cells are infiltrated; the alveolar structure is destroyed, and partial alveolar space atrophy disappears. The pulmonary alveolus inflammation of the model group, the traditional Chinese medicine group and the prednisone acetate treatment group is changed, the lung excess is distributed like a spot, a large amount of fibroblast and collagen fiber hyperplasia can be seen, a small amount of macrophage, lymphocyte and eosinophilic granulocyte are infiltrated, and the periphery of the trachea is obvious. Disordered pulmonary parenchymal structure in a lesion area, thickened alveolar space, damaged alveolar structure, collapsed and fused alveoli, large pulmonary alveoli formed, and a plurality of foam cells (macrophages) in the alveolar cavities are infiltrated; the cilia of the trachea fall off, lodge and adhere, and the outer wall of the bronchus is obviously thickened. Compared with the model group, the Chinese medicine group has different degrees of reduction of alveolus inflammation or fibrosis degree. The prednisone group had a different degree of exacerbation of alveolar inflammation or fibrosis than the model group. The results are shown in FIGS. 1 and 2.
2.5.2.1HE staining pathology score
Compared with the normal group, the HE staining pathological score of the model group and each treatment group is obviously increased (P < 0.01); compared with the model group, the pathological score of each treatment group is obviously reduced (P is less than 0.01), and the traditional Chinese medicine and prednisone are suggested to have the inhibition effect on the lung inflammation of the rat caused by the BLM. The results are shown in Table 11.
TABLE 11 degree of alveolitis in rat HE-stained lung tissue sections
Group of N - + ++ +++
Control group 15 15 0 0 0
Model set ** 8 0 0 0 8
Prednisone group **△△ 11 0 0 8 3
Composition Low dose group **△△ 10 0 2 6 2
Composition medium dosage group **△△ 10 0 0 7 3
High dose compositions **△△ 8 0 0 4 4
Note: in comparison with the normal group, * P<0.05, ** p is less than 0.01; in comparison to the set of models, P<0.05, △△ P<0.01。
2.5.2.2Masson staining pathology score
The Masson staining pathology score was significantly higher in the model group, prednisone group compared to the normal group (P < 0.01); compared with the model group, the pathological score of the prednisone group is in an ascending trend, the score of each traditional Chinese medicine group is in a descending trend, but no statistical difference exists (P is more than 0.05), which indicates that the traditional Chinese medicine has a certain inhibition effect on the development of the pulmonary fibrosis of the rat caused by BLM, and the prednisone may have a certain promotion effect on the development of the pulmonary fibrosis of the rat, and the results are shown in Table 12.
TABLE 12 collagen fiber content of rat Masson stained lung tissue sections
Figure BDA0002165650150000201
Figure BDA0002165650150000211
Note: in comparison with the normal group, * P<0.05, ** p is less than 0.01; in comparison to the set of models, P<0.05, △△ P<0.01。
2.6 detection of relevant indices of Lung tissue homogenate
2.6.1 Effect of the Chinese medicinal composition on rat Lung tissue TGF-beta 1
Compared with the normal group, the level of TGF-beta 1 in the lung tissue of the rat in the prednisone group is obviously increased (P is less than 0.01); compared with the model group, the groups have no obvious difference (P is more than 0.05); compared with the prednisone group, the TGF-beta 1 level of the traditional Chinese medicine medium and high dose groups is obviously reduced (P is less than 0.01), and the result is shown in a table 13.
TABLE 13 detection of TGF-. Beta.1 changes in Lung tissue by ELISA
Figure BDA0002165650150000212
Group of Dosage (g/kg) n TGF-β1(ng/mg)
Normal group - 15 0.042±0.011
Model set - 8 0.050±0.008
Prednisone group 0.006 12 0.055±0.008 **
Composition low dose group 5 10 0.049±0.007
Composition medium dosage group 10 11 0.035±0.016 △△
High dose compositions 20 8 0.036±0.016 △△
Note: in comparison with the normal group, * P<0.05, ** P<0.01; in comparison to the set of models, P<0.05, ▲▲ P<0.01; in comparison to the prednisone group, P<0.05, △△ P<0.01
2.6.2 Effect of the Chinese medicinal composition on rat Lung tissue MCP-1
Compared with the normal group, the model group, the Chinese medicine medium-dose group and the Chinese medicine high-dose group have obviously raised MCP-1 level (P is less than 0.05) of rat lung tissues; compared with the model group, the traditional Chinese medicine low-dose group MCP-1 level is obviously reduced (P is less than 0.05); compared with prednisone, MCP-1 level in the traditional Chinese medicine dosage group is obviously increased (P is less than 0.05), and is shown in Table 14.
TABLE 14 detection of MCP-1 changes in Lung tissue by ELISA
Figure BDA0002165650150000213
Figure BDA0002165650150000214
Figure BDA0002165650150000221
Note: in comparison with the normal group, * P<0.05, ** P<0.01; in comparison to the set of models, P<0.05, ▲▲ P<0.01; in comparison to the prednisone group, P<0.05, △△ P<0.01; compared with the group with low dosage of the traditional Chinese medicine, # P<0.05, ## P<0.01
2.6.3 Effect of the Chinese medicinal composition on IL-6 in rat Lung tissue
Compared with the normal group, the IL-6 level in the lung tissue of the rat in the model group and the prednisone group is obviously increased (P is less than 0.01); compared with the model group, the IL-6 level of the traditional Chinese medicine low-dose group and the traditional Chinese medicine medium-dose group is obviously reduced (P is less than 0.05); compared with prednisone group, IL-6 level of the Chinese medicine low, medium and high dose groups is obviously reduced (P is less than 0.05), as shown in Table 15.
TABLE 15 detection of IL-6 changes in Lung tissue by ELISA
Figure BDA0002165650150000222
Group of Dosage (g/kg) n IL-6(ng/g)
Normal group - 15 2.38±0.38
Model set - 8 2.94±0.30 **
Prednisone group 0.006 12 3.18±0.72 **
Composition low dose group 5 10 2.48±0.34 ▲△△
Composition medium dosage group 10 11 2.50±0.62 ▲△△
High dose compositions 20 8 2.56±0.44
Note: in comparison with the normal group, * P<0.05, ** P<0.01; in comparison to the set of models, P<0.05, ▲▲ P<0.01; in comparison to the prednisone group, P<0.05, △△ P<0.01
2.6.4 Effect of the Chinese medicinal composition on rat Lung tissue COL IV
Compared with the normal group, the COL IV level in the lung tissue of the rat in the prednisone group, the traditional Chinese medicine medium-dosage group and the traditional Chinese medicine high-dosage group is obviously increased (P is less than 0.05); compared with the model group, the COLIV level of the traditional Chinese medicine low-dose group is obviously reduced (P is less than 0.05), and the COLIV level of the traditional Chinese medicine medium-dose group is obviously increased (P is less than 0.01); compared with prednisone, COL IV level in the low-dose group of the traditional Chinese medicine is obviously reduced (P is less than 0.01), and COL IV level in the medium-dose group of the traditional Chinese medicine is obviously increased (P is less than 0.05), which is shown in Table 16.
TABLE 16 detection of COL IV changes in Lung tissue by ELISA
Figure BDA0002165650150000231
Group of Dosage (g/kg) n COLⅣ(ng/mg)
Normal group - 15 1.65±0.39
Model set - 8 1.90±0.22
Prednisone group 0.006 12 2.07±0.53 *
Composition low dose group 5 10 1.52±0.14 ▲△△
Dosage group in composition 10 11 3.20±0.92 **▲▲△##
High dose compositions 20 8 2.40±0.87 *##
Note: in comparison with the normal group, * P<0.05, ** P<0.01; in comparison to the set of models, P<0.05, ▲▲ P<0.01; in comparison to the prednisone group, P<0.05, △△ P<0.01; compared with the group with low dosage of the traditional Chinese medicine, # P<0.05, ## P<0.01
2.6.5 Effect of Chinese medicinal composition particles on rat Lung tissue bFGF
Compared with the normal group, the lung tissue bFGF level of rats in the traditional Chinese medicine medium and high dose groups is obviously increased (P is less than 0.01); compared with the model group, the lung tissue bFGF level of rats in the traditional Chinese medicine medium and high dose groups is obviously increased (P is less than 0.05); compared with prednisone, the bFGF level in the traditional Chinese medicine dosage group is obviously increased (P is less than 0.05), and the table 17 shows.
TABLE 17 detection of changes in bFGF in Lung tissue by ELISA
Figure BDA0002165650150000232
Group of Dosage (g/kg) n bFGF(ng/g)
Normal group - 15 9.41±2.61
Model set - 8 9.57±2.53
Prednisone group 0.006 12 10.70±2.35
Composition low dose group 5 10 9.27±2.42
Dosage group in composition 10 11 13.08±3.45 **▲▲△#
Composition high dose group 20 8 12.64±1.97 **▲#
Note: in comparison with the normal group, * P<0.05, ** P<0.01; in comparison to the set of models, P<0.05, ▲▲ P<0.01; in comparison to the prednisone group, P<0.05, △△ P<0.01; compared with the group with low dosage of the traditional Chinese medicine, # P<0.05, ## P<0.01
2.6.6 Effect of the Chinese medicinal composition on rat Lung tissue HYP
Compared with the normal group, the prednisone group and the traditional Chinese medicine medium-dosage group have obviously increased HYP level (P is less than 0.01) in the lung tissue of rats; compared with the model group, the HYP level of the prednisone group and the traditional Chinese medicine middle dose group is obviously increased (P is less than 0.05); compared with prednisone, HYP levels of the low, medium and high dosage groups of the traditional Chinese medicine have no obvious difference (P is more than 0.05), and are shown in Table 18.
TABLE 18 detection of lung tissue HYP changes by ELISA
Figure BDA0002165650150000241
Figure BDA0002165650150000242
Note: in comparison with the normal group, * P<0.05, ** P<0.01; in comparison to the set of models, P<0.05, ▲▲ P<0.01; in comparison to the prednisone group, P<0.05, △△ P<0.01; compared with the group with low dosage of the traditional Chinese medicine, # P<0.05, ## P<0.01
2.6.7 Effect of the Chinese medicinal composition on rat Lung tissue COL III
Compared with the normal group, the level of COL III in the lung tissue of the rat in the prednisone group is obviously increased, and the level of COL III in the traditional Chinese medicine dosage group is obviously reduced (P is less than 0.01); compared with the model group, the COL III level of the dosage group in the traditional Chinese medicine is obviously reduced (P is less than 0.01); compared with prednisone group, COL III level in the traditional Chinese medicine medium and high dosage groups is obviously reduced (P is less than 0.01), and is shown in Table 19.
TABLE 19 detection of COL III changes in Lung tissues by ELISA
Figure BDA0002165650150000243
Figure BDA0002165650150000244
Figure BDA0002165650150000251
Note: in comparison with the normal group, * P<0.05, ** P<0.01; in comparison to the set of models, P<0.05, ▲▲ P<0.01; in comparison to the prednisone group, P<0.05, △△ P<0.01; compared with the group with low dosage of the traditional Chinese medicine, # P<0.05, ## P<0.01
2.6.8 Effect of the Chinese medicinal composition on TNF-alpha of rat Lung tissue
Compared with the normal group, the level of TNF-alpha in the lung tissue of the rat in the prednisone group is obviously increased (P is less than 0.01); compared with the model group, the TNF-alpha level of the traditional Chinese medicine medium and high dose group is obviously reduced (P is less than 0.05); compared with prednisone, the TNF-alpha level in the traditional Chinese medicine medium and high dose groups is obviously reduced (P is less than 0.01), which is shown in Table 20.
TABLE 20 detection of TNF-alpha changes in Lung tissue by ELISA
Figure BDA0002165650150000252
Figure BDA0002165650150000253
Note: in comparison with the normal group, * P<0.05, ** P<0.01; in comparison to the set of models, P<0.05, ▲▲ P<0.01; in comparison to the prednisone group, P<0.05, △△ P<0.01
2.6.9 Effect of the Chinese medicinal composition on rat Lung tissue TIMP-1
Compared with the normal group, the lung tissue TIMP-1 level of each group of rats is increased (P is less than 0.05); compared with the model group, the groups have no difference (P is more than 0.05); compared with prednisone group, there was no difference between the groups (P > 0.05), see Table 21.
TABLE 21 detection of TIMP-1 changes in Lung tissue by ELISA
Figure BDA0002165650150000254
Figure BDA0002165650150000255
Figure BDA0002165650150000261
Note: in comparison with the normal group, * P<0.05, ** P<0.01; in comparison to the set of models, P<0.05, ▲▲ P<0.01; in comparison to the prednisone group, P<0.05, △△ P<0.01
3 conclusion
Monocyte chemotactic protein 1 (MCP-1) belongs to CC-chemotactic factors, and is secreted by macrophages, endothelial cells, monocytes, dendritic cells, epithelial cells and the like, and inflammatory cells such as monocytes/macrophages, lymphocytes and the like are mainly chemotactic and gathered to a lesion part and activated to generate various cytokines, so that inflammation is generated and developed. In addition, MCP-1 remarkably stimulates lung fibroblasts to synthesize collagen, can cause the production of cytokines or mediators with fibroblast properties, promotes the accumulation of myofibroblasts at the site of lung injury, participates in the formation of pulmonary fibrosis, and is considered to be an important fibrosis-causing chemokine. IL-6 is a multifunctional cytokine with a wide range of biological activities. IL-6 can increase collagen aggregation, inhibit ECM degradation, stimulate fibroblast proliferation, etc. TNF-alpha is a proinflammatory cytokine, is highly expressed in the pathological process of lung injury, participates in local injury and inflammatory reaction, causes inflammatory cell aggregation, further stimulates a large amount of lung fibroblasts to proliferate and secrete collagen, stimulates the release of other cytokines such as IL-1 and the like, and is an important mediator for the generation of lung inflammation. Stimulates the expression of MMP-9 and collagenase and the synthesis of collagen. The research finds that the traditional Chinese medicine composition can reduce the levels of MCP, IL-6 and TNF-alpha in lung tissues, relieve inflammatory reaction and reduce collagen synthesis, thereby playing a role in resisting fibrosis. The experimental result shows that the traditional Chinese medicine composition has better anti-inflammatory and anti-fibrosis action trend than prednisone.
Acute toxicity test results show that the maximum tolerated dose of the traditional Chinese medicine composition is 357.6g (crude drug)/kg after gastric lavage of ICR mice, which is equivalent to 3.6 times of the clinically planned dose, and no abnormality is found.

Claims (3)

1. The application of a traditional Chinese medicine composition in preparing a medicine for treating interstitial lung diseases is characterized in that the traditional Chinese medicine composition is prepared from the following raw material medicines: 10-28 parts of astragalus membranaceus, 10-28 parts of cassia twig, 8-25 parts of eucommia ulmoides, 7-22 parts of dried ginger, 5-20 parts of monkshood, 5-20 parts of radix paeoniae alba, 4-14 parts of schisandra chinensis, 4-14 parts of pseudo-ginseng and 4-14 parts of liquorice.
2. The application of claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw material medicines in parts by weight: 15-24 parts of astragalus membranaceus, 15-24 parts of cassia twig, 12-19 parts of eucommia ulmoides, 10-16 parts of dried ginger, 7-14 parts of monkshood, 7-14 parts of radix paeoniae alba, 5-9 parts of schisandra chinensis, 5-9 parts of pseudo-ginseng and 5-9 parts of liquorice.
3. The application of claim 2, wherein the traditional Chinese medicine composition is prepared from the following raw material medicines in parts by weight:
18 parts of astragalus membranaceus, 18 parts of cassia twig, 15 parts of eucommia ulmoides, 12 parts of dried ginger, 9 parts of monkshood, 9 parts of white paeony root, 6 parts of schisandra chinensis, 6 parts of pseudo-ginseng and 6 parts of liquorice;
or 16 parts of astragalus, 22 parts of cassia twig, 13 parts of eucommia bark, 14 parts of dried ginger, 8 parts of monkshood, 13 parts of white paeony root, 6 parts of Chinese magnoliavine fruit, 8 parts of pseudo-ginseng and 6 parts of liquorice;
or 22 parts of astragalus membranaceus, 16 parts of cassia twig, 18 parts of eucommia ulmoides, 11 parts of dried ginger, 13 parts of monkshood, 8 parts of radix paeoniae alba, 8 parts of schisandra chinensis, 6 parts of pseudo-ginseng and 8 parts of liquorice.
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Non-Patent Citations (4)

* Cited by examiner, † Cited by third party
Title
中医药治疗特发性肺间质纤维化研究进展;金莲等;《中国药业》;20170420;第26卷(第8期);第95-97页,尤其是第95页左栏第1段,第96页左栏第5段 *
中西医结合治疗特发性肺纤维化38例;陈萍等;《光明中医》;20090331;第24卷(第03期);第505-506页 *
李友林教授论治特发性肺纤维化的临床经验;陈妍;《中国社区医师》;20161231;第32卷(第28期);第181-182页,尤其是第181页摘要及左栏第2段、第182页中间栏第1段 *
温阳法在肺间质纤维化中的运用研究;王龙等;《实用中西医结合临床》;20180228;第18卷(第2期);第174-176页 *

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