OBJECTIVETo explore the mechanisms involved in the ligustrazine alleviation of the pulmonary artery hypertension (PAH) in patients of chronic obstructive pulmonary disease (COPD) associated with chronic cor pulmonale (CCP) during exacerbation.

METHODSSeventy patients of COPD and CCP with acute exacerbation were randomly and equally divided into control group and treatment group. The control group received standard treatment with antibiotics, antiasthmatic and expectorant medications, and oxygenation; and the ligustrazine treatment group received ligustrazine treatment (80 mg/d; i.v.; for 2 weeks) in addition to the standard treatment. Before and at the end of 2 week treatment, the clinic responses of the two regimens were evaluated, plasma levels of endothelin-1 (ET-1) and nitric oxide (NO) were determined; arterial oxygen partial pressure (PaO2, mean pulmonary arterial pressure (mPAP), outflow tract of right ventricle (RVOT), and internal diameter of right ventricle (RV) were measured.

RESULTSGood clinic benefits were achieved in both the standard and ligustrazine regimens, plasma level of ET-1, values of mPAP, RV and RVOT decreased significantly, plasma level of NO and PaO2 values decreased (all P < 0.01 vs pre-treatment to all parameters). Compared with the control group, ligustrazine greatly enhanced the clinic efficacy from 77.1% to 97.1% (P < 0.05), and also resulted in more significant changes of all these parameters (P < 0.01 vs control group for all parameters). For both groups, the levels of plasma ET-1 were positively correlated with values of mPAP, RVOT, and RV (r = 0.710, 0.853, and 0.766, respectively, all P = 0.000), and negatively correlated with plasma NO and PaO2 (r = - 0.823, and - 0.752, respectively, all P = 0.000).

CONCLUSIONLigustrazine is effective in treating pulmonary artery hypertension during acute exacerbation of COPD and CCP in patients from the plateau area. The observed changes in the plasma levels of NO and ET-1 in response to ligustrazine treatment suggest that ligustrazine may act through the selective effect on pulmonary blood vessels to enhance the synthesis and release of NO and suppress those of ET-1 from lung vascular endothelial cells, thus reducing pulmonary artery pressure and decreasing pulmonary arterial hypertension.

Altitude ; Blood Gas Analysis ; Chronic Disease ; Endothelin-1 ; blood ; Humans ; Hypertension, Pulmonary ; drug therapy ; Nitric Oxide ; blood ; Pulmonary Artery ; physiopathology ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Pyrazines ; therapeutic use ; Respiration

OBJECTIVETo observe the effects of Bufei Jianpi Recipe (BJR) on the diaphragmatic neural discharge and the diaphragmatic muscle function in rats with chronic obstructive pulmonary disease (COPD).

METHODSRats were randomly divided into the normal control group, the model group, the high dose BJR group (9.68 g/kg x d(-1)), the medium dose BJR group (4.84 g/kg x d(-1)), the low dose BJR group (2.42 g/kg x d(-1)), and the aminophylline group (2.3 mg/kg x d(-1)). The stable phase COPD rat model was prepared using repeated smoke inhalations and bacterial infections. The high, medium, and low dose BJR and aminophylline was respectively administered to rats from the ninth week to the twentieth week. The sampling was taken. The lung function, diaphragmatic neural discharge time (Td), and diaphragmatic neural discharge interval (Tdi), diaphragmatic neural discharge range (Rd), diaphragmatic neural discharge area (Ad), expiratory time (Tex), inspiratory time (Tin), respiratory rate (RR), respiratory excursion (RE), respiratory area (RA), and diaphragmatic muscular tension and endurance were detected.

RESULTSCompared with the normal control group, the tidal volume (TV), peak expiratory flow (PEF), and 50% tidal volume expiratory flow (EF50) significantly decreased in the model group (P < 0.01). Td, Tdi, Tex, and Tin were significantly prolonged (P < 0. 05, P < 0.01). Ad, Rd, RR, RE, RA, diaphragmatic muscular tension and endurance significantly decreased (P < 0.05, P < 0.01). The ratio of type I and IIA diaphragmatic fibers significantly increased and type IIB significantly decreased (P < 0.01). The activity of ATP decreased and the activity of SDH increased (P < 0.01). The aforesaid indices were improved to different degrees in BJR groups, especially in the high dose BJR group and the medium dose BJR group (P < 0.05, P < 0.01).

CONCLUSIONSBJR could significantly improve the diaphragmatic neural discharge and the diaphragmatic muscle function. Its efficacy was better than that of aminophylline.

Aminophylline ; pharmacology ; Animals ; Diaphragm ; drug effects ; physiopathology ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Male ; Phrenic Nerve ; drug effects ; physiopathology ; Phytotherapy ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; physiopathology ; Rats

BACKGROUND/AIMS: Patients with chronic obstructive pulmonary disease (COPD) experience more problematic respiratory symptoms and have more trouble performing daily activities in the morning. The aim of this study was to assess the perception of COPD symptoms related to morning activities in patients with severe airflow limitation. METHODS: Data of 133 patients with severe airflow limitation were analyzed in a prospective, non-interventional study. A clinical symptom questionnaire was completed by patients at baseline. In patients having morning symptoms, defined by at least one or more prominent or aggravating symptom during morning activities, a morning activity questionnaire was also completed at baseline and following 2 months of COPD treatment. RESULTS: The most frequently reported COPD symptom was breathlessness (90.8%). Morning symptoms were reported in 76 (57%) patients; these had more frequent and severe clinical COPD symptoms. The most frequently reported morning activity was getting out of bed (82.9%). The long acting muscarinic antagonist (odds ratio [OR], 6.971; 95% confidence interval [CI], 1.317 to 11.905) and chest tightness (OR, 0.075; 95% CI, 0.011 to 0.518) were identified as significantly related to absence of morning symptoms. There was no significant correlation between the degree of forced expiratory volume in 1 second improvement and severity score differences of all items of morning activity after 2-month treatment. CONCLUSIONS: Fifty-seven percent of COPD patients with severe airflow limitation have morning symptoms that limit their morning activities. These patients also have more prevalent and severe COPD symptoms. The results of this study therefore provide valuable information for the development of patient-reported outcomes in COPD.
Activities of Daily Living ; Aged ; Circadian Rhythm ; Female ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Perception ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive/drug therapy/*physiopathology ; Questionnaires

OBJECTIVETo observe Modified Zhisou Powder (MZP) on the lung function of chronic obstructive pulmonary disease (COPD) model rats of northwest China cold dryness syndrome (NCCDS).

METHODSTotally 90 male Wistar rats were randomly divided into three groups, i.e., the normal control group (n =20), the COPD model group (n =35), and the COPD of NCCDS group (n =35). The COPD model was established by tracheal dripping porcine pancreatic elastase (PEE) in combination with fumigation for 90 days. The COPD of NCCDS model was set up by tracheal dripping PEE +fumigation + cold and dry environmental stress for 90 days. Then rats in the COPD of NCCDS were randomly divided into the MZP intervention group (n =11 )and the normal saline intervention group (n =10).All intervention lasted for 15 successive days. The lung function was detected using Small Animal Lung Function Device at day 90 and day 105. And the lung pathology was also observed.

RESULTSLittle amount of sputum sound could be heard in the airway of the COPD model group and the COPD of NCCDS group. Pathological section showed alveolar ectasia, narrowed and broken alveolar septa, forming larger capsular space with infiltration of inflammatory cells. Rats in the COPD of NCCDS group showed chills, increased amount of drinking water, and loose stool. MZP could improve their symptoms. As for lung function test, compared with the normal control group, Te increased in the COPD model group (P <0.01), and EF50 decreased (P<0.05). PEF and EF50 decreased (P <0.01), Ti and Te increased (P <0.01, P <0.05) in the COPD of NCCDS group. Compared with the normal saline intervention group, PEF and EF50 increased (P < 0.01), Ti and Te decreased (P <0.01) in the MZP intervention group.

CONCLUSIONMZP could improve the symptoms of COPD rats of NCCDS, and delay the velocity of decreased lung function.

Animals ; China ; Drugs, Chinese Herbal ; therapeutic use ; Lung ; physiopathology ; Male ; Models, Animal ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Rats ; Rats, Wistar ; Respiratory Function Tests

OBJECTIVETo observe the clinical efficacy of acupoint-catgut-embedding therapy combined conventional western medication on chronic obstructive pulmonary disease (COPD) at stable stage due to lung and kidney deficiency.

METHODSThe cases were randomized into observation group and control group, 30 cases in each one. In control group, the conventional western medication was administered. In observation group, on the basis of conventional western medication, the catgut-embedding therapy was applied at Dingchuan (EX-B 1), Feishu (BL 13), Shenshu (BL 23), Fenglong (ST 40) and Zusanli (ST 36). The total attack frequency of acute exacerbation of COPD (AECOPD), the attack frequency of AECOPD at moderate or above moderate stage and TCM syndrome score were compared before treatment and 6 months after treatment in two groups.

RESULTSThe total effective rate was 93.3% (28/30) in observation group and was 90.0% (27/30) in control group, indicating equivalent efficacy between two groups. 6 months after treatment, in two groups, the total attack frequency of AECOPD and the attack frequency of AECOPD at moderate or above moderate stage were reduced remarkably as compared with those before treatment (P < 0.01, P < 0.05). The total attack frequency of AECOPD in observation group was reduced remarkably as compared with that in control group (P < 0.05). The scores of cough, expectoration and chest oppression as well as the total score of TCM syndrome were reduced remarkably after treatment in observation group (all P < 0.01).

CONCLUSIONIntegrated therapy of acupoint-catgut-embedding and conventional medication has similar efficacy as simple medication. But, the combination of acupoint-catgut-embedding therapy and western medication can reduce the attack frequency of AECOPD and improve in cough, chest oppression and other symptoms in patients with COPD at stable stage effectively.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Aged ; Aged, 80 and over ; Catgut ; Combined Modality Therapy ; Female ; Humans ; Kidney ; physiopathology ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; physiopathology ; therapy

OBJECTIVETo compare the difference in clinical efficacy on chronic obstructive pulmonary disease (COPD) at stable stage in the patients among the combined therapy of cutting method and western medication (combined therapy), simple cutting method and simple western medication.

METHODSOne hundred and twenty cases of COPD were randomized into three groups, 40 cases in each one. In the cutting method group, for excessive phlegm pattern/syndrome, Feishu (BL 13), Danzhong (CV 17), Dingchuan (EX-B 1) and Yuji (LU 10) were selected as the main acupoints, and Lieque (LU 7) and Pianli (LI 6) were as the supplementary acupoints. For the pattern/syndrome of failure to consolidate kidney primary, Shenshu (BL 23), Pishu (BL 20), Guanyuan (CV 4) and Yuji (LU 10) were selected as main acupoints, and Jueyinshu (BL 14) and Zusanli (ST 36) were as the supplementary acupoint. Three acupoints were selected alternatively in each treatment and the cutting method was applied once every 10 days. Three treatments made one session. Two sessions of treatment were required. In the western medication group, salbutamol sulfate aerosol, one press (200 μg/press) was used each night, as well as salmeterol xinafoate and fluticasone propionate powder for inhalation, one inhalation each night. The treatment of 1 month made one session. Two sessions were required. In the combined therapy group, the cutting method and western medication were applied in combination. The results of clinical symptom score, lung function test, arterial blood gas analysis, degree of inflation as well as clinical efficacy were observed before and after treatment in each group.

RESULTSExcept the degree of lung inflation, the clinical symptom score, indices of lung function test, partial pressure of arterial blood gas (PaO2) and partial pressure of carbon dioxide (PaCO2) were all obviously improved after treatment as compared with those before treatment in each group (all P<0.05). They were apparently improved after treatment in the combined therapy group and the cutting method group as compared with those in the western medication group (all P<0.05). The total effective rate was 77.5% (31/40) in the combined therapy group and was 75.0% (30/40) in the cutting method group, both better than 60.0% (24/40) in the western medication group (both P<0.05).

CONCLUSIONThe simple cutting method based on syndrome differentiation and the combined therapy with western medication achieve the superior efficacy on COPD at stable stage as compared with the simple western medication. The effect mechanism is possibly related to the improvement of bronchial airway function through constant acupoint stimulation.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Albuterol ; administration & dosage ; analogs & derivatives ; Androstadienes ; administration & dosage ; Combined Modality Therapy ; Female ; Fluticasone ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; physiopathology ; therapy ; Salmeterol Xinafoate ; Treatment Outcome

OBJECTIVEDiscuss the therapeutic effect of Bailing capsule and the medical gymnastics (MG) to chronic obstructive pulmonary diseases (COPD) in paracmasis.

METHODAdopt prospective study method that we divide 50 COPD patients into two group in random, the contrast group (25 patients) to treat by routine western medicine. The therapeutic group (25 patients) to treat by the Bailing capsule and the lung recovery medical gymnastics. After 6 months, we observe the patients' condition of lung ventilation, dyspneic respiration and disease resistance.

RESULTThe therapeutic group is better than the contrast group obviously, the patients' condition of dyspneic respiration are improved, the descent rate of the average level of dyspneic respiration. The therapeutic group was 24.53%, the contrast group was 3.7%. The index of lung ventilation is all improved obviously (P < 0.05 or P < 0.01). The disease resistance of the therapeutic group is improved after the treat (P < 0.01).

CONCLUSIONIt is a good method to cure COPD in paracmasis by the traditional Chinese medicine Bailing capsule and the medical gymnastics, to the patients of insufficiency of QI of the lung and kidney especially, the method can improve the disease resistance and lung ventilation.

Aged ; Capsules ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Immunity, Innate ; drug effects ; immunology ; Male ; Middle Aged ; Physical Therapy Modalities ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; immunology ; physiopathology ; therapy ; Recovery of Function ; drug effects ; Respiration ; drug effects

OBJECTIVETo investigate the clinical effect of decoction of invigorating Qi and clearing lung combined standardized myrtol on acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

METHODNinety and eight patients with AECOPD patients were randomly divided into the treatment group and the control group, with 50 cases and 48 cases respectively. All the patients were given the conventional treatment. The control group was treated by standardized myrtol with 3 times a day, 300 mg each time taken orally. The treatment group was given decoction of invigorating Qi and clearing lung with 2 times a day, one dose per day taken orally, combined standardized myrtol (usage as above). After Two weeks, the scores of clinical symptom, blood gas analysis and pulmonary function were observed.

RESULTBoth FEV1 and FEV1% were raised in the two groups after treating. And the treatment group was significantly higher than control group (P < 0.01). PaO2 and PaO2/FiO2 rose, with PaCO2 decreased in the two groups (P < 0.01). PaO2 and PaO2/FiO2 were significantly improved, and PaCO2 was significantly decreased in the treatment group compared to the control group (P < 0.01). In the clinical curative effect comparison aspects, clinical control rates were 42.0% in treatment group and 20.83% in control group respectively, with significant difference between the two groups (P < 0.05). Significant efficiency is 86.0% in treatment group and 52.08% in control group respectively, with significant difference between the two groups (P < 0.01).

CONCLUSIONDecoction of invigorating Qi and clearing lung combined with standardized myrtol can obviously improve clinical symptom, blood gas an analysis and pulmonary function in patients with AECOPD.

Aged ; Blood Gas Analysis ; Drug Combinations ; Drug Therapy, Combination ; Female ; Humans ; Lung ; physiopathology ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Monoterpenes ; standards ; therapeutic use ; Pulmonary Disease, Chronic Obstructive ; blood ; physiopathology ; therapy ; Reference Standards ; Respiratory Function Tests ; Treatment Outcome

OBJECTIVETo systematically observe the clinical effect on chronic obstructive pulmonary disease (COPD) at the stable stage, differentiated as cold phlegm blocking the lung type, treated with acupoint sticking therapy during the dog days and the three nine-day periods after the winter solstice so as to propose the latest clinical idea and theoretic evidence for the treatment of COPD.

METHODSOne hundred and fifty cases of COPD at stable stage, which were in accordance with the inclusive standard were randomly divided into three groups, named group A (treatment in dog days and the three nine-day periods after the winter solstice), group B (treatment in dog days) and group C (treatment in the three nine-day periods after the winter solstice), 50 cases in each group. The ingredients (Semen Brassicae, Euphoribia Kansui, Asarum, Rhizome Corydalis, Cinnamon, ginger juice) and doses of herbal medicine plaster were same in each group. The herbal plaster was applied to Feishu (BL 13), Shenshu (BL 23), Dazhui (GV 14), Tiantu (CV 22), Danzhong (CV 17) and Zhongfu (LU 1). In group B, the treatment was given once on the 1st day of each dog-day period, totally 3 treatments were included. In group C, the treatment was given once on the 1st day of each nine-day periods after the winter solstice, totally, 3 treatments were involved. In group A, the treatment was given once on the 1st day of each dog-day period and each nine-day periods after the winter solstice separately, totally 6 treatments were required. The therapeutic effect was evaluated in 4 aspects, named comprehensive clinical efficacy, survival quality (the scores for symptoms, activity limitation and influence on daily life), the attach frequency and pulmonary function.

RESULTSThe total effective rate was 88.0% (46/50) in group A, which was superior to 76.0% (38/50) in group B and 70.0% (35/50) in group C separately (P < 0.01, P < 0.001). The results of the attack frequency, clinical symptom score and pulmonary function indices after treatment were all improved apparently as compared with those before treatment in each group (all P < 0.01). All the above indices in group A were improved much apparently as compared with the other two groups (P < 0.01, P < 0.001). Except for the level of forced vital capacity (FVC), the results of clinical symptom score and the other pulmonary function indices in group B were all improved significantly as compared with group C (P < 0.05, P < 0.001).

CONCLUSIONAcupoint sticking therapy during different season of the year achieves a superior clinical efficacy for the patients with COPD at stable stage. This therapy can reduce the attack frequency and improve the survival quality and pulmonary function for the patients. It is concluded that the efficacy of the treatment in dog days and the three nine-day periods after the winter solstice is superior to simple dog-day treatment and the treatment in the three nine-day periods after the winter solstice, and the efficacy of dog days treatment is better than that in the three nine-day periods after the winter solstice.

Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Lung ; metabolism ; physiopathology ; Male ; Middle Aged ; Mucus ; chemistry ; metabolism ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; metabolism ; physiopathology ; Seasons ; Vital Capacity

OBJECTIVE: To investigate the effects of vitamin E on the respiratory function impairment in rats with chronic obstructive pulmonary disease (COPD) after exposed to high temperature and PM. METHODS: Fifty-four 7-week-old SPF male Wistar rats were randomly divided into 9 experimental groups (n=6). The rat COPD model was established by lipopolysaccharide (LPS) and smoke exposure. After modeled, the rats were tracheal instilled with PM (0 mg/ml, 3.2 mg/ml) and intraperitoneally injected with vitamin E at the dose of 40 mg/kg (20 mg/ml). Part of rats (high temperature groups) were then exposed to high temperature (40℃), once (8 h) a day for three consecutive days. After the last exposure, the lung function of rats was detected. The expression levels of inducible nitric oxide synthase (iNOS), tumor necrosis factor-α (TNF-α) and monocyte chemotactic protein-1 (MCP-1) were detected by corresponding ELISA kits. RESULTS: Compared with the control group, exposure of high temperature and PM could inhibit the lung function of COPD rats significantly (P＜0.05); the level of MCP-1 was increased significantly in PM-exposure groups (P＜0.05); iNOS was increased significantly in the groups of high temperature (P＜0.05). Compared with the single-PM exposure groups, TNF-α in lung was decreased in the normal temperature health group and high temperature COPD group (P＜0.05) after treated with vitamin E; MCP-1 was decreased in all vitamin E-treated groups (P＜0.05); the decreased iNOS only appeared in the group of high temperature with vitamin E treatment. CONCLUSION High temperature and PM could aggravate the inflammation of COPD rats. As an antioxidant, vitamin E may protect the lung from the damage effects.
Animals ; Chemokine CCL2 ; metabolism ; Hot Temperature ; adverse effects ; Lung ; physiopathology ; Male ; Nitric Oxide Synthase Type II ; metabolism ; Particulate Matter ; adverse effects ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Random Allocation ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha ; metabolism ; Vitamin E ; pharmacology