ObjectiveTo evaluate the quality of methodology and evidence of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture therapy for bronchial asthma. MethodsCNKI, CBM, VIP, WanFang Data, PubMed, The Cochrane Library and Web of Science databases were electronically searched to collect SRs/MAs of acupuncture therapy for bronchial asthma from inception to October 31, 2021. Four reviewers independently screened literature, extracted data, and applied the AMSTAR 2 to evaluate the quality of methodology of the included studies and the GRADE system to assess the certainty of evidence for outcomes. ResultsA total of 14 SRs/MAs were included and their main conclusions were that acupuncture therapy was beneficial in improving the clinical efficacy of bronchial asthma treatment. The evaluation of AMSTAR 2 showed that the methodological quality of all studies was all extremely low. The evidence grading of GRADE system showed that, in the total of 59 outcomes, 7 were graded as medium-level, 24 as low-level, 28 as extremely low-level, and none was graded as high-level. ConclusionThe current evidence shows the advantages of acupuncture therapy for bronchial asthma but the reliability of SRs/MAs is low. High-quality clinical studies are still needed to verify the efficacy of acupuncture therapy for bronchial asthma.
ObjectiveTo systematically review the effects of aminophylline combined with traditional Chinese medicine (TCM) in the treatment of asthma. MethodsDatabases including The Cochrane Library(Issue 1, 2015), PubMed, EMbase, CNKI, VIP and WanFang Data databases were electronically searched from January 2005 to December 2014 to collect randomized controlled trials (RCTs) about the treatment of bronchial asthma combining aminophylline with TCM. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 10 RCTs involving 820 participants were included. The results of meta-analysis showed that: The total clinical effective rate in the aminophylline plus TCM group was higher than that of the aminophylline alone group (RR=1.22, 95%CI 1.11 to 1.33). The FEV1 in the aminophylline plus TCM group was also higher than that of the aminophylline alone group (MD=0.53, 95%CI 0.33 to 0.73). ConclusionCurrent evidence shows, the total clinical effective rate of aminophylline combined with TCM for asthma is better than that of aminophylline alone, and its mechanism may be related to the improvement of FEV1. Due to the limited quantity and quality of included studies, the above conclusion needs to be further verified by more high quality studies.
Objection To investigate the changes of insulin and insulin receptor in asthma patients.Methods Forty asthma patients were allocated into two groups：20 newly diagnosed treatment–naiuml;ve mild-moderate asthma patients，20 mild-moderate persistent asthma patients treated with inhaled corticosteroid. 20 healthy volunteers were enrolled as normal control.Blood samples were obtained from 40 asthma patients and 20 healthy volunteers.Total and differential leukocyte counts,blood glucose concentration and serum insulin concentration were measured.The level of lymphocyte insulin receptor in peripheral blood were assayed by flow cytomertry.Pulmonary function were performed at the same time.Results The numbers of eosinophil in the two asthma groups were significantly higher than those in the normal control group [(4.04±2.57)% and (4.24±2.34)% vs (0.90±1.38)%，Plt;0.05)，the levels of insulin and insulin receptor in the treatment-naiuml;ve group were significantly higher than those in the control group [insulin：(13.00±5.20)mIU/L vs (10.08±3.79)mIU/L，Plt;0.05；insulin receptor：(2.59±3.11)% vs (0.99±0.62)%，Plt;0.05).Conclusion Insulin secretion and insulin receptor expression in asthma patients are increased in the presence of inflammation.
ObjectiveTo investigate the fatigue of asthma patients, and to analyze its influencing factors, and provide a reference for clinical intervention.MethodsThe convenience sampling method was adopted to select asthma patients who were in clinic of the First Affiliated Hospital of Guangxi Medical University from November 2018 to March 2019. The patients’ lung function were measured. And questionnaires were conducted, including general data questionnaire, Chinese version of Checklist Individual Strength-Fatigue, Asthma Control Test, Chinese version of Self-rating Depression Scale. Relevant data were collected for multiple stepwise linear regression analysis.ResultsFinally, 120 patients were enrolled. The results of multiple stepwise linear regression analysis showed that age, education level, place of residence, time period of frequent asthma symptoms, degree of small airway obstruction, Asthma Control Test score and degree of depression were the influencing factors of fatigue in asthma patients (P≤0.05). Multivariate linear stepwise regression analysis showed that degree of small airway obstruction, degree of depression and time period of frequent asthma symptoms were the main influencing factors of fatigue in asthma patients, which could explain 51.8% of the variance of fatigue (ΔR2=0.518).ConclusionsThe incidence of fatigue in asthma patients is at a relatively high level. Medical staff should pay attention to the symptoms of fatigue in asthma patients. For asthma patients, it is recommended to strengthen standardized diagnosis and treatment, reduce the onset of symptoms at night and eliminate small airway obstruction. Psychological intervention methods are needed to improve patients’ depression, reduce fatigue symptoms, and improve quality of life.
ObjectiveTo analyze misdiagnosis of other lung diseases as asthma to avoid medical error. MethodsSixty-nine cases who were misdiagnosed as asthma between February 2012 and February 2014 were recruited. Clinical data was collected and analyzed including characteristics of symptoms, induced sputum, pulmonary function and blood tests. ResultsThere were 13 diseases misdiagnosed as asthma, and eosinophilic bronchitis(21.74%), upper airway cough syndrome(20.29%), chronic obstructive pulmonary disease(13.04%), allergic bronchopulmonary aspergillosis(7.25%) and hyperventilation syndrome (7.25%) were the top five diseases in these cases. Some rare diseases were also found such as idiopathic hypereosinophilic syndrome and vocal cord dysfunction. ConclusionsA variety of diseases have the similar clinical symptoms with asthma. The key to avoid and reduce misdiagnosis is to strengthen the understanding of asthma and similar diseases.
Objective To systematically assess the efficacy and safety of probiotics in prevention and treatment of bronchial asthma. Methods Randomized controlled trials (RCTs) of probiotics in prevention/treatment of asthma compared with placebo were searched in PubMed, EMbase, Web of Science, OVID and The Cochrane Library published before August 2011. The quality of the included RCTs was evaluated and the data were extracted by two assessors independently. Meta-analyses were performed with RevMan 5.1 software. Results Eleven RCTs on probiotics preventing asthma (n=3 656) and 5 RCTs on probiotics treating asthma (n=430) were identified. The Meta-analyses on preventing asthma showed that probiotics didn’t statistically decease the incidence of asthma (RR=0.76, 95%CI 0.47 to 1.22, P=0.25) and asthma-like wheezing (RR=0.92, 95%CI 0.62 to 1.39, P=0.71) compared with placebo. The Meta-analyses on treating asthma indicated that probiotics could prolong free episodes of asthma (RR=1.48, 95%CI 1.20 to 1.76, Plt;0.000 1) in comparison with placebo. No severe adverse events were found in all included studies. Conclusion The present evidence is not b enough to prove that probiotics is effective to prevent asthma, but it may prolong free episodes of asthma. Although it seems to have the effect on improving lung function, it fails to reduce the acute onset of asthma and has no have the advantage of improving immune function.
Chronic airway diseases constitute the majority of mortality of respiratory diseases in China. The 2017 Global Initiative for Chronic Obstructive Lung Disease has proposed a novel scheme for classification of disease severity. The mainstream for chronic obstructive pulmonary disease (COPD) management has shifted to the combination of long acting β2 agonists (LABA) and long acting muscarinic cholinergic antagonists instead of inhaled corticosteroid and LABA. Tiotropium was effective in early COPD with little or even without symptoms. The manangement strategy on COPD may be moving to the upper stream (early intervention). Greater interest has been focusing on clinical phenotyping and inflammatory pathways in asthma. The greater understanding of the pathogenesis of asthma has been associated with the clinical trial progress which suggests that multiple medications targeting at Th2 pathways may provide benefits for implementing personalized therapy. Medications targeting at neutrophilic airway inflammation and blockade of KIT pathways are expected to provide novel rationales for managing asthma with different phenotypes. There has been a considerable progress in bronchiectasis research in China, particularly in terms of etiology, bacteriology and clinical phenotying investigations. The establishment of bronchiectasis research centers in China may help better understanding of the pathogenesis of bronchiectasis, thus identifying potential targets for intervention, which may provide crucial rationale for future intervention to improve the long-term prognosis.
ObjectiveTo observe the effect of Budesonide formoterol inhalant on teenager patients with allergic rhinitis accompanied with asthma. MethodsForty-five teenager patients with allergic rhinitis accompanied with asthma treated between January 2012 and December 2013 were randomly divided into general treatment group, budesonide group and budesonide formoterol group, with 15 patients in each. Another 15 subjects undergoing physical examination were designated as the control group. Besides routine treatment, the budesonide group was also treated with budesonide inhalation at 100-200 μg twice a day, and the budesonide formoterol group was also treated with budesonide formoterol inhalation at 160 μg and 4.5 μg twice a day. The course of treatment lasted for four weeks. The patients were followed up for four weeks after the use of medicine halted. After treatment, exhaled nitric oxide (NO) examination were performed. ResultsThe amount of NO in the exhaled gas in all the three treatment groups were significantly different from the control group (P<0.05), and it was also significantly different between the Budesonide group and the budesonide formoterol group (P<0.05). ConclusionBudesonide formoterol inhalant has a good effect on teenager patients with allergic rhinitis accompanied with asthma in terms of improving exhaled NO.
Objective To investigate the association between polymorphism of S2 locus allele in ADAM33 gene and bronchial asthma in Xinjiang Uygur population.Methods PCR-RFLP was used to determine polymorphismof S2 locus allele in ADAM33 gene in 131 Uygur patients with bronchial asthma ( asthma group) and 90 Uygur healthy individuals ( control group) .Results The comparison of three genotypes and allele frequency of the S2 in the ADAM33 gene had statistical significance in the asthma group and the control group ( X2 =6. 065, P lt;0. 05;X2=5. 255, P lt;0. 025) . The G allele of S2 site increased the risk of asthma( OR =1. 616, P lt;0. 05) . The CG genotype also increased the risk of asthma ( OR= 1. 351,P lt;0. 05) . The FEV1% pred and FVC% pred had significant difference between three genotypes of the S2 site in the ADAM33 gene in the asthma group ( F = 6. 248, P lt; 0. 01; F = 7. 067, P lt; 0. 01) .Conclusion The polymorphism of the S2 site in the ADAM33 gene has significant correlation with asthma in Xinjiang Uygur population, and can increase risk of asthma in the Uygur population.
Objective To observe the effect of NLRP3 inflammasome inhibitor MCC950 intervention on airway Muc5ac level in asthmatic mice, and to explore the role and mechanism of NLRP3 inflammasome in asthmatic airway mucus hypersecretion. Methods A total of 50 SPF grade BALB/c female mice aged 6 - 8 weeks were randomly divided into normal control group (NS group), asthma model group (AS group), dexamethasone group (Dex group), MCC950 high-dose intervention group (MH group) and MCC950 low-dose intervention group (ML group), with 10 mice in each group. Furthermore, the bronchoalveolar lavage fluid (BALF) of mice in each group was counted by total cell count, associated with white blood cell different count. In addition, the concentrations of interleukin (IL)-18 and IL-1β in BALF were tested by enzyme-linked immunosorbent assay; The lung tissues were prepared into paraffin-embedded sections, which were then subject to hematoxylin-eosin (HE) staining, Alcian blue-periodic acid Schiff base staining and Masson staining to observe the pathological changes of lung tissues. Immunohistochemistry was used to detect the protein expression levels of Muc5ac, NLRP3 and caspase-1 in lung tissues. Real-time quantitative polymerase chain reaction was performed to detect the relative mRNA expressions of Muc5ac, NLRP3 and Caspase-1 in lung tissues. Results Compared with NS group, AS group showed significant increase in total cell count of BALF, the percentage of eosinophils, the infiltration score of inflammatory cells around the airway, the positive relative staining area of airway mucus and the deposition area of airway collagen fibers in mice (P<0.05), upregulated protein expression levels of Muc5ac, NLRP3 and Caspase-1 in lung tissues (P<0.05), elevated relative mRNA expressions of Muc5ac, NLRP3 and Caspase-1 in lung tissues (P<0.05), and raised concentrations of IL-18 and IL-1β in BALF (P<0.05). While compared with AS group, the above indicators were reduced in MH group and ML group (P<0.05). Moreover, in relative to Dex group, these indicators were increased in MH group ML group (P<0.05). In addition, no statistically significant difference was observed in the aforementioned indications between MH group and ML group.Conclusions MCC950 intervention can inhibit airway inflammation and airway mucus secretion in asthmatic mice. Its mechanism is speculated to be related to the suppression of NLRP3, Caspase-1, IL-18 and IL-1β expressions, downregulation of Muc5ac expression, and inhibition in airway mucus hypersecretion.