Objective

2

To explore the mechanism of

Shengyang Yiwei Decoction

（升阳益胃汤， SYD） in the treatment of chronic obstructive pulmonary disease （COPD） with lung-spleen

qi

deficiency syndrome.

Methods

2

Eighty-four SD rats were randomly divided into 7 groups， namely blank group， model group， rebamipide group， dexamethasone group， high-， medium- and low-dose SYD group， with 12 rats in each group. Except for the blank control group， rats were given cigarette smoke plus intratracheal instillation of lipopolysaccharide plus intragastric administration of Dahuang （

Radix et Rhizoma Rhei

） suspension to establish the model of COPD with lung-spleen

qi

deficiency syndrome for a total of 28 days. Since the 15th day of modeling， the rats in the high-， medium- and low-dose SYD groups were given 24.930， 12.465， and 6.233 g/（kg·d） of SYD by gavage， respectively. The rats in the dexamethasone group were given 0.0675 mg/（kg·d） of dexamethasone acetate tablet solution， while those in the rebamipide group were given 9 mg/（kg·d） of rebamipide tablet solution by gavage. The blank group and model group were given 10 ml/ （kg·d） of normal saline by gavage. All groups were administered once a day for 14 consecutive days. After treatment， the pathological changes of lung， trachea， and gastrointestinal tissues were observed by HE staining. The levels of T helper 17 （Th17） and regulatory T cells （Treg） in the peripheral blood were detected by flow cytometry， and the Th17/Treg ratio was calculated. The changes of diamine oxidase （DAO）， interleukin 6 （IL-6）， interleukin 10 （IL-10）， interleukin 17 （IL-17） and transforming growth factor beta （TGF-β） in serum and myeloperoxidase （MPO） in lung tissue of rats were detected by ELISA. The expression of forkhead/winged helix transcription factor （FoxP3） mRNA and retinoic acid-related nuclear orphan receptor γ （RORγt） mRNA in lung tissue were determined by real-time fluorescence quantitative PCR.

Results

2

Compared to those in the blank group， the alveolar structure of the rats in the model group was incomplete with a large number of inflammatory cells infiltration， and damaged airway and gastrointestinal mucosa； the values of Th17， Th17/Treg ratio， MPO， DAO， IL-6， IL-17， TGF-β levels and RORγt mRNA in the model group significantly increased， while the levels of Treg， IL-10 and FoxP3 mRNA were reduced （

P

＜0.05）. Compared to those in the model group， the histopathological damage of the lung， trachea， and gastrointestinal tissues were improved in the high-dose SYD group， while only the damage of lung and trachea in the dexamethasone group， and the damage of gastrointestinal tissues in the rebamipide group improved； the values of Th17， Th17/Treg ratio， MPO， DAO， IL-6， IL-17， TGF-β， and RORγt mRNA were significantly reduced in high-dose SYD group， dexamethasone group and rebamipide group， while Treg， IL-10 levels and FoxP3 mRNA increased （

P

＜0.05）， but there was no difference in expression of FoxP3 mRNA in dexamethasone group. The high-dose SYD group was better than the medium- and low-dose groups in decreasing Th17， Th17/Treg ratios， MPO in lung tissue and serum inflammatory factor levels， and improving RORγt and FoxP3 mRNA expressions （

P

＜0.05）.

Conclusion

2

SYD is effective in the treatment of COPD with lung-spleen

qi

deficiency， which may be related to its function of improving the pathological damage of the lung， trachea， gastrointestinal tissues simultaneously， regulating Th17/Treg balance， and reducing the levels of related inflammatory factors.