Stroke is a type of devastating cerebrovascular event that disrupts cerebral blood flow due to the blockage or burst of cerebral blood vessels, which easily causes physical disability and multiple functional impairments in patients. The mortality rate of stroke patients in China is the first in the world, and pulmonary infection is an important cause of impaired clinical outcomes in patients with acute stroke, The term stroke associated pneumonia (SAP) has been proposed so far, emphasizing the fact that the two are closely related in pathophysiology.tcm holds that phlegm heat Fu decoction is the most common syndromic form of stroke, and Hua Duan Fu method represents the prescription of Fang Xinghui Qi Decoction for treating stroke.xinghui Qi Decoction is the most representative formula for treating stroke with phlegm heat Fu The theory of traditional Chinese medicine (TCM) and the "" bacteria intestine brain axis "" proposed in modern medicine have a different variety. Many clinical trials have confirmed the exact clinical efficacy and neuroprotective effect of Xinghui Chengqi Decoction in treating sap, however, the study of its effect mechanism is still insufficient. Therefore, the author intends to carry out a combed summary of histfang herbal chemical components, pharmacological effects and their mechanisms of action of xinglouchengqi Decoction to deeply explore the intestinal microecological mechanism of sap and the effector mechanism of xinghuichengqi Decoction in treating post-stroke pneumonia of phlegm heat Fu solid type.

Zhang Yang. Mechanism of Pneumonia after Treatment of Phlegm Heat Fu Solid Type Stroke Using Xinglouchengqi Decoction. Frontiers in Medical Science Research (2022) Vol. 4, Issue 2: 17-23. https://doi.org/10.25236/FMSR.2022.040204.

[1] Sarahh, Hendrikh, Lwnau, et al. Stroke-inducedimmu-nodepression and dysphagia independently predict stroke - associated pneumonia - The PREDICT study [J]. J Cereb Blood Flow Metab, 2017, 37(12): 3671 -3682. 

[2] Kalra L, Smith C J, Hodsoll J, et al. Elevated C - reactive pro- tein increases diagnostic accuracy of algorithm - defined stroke - asso- ciated pneumonia in afebrile patients [J]. Int J Stroke, 2019, 14(2): 167 - 173. 

[3] Hou Golin, Wang G. The current status of multi drug resistant bacterial infections in patients in comprehensive care unit and their drug resistance analysis [J]. South China Preventive Medicine, 2017, 43 (4): 356-358

[4] Weipeng Yu, Meilan Xian, Yirong Huang. Susceptibility factors and resistance analysis of multi drug resistant infections in hospital acquired pneumonia [J]. Zhonghua modern medical journal, 2017, 27 (5): 125-129

[5] Ying Chen, Jing Li. Screening test foran Ti helicobacter pylori activity of traditional Chinese herb [J]. World Journal of Gastroenterology, 2010, 16 (44): 115-119.

[6] Mao L, Liu X, Zheng P, et al. Epidemiologic Features, Risk Factors, and Outcomes of Respiratory Infection in Patients with Acute Stroke [J]. Ann Indian Acad Neurol. 2019; 22(4): 395-400.

[7] Westendorp W F, Nederkoorn P J, Vermeij J D, et al. Post-stroke infectiona systematic review and meta-analysis. BMC Neurol. 2011; 11: 110

[8] Xingfeng Zhang, WanFei sun, Jinlong Xue, et al Risk factors and susceptibility of multidrug-resistant bacterial infection in stroke associated pneumonia]. J Chinese Journal of Nosocomiology, 2017, 27 (19): 4401-4404

[9] Niimi M, Hashimoto G, Hara T, et al. Relationship tween frequency of spontaneous swallowing and salivary substance p level in patients with acute stroke [J]. Dysphagia. 2018; 33(4): 414-418.

[10] Santos Samary C, Pelosi P, Leme Silva P, et al. Immunomodulation after ischemic stroke: potential mechanisms and implications for therapy. Crit Care. 2016; 20(1): 391.

[11] De Vries HE, Kuiper J, de Boer AG, et al. The blood-brain barrier inneuroinflammatory diseases. Pharmacol Rev. 1997; 49(2): 143-155.

[12] Offner H, Subramanian S, Parker SM, et al. Experimental stroke induces massive, rapid activation of the peripheral immune system. J Cereb Blood Flow Metab. 2006; 26(5): 654-665.

[13] Vahedi K, Hofmeijer J, Juettler E, et al. Early decompressive surgery inmalignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials [J]. Lancet Neurol. 2007; 6(3): 215-222.

[14] Liu Q, Jin WN, Liu Y, et al. Brain Ischemia Suppresses Immunity in the Periphery and Brain via Different Neurogenic Innervations. Immunity. 2017; 46(3): 474-487.

[15] Chamorro A, Urra X, Planas AM. Infection after acute ischemic stroke: amanifestation of brain-induced immunodepression. Stroke. 2007; 38(3): 1097-1103.

[16] Hug A, Dalpke A, Wieczorek N, et al. Infarct volume is a major determiner of post-stroke immune cell function and susceptibility to infection. Stroke. 2009; 40(10): 3226-3232.

[17] Theodore J, Robin ED. Speculations on neurogenic pulmonary edema (NPE). Am Rev Respir Dis. 1976; 113(4): 405-411.

[18] Wenjia Jian, Shi Jing and Jinzhou Tian. On stroke analysis by applying the huanyantong Fu method by Mr. Yongyan Wang [J] Tianjin traditional Chinese medicine, 2015, 3 (2 2): 65-67

[19] Yingzheng Xie, Huai Zou, and Limun Sun. Applying the huanutantong Fu method to treat stroke patients [J] Journal of basic Chinese medicine, 2010, 16 (3): 221-222

[20] Tang Yuan Yu, Wang Ning, Ji Li Jin. The connotation of "heat urbation in the interior, plain to Xianhan and Zuo to bitter Gan" and its application in the treatment of collaterals in traditional Chinese medicine, Chengdu University of Chinese medicine, 2010, 3 (34): 85-87

[21] Gecibesler I H ,  Disli F ,  Bayindir S , et al. The isolation of secondary metabolites from Rheum ribes L. and the synthesis of new semi-synthetic anthraquinones: Isolation, synthesis and biological activity[J]. Food Chemistry, 2020, 342(3):128378.

[22] Ding, X. Chemical composition of rhubarb and semisynthetic studies on the active ingredient Rhein [D] Guangzhou: Guangdong Pharmaceutical College, 2007

[23] Fu Xing, Liu Xunhong. Chemical constituents and pharmacological effects of rhubarb recent advances [J] Chnl Med 2011, 20 (16): 1534 - 1538, 1568

[24] Lixue Wang. Bioactivity based quality control study of rhubarb [D] Beijing: Chinese Academy of Chinese Medical Sciences, 2020

[25] Krumbiegel G, Schulz H U. Rhein and aloe- emodin kinetics from senna laxatives in man [J]. Pharmacology, 1993, 4(7 Suppl 1): 120-124.

[26] Akao T, Che Q M, Kobashi K, et al. A purgative action of barbaloin is induced by Eubacterium sp. strain BAR, a human intestinal anaerobe, capable of transforming barbaloin to Aloe-Emodin anthrone [J]. Biol Pharm Bull, 1996, 1(9 1): 136-138.

[27] Nesthimao, He Bo. Chemical composition study of building fruit [J] Journal of Chinese traditional medicine, 1999, 2 (4 10): 36-37, 62

[28] Wang Y F, Wu B, Yang J, et al. A Rapid Method for the Analysis of Ten Compounds in Psoralea Corylifolia L. by UPLC[J]. Chromatographia, 2009, 70(1-2):199-204.

[29] Xu, Guofeng. Sessiliflorus fruits and its formulation quality control study [D] Dalian: Liaoning University of traditional Chinese medicine, 2006

[30] Tengy Rong, Liang Man Wang, Yong Qing Zhang Progress in pharmacological research on Guar [J]. Qilu Pharm., 2010, 2 (9 7): 417-419

[31] Sun Yang. Evaluation of the quality of guar seeds and its antioxidant effect study [D] Dalian: Liaoning University of traditional Chinese medicine, 2020

[32] Xiao Yi Wu, Zhi Mao, Hai Ping Liu, et al. A review of sterol composition of medicinal plants of Cucurbitaceae family [J] Natural products research and development, 2012, 24 (S1): 169-175

[33] Wang X M, Cao Gen. A review of the pharmacological effects of flavonoids [J] Journal of Suzhou College, 2007, 2 (2 1): 105-107, 141

[34] Mengqi Mu, Jie Liang, Guifan Wu, et al. Recent advances in the pharmacological effects of alkaloids [J] Shizhen Guo Yi Guo Yao, 2003, 1 (4 11): 700-702

[35] Feng Li. Building peel chemical composition study [D] Jinan: Shandong University of traditional Chinese medicine, 2014

[36] Cui Yachen, Dan Liqian, Xiao Feng Liu, et al. An examination of the protective effects of different bilesalts and their made bilesalts in rats with LPS induced acute lung injury [J] Journal of experimental formulas, 2020, 2 (6 1): 125-132

[37] Wei Peng Yang, Yi Wei Wang, Yan Li Wang, et al. An experimental study on the effective effect of different methods of biliary gunning on the detoxification and survival of Panax sinensis [J] Journal of experimental formulas, 2009, 1 (5 12): 33-35

[38] Kun Lin, Jianhua Wei, Chaocheng Deng, et al. Summary of research on the chemical composition and pharmacological effects of gunning on Tiannan Star [J] Guangxi Traditional Chinese medicine, 2018, 4 (14): 73-75

[39] Tang C Q, Li Pu, Wang Q H, et al. Review of the chemical composition, pharmacological effects and clinical applications of related compounds in cholangiocarcinoma [J] Pharmacy, China 2020, 3 (1 12): 1523-1527

[40] Li Yao. Composition changes and quality standards before and after panning by choledochus [D] Nanjing: Nanjing University of Chinese medicine, 2018

[41] Gong Rui Yu, Li Dong Zhang, he Jiaqi, et al. Synthesis and antimicrobial anti-inflammatory effects of tcdcana [J] Fine chemicals, 2007, 24 (11) 1087 - 1090

[42] Yujing Zhang, Xia Jing, Jiasi Feng, et al. Pharmacological effects and quantitative analysis methods of bile acids from rhubarb a recent review [J] Int j Pharm res, 2016, 4 (3 2): 268-274

[43] Chao Yang, Jie Tang, Suhui Xiong, et al. Antitumor activity of volatile oils from traditional Chinese medicine [J] Zhongnan pharmacy, 2017, 1 (59): 1190-1194

[44] Xiao, Yunyuan. A serum medicinal chemistry study of dahchengqi Decoction [D] Chengdu: Southwest Jiaotong University, 2010

[45] Han Gang, Guo Xiao Fei, Zhao Ping Xin, et al. Effect of Mangxiao in a traditional Chinese medicine group formula on the dissolution of anthraquinones from rhubarb [J] Journal of experimental formulas, 2011, 1 (7 1): 72-74, 77

[46] He Gutang, Wu Tao, Lu Fang Guo. Clinical application and experimental progress of the "" lung and large intestine facies first cousin "" theory [J] Hunan Journal of traditional Chinese medicine, 2018, 34 (12): 150-152

[47] Wang L, Xu M, Dong H, et al. To discuss the theory of "lung and large intestine facies surface" from an immunological point of view [J] Liaoning Traditional Chinese medicine journal, 2019, 46 (11): 2309-2311

[48] Xurui Zheng, Yang Yu, Xiuli Zheng, et al. Lung and large intestine facing the surface of the lung: a review from the changes in ERK signaling pathway in the lung and intestine: [J] Zhongcheng Yao, 2014, 36 (11): 2388-2390