• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Effects of Suhuang Zhike Capsule on Pulmonary Function,Blood Gas Analysis Index, Serum PCT and CRP Expression in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

    2019-04-12 03:40:56RenJunqing任君清

    Ren Junqing (任君清)

    Xuancheng People's Hospital, Anhui Province, 242000, China

    ABSTRACT OBJECTIVE: To observe the effects of Suhuang Zhike Capsule on pulmonary function, blood gas analysis index, serum PCT and CRP expression in patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: A total of 88 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Xuancheng People's Hospital of Anhui Province from December 2014 to December 2016 were randomly divided into the observation group and the control group, with 44 cases in each group. The control group was given routine clinical treatment, and the observation group was given Suhuang Zhike Capsule on the basis of the treatment method of the control group. After 7 days' treatment,the improvement of lung function indexes were observed and evaluated before and after treatment (forced expiratory volume in one second (FEV1), forced expiratory volume occupancy in the 1st second percentage of vital capacity (FEVl/FVC), peak expiatory flow (PEF)), blood gas analysis index (Arterial oxygen partial pressure (PaO2) and arterial blood carbon dioxide partial pressure (PaCO2), oxygenation index (OI)) and serum cytokine levels (procalcitonin (PCT) and C reactive protein (CRP). RESULTS: The total effective rate of the observation group was significantly higher than that of the control group (P < 0.05). The FEV1, FEV1/FVC and PEF in 2 groups were significantly increased after the treatment (P < 0.05), and the above lung function indexes in the observation group were significantly higher than the control group (P < 0.05). PaO2 and OI were significantly increased after the treatment (P < 0.05), PaCO2 was significantly decreased after the treatment (P < 0.05), and the improvement of above blood gas analysis indexes were significantly superior of the observation group than the control group (P < 0.05). The serum PCT and CRP levels in 2 groups were significantly decreased after the treatment (P < 0.05), and the improvement in the observation group were more significant than that in the control group (P < 0.05). CONCLUSION: Suhuang Zhike Capsule can inhibit serum inflammatory cytokine levels in patients with acute exacerbation of chronic obstructive pulmonary disease, improve blood gas analysis indicators,and improve lung functions.

    KEYWORDS: Chronic obstructive pulmonary disease; Acute exacerbation; Suhuang Zhike Capsule; Lung function; Blood gas analysis index; Procalcitonin; C-reactive protein

    Chronic obstructive pulmonary disease(COPD) is a relatively common respiratory disease characterized by persistent airflow limitation.The airflow limitation is progressive, and the clinical symptoms are mainly dyspnea, oppression in chest, gasping, sputum, chronic cough, etc.,which can further evolve into pneumocardial disease or respiratory failure with high morbidity and mortality[1]. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an important disease course in the development of COPD disease, which seriously affects the health conditions of COPD patients. Studies have shown that 25% COPD patients with decline in lung function can be attributed to AECOPD, and AECOPD can significantly accelerate the course of COPD,which is an independent risk factor for the death of COPD patients[2]. At present, the main purpose of western medicine treatment on AECOPD is to delay the deterioration of lung function, stabilize clinical symptoms and prevent complications. The treatment methods include dilating airway, preventing infection and inhibiting airway inflammation, while the overall efficacy is limited[3]. Traditional Chinese medicine believes that the pathogenesis of AECOPD is mostly the lung deficiency caused by chronic illness or the retention of turbid phlegm, causing the distention of lung qi. If the patients suffer the exogenous pathogens as well, it will lead to acute exacerbation or recurrent episodes, symptoms of cough, wheezing,expectoration and asthma, which will significantly aggravate in a short period of time. Suhuang Zhike Capsule is a kind of proprietary Chinese medicine based on the theory of wind cough and developed by the well-known Chinese medicine practitioner Chao Enxiang with decades of clinical experience.It has the functions of relieving sore throat and cough, dispelling wind and ventilating the lung,and is especially effective for coughing, bucking,and itching pharynx caused by the lung qi failing in dispersing and wind pathogen invading the lung as well as the worsen disease condition caused by factors like sudden cold air or shortness of breath. In recent years, reports on the treatment of AECOPD by Suhuang Zhike Capsule have emerged. Pulmonary function tests are important objective indicators for clinical assessment of airflow limitation. Blood gas tests help to determine the extent of AECOPD.Bacterial infection is an important pathological basis for AECOPD, while serum procalcitonin (PCT) and C-reactive albumin. (CRP) are sensitive indicators for clinical identification of bacterial infections.Therefore, in this study, the author used Suhuang Zhike Capsule to treat 44 cases of AECOPD. It is proposed to observe the changes of lung function index, blood gas analysis index and serum PCT and CRP expression before and after the treatment to explore the mechanism and clinical efficacy of Suhuang Zhike Capsule in treating AECOPD.

    MATERIALS AND METHODS

    Clinical materials

    A total of 88 patients with AECOPD admitted to the Department of Respiratory Medicine, Xuancheng People's Hospital of Anhui Province from December 2014 to December 2016 were randomly divided into 2 groups, with an amount of 44 in each group. There are 39 males and 5 females in the observation group,ranging in age from 58 to 85, with an average age of(75.5±4.3), while the duration of COPD was 1 to 13 years, with the mean value of (6.5±1.1) years,and the duration of AECOPD was 0.5 to 5 days, with the mean value of (3.41±0.33) days. There were 40 males and 4 females in the control group, ranging in age from 60 to 85, with an average age of (75.3±4.2),while the duration of COPD was 1 to 14 years, with the mean duration of (6.8±1.0) years, and the course of AECOPD was 0.5 to 5.5 days, with the average duration of (3.44 ± 0.32) days. There were no significant differences in gender, age, and duration of disease between the 2 groups (P > 0.05), which was comparable.

    Diagnostic criteria

    The western medicine diagnostic criteria refers to the diagnosis of COPD on Guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease (revision of 2013)[4]. The course of the disease is acute exacerbation: COPD patients with respiratory symptoms beyond the scope of daily variation, requiring for changes of the clinical treatment program, represented as cough, shortness of breath, expectoration, worsen gasping, the significantly increased amount of sputum, possibly accompanied by fever and other inflammatory reactions. Pulmonary function test: FEV1/FVC value<70% after bronchodilator adoption. The diagnostic criteria for traditional Chinese medicine (TCM)syndromes refer to the regulation of phlegm-heat stasis type of Diagnostic and Efficacy Standards for TCM Syndrome[5]: cough, expectoration, yellow and turbid phlegm, shortness of breath, wheezing,attenuated breath sounds of both lungs, and audible dry and wet rales, red tongue, thin yellow tongue coating, floating rapid pulse.

    Inclusion criteria

    The patient's age ranged from 55 to 85, and the stage of the disease was acute exacerbation. The patient or the patient's family informed consent to the clinical trial related to the treatment. This study was approved by the hospital ethics committee.

    Exclusion criteria

    Those who had co-morbidity of severe insufficiency of important organs such as cardiac insufficiency, hepatic insufficiency, and renal insufficiency. Those with co-morbidity of serious lesion in blood system and immune system. Those combined with tuberculosis, bronchial asthma,bronchiectasis, silicosis, lung cancer, tuberculosis and other serious lung diseases. Those combined with diabetes mellitus, hypertension, malignant tumor,upper respiratory tract infection and asthma, and mental disease.

    Therapeutic methods

    The control group was given routine medical treatment, including Cefoperazone Sodium and Sulbactam Sodium (Shenzhen Zhijun Pharmaceutical Co., Ltd., production batch number: 20141103,specification: 1.5 g) (3.0 g/time, intravenous drip,1 time/12 h), low flow oxygen therapy (2 L/min),Aminophylline Injection (Sichuan Meida Kang Huakang Pharmaceutical Co., Ltd., production batch number: 14100826, specification 10 mL:0.25 g) (0.5 g/time, intravenous drip, 1 time/d),Ambroxol Hydrochloride Sodium Injection (Jiangsu Haosen Pharmaceutical Co., Ltd., production batch number: 20141004, specification 30 mg)(30 mg/time, intravenous drip, 2 times/d). On the basis of the treatment method of the control group, the observation group was given Suhuang Zhike Capsule(Yangzijiang Pharmaceutical Group Beijing Haiyan Pharmaceutical Co., Ltd., production batch number:14071511, specification 0.45 g per capsule) for treatment, 3 capsules a time by oral administration, 3 times a day. The efficacy of the 2 groups was evaluated after 7 days of treatment.

    Indicator

    (1) Clinical efficacy: this study took the Guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease[4]as accordance.Clinical control: after the treatment, clinical symptoms of cough, wheezing, expectoration, lung sounds,etc. completely or basically disappeared. Laboratory indicators such as leucocyte count, CRP and neutrophils completely got back to normal. Markedly effective: after the treatment, clinical symptoms of cough, wheezing, expectoration, lung sounds, etc.were significantly relieved. Laboratory indicators such as leucocyte count, CRP and neutrophils were significantly improved. Improvement: after the treatment, clinical symptoms of cough, wheezing,expectoration, lung sounds, etc. were relieved.Laboratory indicators such as leucocyte count, CRP and neutrophils had been improved for some extent.Invalid: after the treatment, clinical symptoms of cough, wheezing, expectoration, lung sounds, etc.did not be alleviated at all. Laboratory indicators such as leucocyte count, CRP and neutrophils did not be improved or even deteriorated. Total effective = clinical control + markedly effective + improved. (2) Pulmonary function indicators: the improvement of lung function indicators were determined before and after the treatment, including forced expiratory volume in one second (FEV1), forced expiratory volume in the 1stsecond (FEVl), percentage of forced expiratory volume in 1stsecond to forced vital capacity (FEVl/FVC) and peak expiratory flow (PEF). (3) Blood gas analysis index: the blood gas analyzer was used to detect the inhaled oxygen concentration (FiO2), arterial oxygen partial pressure (PaO2) and arterial blood carbon dioxide partial pressure (PaCO2) before and after the treatment, and calculate the Oxygenation Index(OI) =PaO2/FiO2. (4) Serum cytokine level test: a total of 5 ml fasting peripheral vein before and after the treatment has been taken, after corresponding processes, centrifuge at 3000 rpm for 10 minutes,separate serum, and detect the levels of serum procalcitonin PCT and CRP by enzyme-linked immunosorbent assay. The whole process is strictly in accordance with the operating instructions.

    Statistical methods

    Statistical analysis was performed by SSPS 22.0 statistical software. The measurement data was expressed by (x–±s), t test. Count data comparison was represented by n (%), χ2test. P < 0.05 indicates significant difference.

    RESULTS

    Comparison of clinical effects between the 2 groups after the treatment

    The clinical efficacy in observation group was significantly higher than that in the control group. The difference was statistically significant (P < 0.05). See Table 1.

    Table 1. Comparison of clinical effects between the 2 groups after the treatment (n (%))

    Table 2. Comparison on lung function indexes of the 2 groups before and after the treatment (x–±S)

    Table 3. Comparison on the change of blood gas analysis indexes of the 2 groups before and after the treatment (±S)

    Table 3. Comparison on the change of blood gas analysis indexes of the 2 groups before and after the treatment (±S)

    Note: 1) compared with the data before the treatment, P < 0.05; 2) compared with the control group, P < 0.05

    The control group 44 Before the treatment 66.35±7.81 59.01±6.75 203.62±29.71 After the treatment 76.42±8.73① 52.27±6.19① 268.40±37.19①The observation group 44 Before the treatment 65.96±7.73 54.86±6.83 198.79±26.88 After the treatment 89.71±9.86①② 43.75±5.43①② 338.53±41.16①②

    Comparison on lung function indexes of the 2 groups before and after the treatment

    There was no significant difference in FEV1,FEV1/FVC and PEF between the 2 groups before the treatment (P > 0.05). The FEV1, FEV1/FVC and PEF were significantly increased after the treatment (P <0.05), and the improvement of above lungs functional indicators in observation group were significantly higher than that of the control group (P < 0.05). See Table 2.

    Comparison on the change of blood gas analysis indexes of the 2 groups before and after the treatment

    There was no significant difference in PaO2, PaCO2and OI between the 2 groups before the treatment (P > 0.05).The PaO2and OI were significantly increased in the 2 groups after the treatment (P < 0.05), and PaCO2was significantly decreased (P < 0.05). Moreover, the improved degree of the above blood gas analysis indexes in the observation group were significantly higher than that of the control group (P < 0.05). See Table 3.

    Comparison on the levels of serum cytokine of the 2 groups before and after the treatment

    There was no significant difference in serum PCT and CRP levels between the 2 groups before the treatment(P > 0.05). The serum PCT and CRP levels were significantly decreased after the treatment (P < 0.05), and the improved degree in observation group was significantly higher than that in the control group (P < 0.05). See Table 4.

    Table 4. Comparison on the levels of serum cytokine of the 2 groups before and after the treatment (x–±S)

    DISCUSSION

    AECOPD is an acute onset process, which refers to the acute exacerbation of respiratory symptoms in patients with COPD. The symptoms including cough, dyspnea, increased sputum, yellow and turbid sputum, are far exceeded than daily variation,and usually require changes in medicinal treatment guildlines[6]. The pathogenesis of AECOPD is very complex. The modern medical research has confirmed that mostly AECOPD is developed from respiratory virus infection, especially rhinovirus infection.Molecular biology techniques identified that over 60% of patients with AECOPD carried respiratory viruses, who showed more pronounced symptoms of airway inflammation comparing with patients without viral infection. In addition, the study also found that patients with stable COPD had bacterial colonization in the lower respiratory tract, and the bacterial load increased significantly during the acute exacerbation period. Bacterial infection is often secondary to viral infection rather than the origin of AECOPD[7].Therefore, respiratory virus infection and bacterial infection play important roles in the pathogenesis of AECOPD. In clinical treatment, appropriate antiinfective medicines should be adopted in time to prevent the development of the disease. Whether to use the antibiotics is determined according to the color and texture of the sputum, changes of body temperature and peripheral leucocyte counts,etc. of AECOPD patients. However, the above indicators lack of specificity, so that a biomarker or a group of biomarkers in helping clinical adoption on antibacterial drugs have clinical significance.Serum PCT and CRP are biomarkers found in clinical practice in recent years, and have high specificity and sensitivity for the diagnosis of bacterial infectious diseases. PCT is a calcitonin propeptide glycoprotein produced by thyroid C cells. Under normal physiological conditions, PCT is extremely low in the body (<0.1 ng/ml), but after suffering from bacterial or endotoxin infection, a large amount of PCT will be secreted by liver monocytes, macrophages,tissue lymphocytes of gastrointestine and lung, and endocrine cells, resulting in a significant increase of serum PCT levels, which will gradually decrease with the control of infection. CRP is an acute phasereactive protein synthesized by the liver. It presents in the body in a trace form under normal physiological conditions. Its level will be significantly increased when it is infected by bacteria, which can be several thousand times higher than the normal level. Under normal circumstances, when the CRP level exceeds 20 mg/L, there might be a presence of bacterial infection[8]. With the control of infection and the recovery of the disease, the CRP level will also decrease rapidly.The results of this study shows that the serum PCT and CRP were significantly higher than normal before the treatment, while were significantly decreased after the treatment, which suggests that detecting serum PCT and CRP levels are helpful to determine whether there is bacterial infection in AECOPD patients. It has an important clinical significance in guiding the rational adoption of antibiotics, evaluating the prognosis of AECOPD and directing anti-infective therapy[9].

    COPD belongs to the category of "lung inflation", "hepatitis syndrome" and "cough" in TCM.Chinese medicine believes that the lung is delicate zang-organ, governing diffusion, purification and descent. Diffusion refers to transmitting the essence of the foods, and nourishing the skin, the hair, and the whole body. The purification and descent is clearing and falling of lung qi. The lungs locate on the top of internal organs, and the lung qi is calm and descending. If people suffering the wind pathogen,upward disturbance of the wind-heat, the lung failing to diffuse and purify as well as the lung qi failing to descend, it will cause asthma, cough and adverse rising of lung qi. The patients in this study are mostly vulnerable senior citizens, the viscera and qi are deficient, and the lungs have been exposed to exogenous evil for a long time. As a result, the lung qi is damaged, and the spleen fails to transport,causing food and drink being difficult to become essence. The phlegm and body fluid stuffed deep inside the lungs, causing the deficiency of both the lung and the spleen. According to the principle of"treat the exterior syndrome first for acute onset", on the one hand, the treatment should be dispellig windevil and cold, on the other hand, ventilating the lung and relieving the cough to eliminate the root cause of the disease. Suhuang Zhike Capsule consists of 9 kinds of material medica. In this formula, ephedra is used for ventilating lung, relieving cough and asthma. Perilla leaves relieving exterior syndrome,dispelling cold, and ventilating lung qi to dissipate phlegm. Earthworm is used for clearing lung-heat and relieving asthma. Honeyed folium eriobotryae is used for clearing the lung and relieving cough, descending adverse qi and reducing vomiting. Perilla fruit is used for relieving cough and asthma, descending adverse qi and eliminating phlegm. Cicada slough is used for clearing wind-heat, relieving sore throat and producing sound. Hogfennel root is used for clearing heat and dispelling wind, descending adverse qi and resolving phlegm. Great burdock achene is used for dispelling wind-heat, ventilating lung qi,relieving sore throat, and removing toxicity for detumescence. Chinese magnoliavine fruit is used for astringing lung and promoting production of fluid, nourishing yin and securing essence. All these material medica are compatible with each other in dispelling the wind and cold, as well as ventilating lung qi for relieving cough. Modern pharmacological studies have shown that ephedrine volatile oil has a good effect on sweating, and ephedrine has a significantly antiasthmatic effect by exciting α-adrenergic receptors, relaxing bronchial smooth muscle, promoting the release of norepinephrine and adrenaline, and inhibiting the release of allergic transmitters[10]. Perilla can effectively alleviate symptoms of oppression in chest, shortness of breath,wheezing, cough, etc. in asthma patients. It has good effects on antitussive, antiasthmatic and expectorant.Perilla leaves can strongly inhibit many pathogenic bacteria such as Staphylococcus aureus and Escherichia coli[11]. Succinic acid and hypoxanthine in earthworm can effectively inhibit airway remodeling in asthma patients, and have anti-asthmatic and antitussive effects[12]. Cicada slough has a function of expelling phlegm, antitussive, antispasmodic and antiasthmatic by improving the number of leucocyte and microscopic blood stasis[13]. The extraction of hogfennel root with white flowers has a certain inhibitory effect on experimental cough in mice.It can relax bronchial smooth muscle, resisting allergic medium release with an obvious calcium ion antagonistic activity, and has a definite therapeutic effects on respiratory tract infection[14]. Chinese magnoliavine fruit has functions of bacteriostasis,anti-fatigue, anti-aging, enhancing immunity, etc.

    As mentioned above, bacterial infection is an important pathological basis of AECOPD. Serum PCT and CRP are sensitive indicators for clinical identification of bacterial infections. The results of this study showed that serum PCT and CRP levels were significantly decreased after the treatment,and the decreased degree were significantly lower than that in the control group, which suggested that Suhuang Zhike Capsule can inhibit the development of AECOPD by decreasing serum PCT and CRP levels. Pulmonary function tests are of great value for com firming air flow limitation and are the very standard for clinical diagnosis of COPD. After the adoption of bronchodilators, FEVl/FVC < 70% indicates that the patient has air flow limitation and cannot be completely reversed. The results of this study showed that both groups had a pre-treatment FEV1/FVC of < 70%, and the data were significantly increased after the treatment,while FEVl/FVC > 70% for all patients in the observation group. In addition, the FEV1and PEF levels in the observation group were significantly higher than that in the control group after the treatment, which suggests that Suhuang Zhike Capsule can effectively improve lung function in patients with AECOPD. The detection of blood gas analysis indicators is helpful to judge the degree of disease development of AECOPD patients.PaO2, PaCO2 and OI are common blood gas analysis indicators. The results of this study showed that PaO2 and OI were significantly increased and PaCO2 was significantly decreased after the treatment. Moreover,the improvement degree of blood gas analysis indexes above in the observation group was significantly higher than that of the control group, which suggests that Suhuang Zhike Capsule can effectively improve the blood gas analysis indexes of AECOPD patients. In summary, Suhuang Zhike Capsule has certain effects on inhibiting serum inflammatory cytokine levels in patients with acute exacerbation of chronic obstructive pulmonary, improving blood gas analysis indicators,and improving lung functions.

    天天一区二区日本电影三级| 毛片女人毛片| 狠狠狠狠99中文字幕| 观看美女的网站| 午夜福利在线观看吧| 久久久久网色| 国产老妇伦熟女老妇高清| 性色avwww在线观看| 久久人人爽人人爽人人片va| 少妇裸体淫交视频免费看高清| 日韩av在线大香蕉| 日本一二三区视频观看| 日本欧美国产在线视频| 久久精品国产亚洲网站| 夜夜夜夜夜久久久久| 亚洲人与动物交配视频| 久久6这里有精品| 国产成人91sexporn| 久久欧美精品欧美久久欧美| 内射极品少妇av片p| 国产在线精品亚洲第一网站| 99热这里只有是精品在线观看| 天美传媒精品一区二区| 色综合亚洲欧美另类图片| 欧美+亚洲+日韩+国产| 尾随美女入室| 国产久久久一区二区三区| 麻豆乱淫一区二区| 亚洲av第一区精品v没综合| 精品一区二区免费观看| 亚洲乱码一区二区免费版| 国内少妇人妻偷人精品xxx网站| 亚洲欧美日韩东京热| 亚洲美女搞黄在线观看| 国产成人aa在线观看| 我要搜黄色片| 久久久成人免费电影| 一区二区三区高清视频在线| 免费搜索国产男女视频| 国产精品福利在线免费观看| 不卡视频在线观看欧美| 久久久a久久爽久久v久久| 久久99热6这里只有精品| 久久午夜福利片| 国产精品久久久久久精品电影| 亚洲成人久久性| 国产精品乱码一区二三区的特点| 观看免费一级毛片| 国产中年淑女户外野战色| 国产国拍精品亚洲av在线观看| 亚洲欧美日韩东京热| 国内久久婷婷六月综合欲色啪| av在线播放精品| 亚洲欧美日韩无卡精品| 国产日韩欧美在线精品| 蜜桃亚洲精品一区二区三区| videossex国产| 久久久精品94久久精品| 99久久精品热视频| 成年女人看的毛片在线观看| 99久久精品一区二区三区| 日本三级黄在线观看| 久久久国产成人免费| 国产精品av视频在线免费观看| ponron亚洲| 97热精品久久久久久| 日韩一本色道免费dvd| 精品久久久久久久久亚洲| 国内精品美女久久久久久| 亚洲国产色片| 国产乱人偷精品视频| 97在线视频观看| 91久久精品电影网| 亚洲精品乱码久久久v下载方式| 国产一区二区亚洲精品在线观看| ponron亚洲| 91狼人影院| 国产精品永久免费网站| 尤物成人国产欧美一区二区三区| 日日摸夜夜添夜夜爱| a级一级毛片免费在线观看| 女人被狂操c到高潮| 久久人人精品亚洲av| 中国美白少妇内射xxxbb| 亚洲人成网站在线播| 日韩欧美精品免费久久| 亚洲精品成人久久久久久| 九草在线视频观看| 日本一本二区三区精品| 国产精品女同一区二区软件| 高清日韩中文字幕在线| 日韩成人av中文字幕在线观看| 日韩 亚洲 欧美在线| 精品久久久久久久久久免费视频| 亚洲欧美精品自产自拍| 国产私拍福利视频在线观看| 99riav亚洲国产免费| 精品久久久久久成人av| 人人妻人人澡人人爽人人夜夜 | 内地一区二区视频在线| 18+在线观看网站| 日韩欧美 国产精品| 国产精品,欧美在线| 免费人成视频x8x8入口观看| 欧美高清性xxxxhd video| 国产伦在线观看视频一区| 99国产极品粉嫩在线观看| 国产黄色视频一区二区在线观看 | 九草在线视频观看| 菩萨蛮人人尽说江南好唐韦庄 | 精品久久久久久久末码| 尤物成人国产欧美一区二区三区| 成人特级黄色片久久久久久久| 国内揄拍国产精品人妻在线| 亚洲五月天丁香| 99热这里只有精品一区| av福利片在线观看| 国产成人91sexporn| 欧美成人a在线观看| 久久久国产成人精品二区| 日韩在线高清观看一区二区三区| 亚洲欧美精品自产自拍| 五月玫瑰六月丁香| 人妻少妇偷人精品九色| 赤兔流量卡办理| 精品人妻偷拍中文字幕| 18禁在线播放成人免费| 91精品国产九色| 亚洲,欧美,日韩| 男人舔奶头视频| 成年女人永久免费观看视频| 亚洲成人久久爱视频| 成人欧美大片| 99国产极品粉嫩在线观看| 最近视频中文字幕2019在线8| 乱系列少妇在线播放| 国产在线精品亚洲第一网站| 一区二区三区高清视频在线| 黄色视频,在线免费观看| 久久久久性生活片| 日韩国内少妇激情av| 亚洲自拍偷在线| 中国国产av一级| 久99久视频精品免费| 亚洲欧美日韩高清在线视频| 精品人妻偷拍中文字幕| 校园人妻丝袜中文字幕| 国产久久久一区二区三区| 日本成人三级电影网站| 亚洲内射少妇av| 亚洲人与动物交配视频| 日韩国内少妇激情av| av国产免费在线观看| 日本免费a在线| 夜夜夜夜夜久久久久| 97超碰精品成人国产| 久久热精品热| 日本免费a在线| 人妻久久中文字幕网| 黄色配什么色好看| 亚洲国产高清在线一区二区三| 亚洲三级黄色毛片| 欧美日本亚洲视频在线播放| 亚洲无线观看免费| 欧美色欧美亚洲另类二区| 国产黄色小视频在线观看| 久久精品影院6| eeuss影院久久| 日韩欧美精品v在线| 亚洲欧洲日产国产| 热99re8久久精品国产| 久久久久久久久中文| 日本免费一区二区三区高清不卡| 欧美性感艳星| 亚洲最大成人手机在线| 91麻豆精品激情在线观看国产| 欧美成人一区二区免费高清观看| 国产av在哪里看| 夫妻性生交免费视频一级片| 亚洲在久久综合| 变态另类成人亚洲欧美熟女| 亚洲欧美精品专区久久| 亚洲自偷自拍三级| 日韩欧美三级三区| 国产一级毛片七仙女欲春2| 啦啦啦韩国在线观看视频| 国产激情偷乱视频一区二区| 综合色丁香网| 六月丁香七月| 午夜激情福利司机影院| 亚洲丝袜综合中文字幕| 全区人妻精品视频| 美女大奶头视频| 久久久久久久午夜电影| 亚洲av一区综合| 一本一本综合久久| 久久精品国产99精品国产亚洲性色| 亚洲国产精品久久男人天堂| 免费一级毛片在线播放高清视频| av在线亚洲专区| 大香蕉久久网| 三级经典国产精品| kizo精华| 人人妻人人看人人澡| 免费看光身美女| 麻豆久久精品国产亚洲av| 国产午夜精品久久久久久一区二区三区| 国产精品人妻久久久影院| 插阴视频在线观看视频| 91狼人影院| 国产伦精品一区二区三区视频9| 亚洲精品久久国产高清桃花| 赤兔流量卡办理| 久久人人精品亚洲av| 欧美zozozo另类| 国产 一区 欧美 日韩| 精品一区二区三区人妻视频| 亚洲欧洲日产国产| 日本欧美国产在线视频| 自拍偷自拍亚洲精品老妇| 成熟少妇高潮喷水视频| 亚洲高清免费不卡视频| 麻豆成人午夜福利视频| 亚洲欧美日韩高清在线视频| 成人毛片a级毛片在线播放| 色综合亚洲欧美另类图片| 日本免费a在线| 国产69精品久久久久777片| 中文资源天堂在线| 91久久精品电影网| 久久久久久国产a免费观看| 99久国产av精品国产电影| 国产色婷婷99| 日本免费一区二区三区高清不卡| 淫秽高清视频在线观看| 亚洲四区av| 内地一区二区视频在线| 国产免费男女视频| 国产精品一区二区性色av| 日本免费一区二区三区高清不卡| 少妇人妻一区二区三区视频| 久久精品影院6| 亚洲精品久久国产高清桃花| 蜜桃久久精品国产亚洲av| 91狼人影院| 91aial.com中文字幕在线观看| 久久6这里有精品| 久久久精品大字幕| 亚洲欧洲国产日韩| 国产精品一二三区在线看| 九草在线视频观看| av在线天堂中文字幕| 又爽又黄a免费视频| 日本免费一区二区三区高清不卡| 色哟哟·www| av女优亚洲男人天堂| 久久人妻av系列| 一卡2卡三卡四卡精品乱码亚洲| 亚洲av中文字字幕乱码综合| 国产乱人视频| 又粗又硬又长又爽又黄的视频 | 日韩强制内射视频| 人妻少妇偷人精品九色| 人人妻人人看人人澡| av在线蜜桃| 久久久久久伊人网av| 久久综合国产亚洲精品| 可以在线观看的亚洲视频| 黄色欧美视频在线观看| 天堂中文最新版在线下载 | 亚洲精品日韩在线中文字幕 | 在线观看av片永久免费下载| 中文资源天堂在线| 精品熟女少妇av免费看| 日韩欧美三级三区| 日本欧美国产在线视频| 大又大粗又爽又黄少妇毛片口| 边亲边吃奶的免费视频| 精品久久国产蜜桃| 夜夜夜夜夜久久久久| 黄色配什么色好看| 欧美日韩乱码在线| 小蜜桃在线观看免费完整版高清| 亚洲自偷自拍三级| 午夜久久久久精精品| 亚洲真实伦在线观看| 在现免费观看毛片| 亚洲成人av在线免费| 国产黄a三级三级三级人| 日韩亚洲欧美综合| 99国产精品一区二区蜜桃av| 亚洲内射少妇av| 国产精品久久久久久精品电影小说 | 一区福利在线观看| 国产一区二区激情短视频| 成人鲁丝片一二三区免费| 成人毛片a级毛片在线播放| 日韩高清综合在线| www.av在线官网国产| 亚洲精品国产成人久久av| 国产高清三级在线| 高清日韩中文字幕在线| 午夜久久久久精精品| 男人舔女人下体高潮全视频| 亚洲av不卡在线观看| 国产精品福利在线免费观看| 一级黄片播放器| 一区二区三区高清视频在线| 国产精品久久久久久精品电影小说 | 熟女电影av网| 亚洲va在线va天堂va国产| 人妻制服诱惑在线中文字幕| 狠狠狠狠99中文字幕| 91精品一卡2卡3卡4卡| 爱豆传媒免费全集在线观看| 久久久久久久亚洲中文字幕| 国产精品免费一区二区三区在线| 久久精品国产亚洲av天美| 亚洲乱码一区二区免费版| 能在线免费观看的黄片| 国产免费一级a男人的天堂| 亚洲精品国产av成人精品| 大香蕉久久网| 毛片一级片免费看久久久久| 欧美不卡视频在线免费观看| av卡一久久| 免费看光身美女| 偷拍熟女少妇极品色| 99久久精品一区二区三区| 色综合亚洲欧美另类图片| 成年av动漫网址| 日韩欧美精品v在线| a级毛色黄片| 日韩精品青青久久久久久| 国产精品一区www在线观看| 高清午夜精品一区二区三区 | 午夜福利高清视频| 插阴视频在线观看视频| av.在线天堂| 久久久久九九精品影院| 天堂中文最新版在线下载 | 菩萨蛮人人尽说江南好唐韦庄 | 在线国产一区二区在线| 人妻夜夜爽99麻豆av| 中国美白少妇内射xxxbb| 99riav亚洲国产免费| 一级av片app| 国产白丝娇喘喷水9色精品| 美女国产视频在线观看| 麻豆乱淫一区二区| 欧美最新免费一区二区三区| 国产一区二区亚洲精品在线观看| 麻豆av噜噜一区二区三区| 国产大屁股一区二区在线视频| 亚洲欧美成人精品一区二区| 自拍偷自拍亚洲精品老妇| 精品免费久久久久久久清纯| 秋霞在线观看毛片| 成人永久免费在线观看视频| 国产伦精品一区二区三区视频9| 国产黄a三级三级三级人| 51国产日韩欧美| 国产成人精品一,二区 | 此物有八面人人有两片| 两个人视频免费观看高清| 少妇人妻精品综合一区二区 | 久久久久久久久久久免费av| 久久国产乱子免费精品| 男人的好看免费观看在线视频| 国产乱人偷精品视频| 日韩精品青青久久久久久| 久久精品国产清高在天天线| 精品人妻熟女av久视频| 欧美最黄视频在线播放免费| 亚洲欧美日韩东京热| 好男人视频免费观看在线| 久久韩国三级中文字幕| 乱系列少妇在线播放| 天堂网av新在线| 一级黄色大片毛片| 亚洲精品乱码久久久久久按摩| 少妇丰满av| 91aial.com中文字幕在线观看| 日韩强制内射视频| 变态另类成人亚洲欧美熟女| 人妻制服诱惑在线中文字幕| 全区人妻精品视频| 久久精品国产清高在天天线| 夜夜爽天天搞| 成人欧美大片| 亚洲精品日韩在线中文字幕 | 狠狠狠狠99中文字幕| 99久国产av精品| 亚洲精品自拍成人| 岛国在线免费视频观看| 精品日产1卡2卡| 99视频精品全部免费 在线| 最好的美女福利视频网| 97在线视频观看| 午夜激情欧美在线| 国产在线男女| 大香蕉久久网| 久久亚洲精品不卡| 九色成人免费人妻av| 熟女人妻精品中文字幕| 国产av一区在线观看免费| 麻豆久久精品国产亚洲av| 色综合站精品国产| 99riav亚洲国产免费| 国产精品久久久久久久久免| 欧美高清性xxxxhd video| 欧美潮喷喷水| 国产成人freesex在线| 婷婷亚洲欧美| 亚洲精品亚洲一区二区| 嫩草影院新地址| 久久久国产成人免费| 欧美高清性xxxxhd video| 人人妻人人看人人澡| 九九在线视频观看精品| 亚洲成人久久性| 黄片wwwwww| 中国国产av一级| 久久久国产成人免费| 亚洲国产精品国产精品| 国产久久久一区二区三区| 人体艺术视频欧美日本| 哪个播放器可以免费观看大片| 亚洲欧洲日产国产| 久久久国产成人精品二区| 国产色爽女视频免费观看| 欧美不卡视频在线免费观看| 亚洲国产精品sss在线观看| 国产精品日韩av在线免费观看| 麻豆av噜噜一区二区三区| 老师上课跳d突然被开到最大视频| 久久热精品热| 综合色丁香网| 成人鲁丝片一二三区免费| 26uuu在线亚洲综合色| 九色成人免费人妻av| 日韩亚洲欧美综合| 国产大屁股一区二区在线视频| 中文字幕av在线有码专区| 亚洲自拍偷在线| 中国国产av一级| 国产精品蜜桃在线观看 | 熟女人妻精品中文字幕| 精品日产1卡2卡| 久久久久久久久中文| 国内精品美女久久久久久| 久久久久久久久久黄片| 禁无遮挡网站| 天堂影院成人在线观看| 国内精品美女久久久久久| 婷婷六月久久综合丁香| 免费搜索国产男女视频| 久久久国产成人精品二区| 国产成人一区二区在线| 日韩三级伦理在线观看| 三级毛片av免费| 高清午夜精品一区二区三区 | 亚洲国产欧美在线一区| 国产91av在线免费观看| 日本成人三级电影网站| 日日摸夜夜添夜夜爱| 成人鲁丝片一二三区免费| .国产精品久久| 国产精品人妻久久久影院| 蜜桃久久精品国产亚洲av| 国产成人精品久久久久久| 一个人免费在线观看电影| 国产91av在线免费观看| 免费观看a级毛片全部| 国产精品美女特级片免费视频播放器| 成人永久免费在线观看视频| 狂野欧美激情性xxxx在线观看| 如何舔出高潮| 2022亚洲国产成人精品| 日韩成人av中文字幕在线观看| 99久久精品一区二区三区| 亚洲成人精品中文字幕电影| 国产片特级美女逼逼视频| 尾随美女入室| 床上黄色一级片| 午夜福利成人在线免费观看| 亚洲成人精品中文字幕电影| 成人无遮挡网站| 亚洲欧美日韩东京热| 男女边吃奶边做爰视频| 九草在线视频观看| 久久6这里有精品| 亚洲中文字幕一区二区三区有码在线看| 亚洲人与动物交配视频| 日韩欧美 国产精品| 久久99热6这里只有精品| 中文字幕av成人在线电影| 欧美成人精品欧美一级黄| 久久精品国产清高在天天线| 国产精品人妻久久久久久| 国产成人福利小说| 亚洲性久久影院| 能在线免费看毛片的网站| 国产乱人视频| 欧美高清性xxxxhd video| 变态另类丝袜制服| 不卡视频在线观看欧美| 男人和女人高潮做爰伦理| 亚洲真实伦在线观看| 成人av在线播放网站| 国产真实伦视频高清在线观看| 一卡2卡三卡四卡精品乱码亚洲| 我的老师免费观看完整版| 青春草亚洲视频在线观看| 国产 一区精品| 一个人观看的视频www高清免费观看| 亚洲av成人精品一区久久| 欧美激情久久久久久爽电影| 国产高清视频在线观看网站| 级片在线观看| 蜜臀久久99精品久久宅男| 午夜激情福利司机影院| av天堂中文字幕网| 能在线免费观看的黄片| 成人特级黄色片久久久久久久| 给我免费播放毛片高清在线观看| 夜夜看夜夜爽夜夜摸| 国产精品嫩草影院av在线观看| 久久99精品国语久久久| 麻豆精品久久久久久蜜桃| 99热网站在线观看| 成人二区视频| 波多野结衣高清作品| 伊人久久精品亚洲午夜| 欧美zozozo另类| 边亲边吃奶的免费视频| 在线观看美女被高潮喷水网站| 久久精品国产亚洲av涩爱 | 日本撒尿小便嘘嘘汇集6| 国产伦精品一区二区三区视频9| 国产91av在线免费观看| 国国产精品蜜臀av免费| 网址你懂的国产日韩在线| 欧美在线一区亚洲| 大型黄色视频在线免费观看| 男人和女人高潮做爰伦理| 91av网一区二区| 大又大粗又爽又黄少妇毛片口| 亚洲av成人av| 亚洲最大成人中文| 18禁在线播放成人免费| 小说图片视频综合网站| 人妻系列 视频| 亚洲激情五月婷婷啪啪| 别揉我奶头 嗯啊视频| 国产黄a三级三级三级人| 赤兔流量卡办理| 国产精品久久视频播放| 亚洲真实伦在线观看| 一级av片app| АⅤ资源中文在线天堂| www.av在线官网国产| 亚洲婷婷狠狠爱综合网| 日韩精品青青久久久久久| 国产在视频线在精品| 国产成人91sexporn| av在线亚洲专区| 男人的好看免费观看在线视频| 精品一区二区三区人妻视频| 亚洲人成网站在线播| av国产免费在线观看| 91精品国产九色| 国产精品三级大全| 可以在线观看毛片的网站| 美女内射精品一级片tv| 只有这里有精品99| 成人二区视频| 国产一区二区在线av高清观看| 国产精品一区二区三区四区免费观看| 少妇猛男粗大的猛烈进出视频 | 一本一本综合久久| av福利片在线观看| 国产69精品久久久久777片| 亚洲国产欧洲综合997久久,| 欧美一级a爱片免费观看看| 亚洲七黄色美女视频| 大型黄色视频在线免费观看| 免费在线观看成人毛片| 亚洲18禁久久av| 日韩,欧美,国产一区二区三区 | 男人狂女人下面高潮的视频| 99国产极品粉嫩在线观看| 亚洲av成人精品一区久久| 91久久精品国产一区二区成人| 神马国产精品三级电影在线观看| 中文字幕人妻熟人妻熟丝袜美| 最近视频中文字幕2019在线8| 国产成人freesex在线| 国产黄色视频一区二区在线观看 | 国模一区二区三区四区视频| 永久网站在线| 亚洲av不卡在线观看| 日韩强制内射视频| 亚洲性久久影院| 成人性生交大片免费视频hd| 久久久久久伊人网av| 欧美激情国产日韩精品一区| 久久午夜福利片| 美女大奶头视频| 亚洲人成网站在线观看播放| 日韩强制内射视频| 精品一区二区三区人妻视频| 色尼玛亚洲综合影院| 亚洲av免费在线观看| 网址你懂的国产日韩在线|