【摘要】：背景中醫(yī)藥治療小兒肺炎喘嗽具有一定優(yōu)勢。汪受傳教授治療肺炎喘嗽,效果較顯著,且安全性高、副作用少。因此,需要全面深入挖掘汪教授治療肺炎喘嗽的用藥規(guī)律。目的利用聚類和關(guān)聯(lián)規(guī)則分析方法挖掘汪教授治療兒童肺炎喘嗽的用藥規(guī)律。方法以汪教授門診治療肺炎喘嗽的249份病案為基礎(chǔ),通過使用SPSS 19.0和Clementine 12.0軟件對29味高頻藥物進(jìn)行聚類和關(guān)聯(lián)規(guī)則分析,探究其用藥規(guī)律。結(jié)果1.聚類分析共分4個類別。C1:炙麻黃、苦杏仁、黃芩、虎杖、葶藶子、蘇子及前胡;C2:桑葉、桑白皮、膽南星、枇杷葉、辛夷及重樓;C3:桔梗、枳殼、浙貝母、地龍、蟬蛻、瓜蔞、紫苑、百部、生石膏及丹參;C4:炙黃芪、白術(shù)、防風(fēng)、煅龍骨、煅牡蠣。2.關(guān)聯(lián)規(guī)則分析:從兩藥關(guān)聯(lián)來看,前胡與炙麻黃、炙麻黃與杏仁、桑葉與桑白皮、前胡與杏仁、蘇子與葶藶子、蘇子與前胡、前胡與黃芩、虎杖與黃芩、膽南星與黃岑、膽南星與前胡、桑白皮與黃芩等兩位常用藥物組合;從三藥關(guān)聯(lián)來看,基本體現(xiàn)出治療肺炎喘嗽當(dāng)以宣肅肺氣,清熱化痰為治療大法。宣肺類代表藥物為炙麻黃、桑葉,肅降肺氣類代表藥物為杏仁、桑白皮、枇杷葉、前胡、葶藶子、蘇子等,清肺瀉熱類代表藥物為黃芩、虎杖等,化痰類代表藥物為膽南星、杏仁等。結(jié)論運用聚類分析和關(guān)聯(lián)規(guī)則分析可以初步揭示汪教授臨證治療肺炎的用藥規(guī)律,即以炙麻黃、苦杏仁、桑葉、桑白皮、黃芩、虎杖、葶藶子、蘇子、膽南星、前胡等為核心藥物,配伍桔梗、枳殼、浙貝母、瓜萎、紫菀、百部、生石膏等清熱化痰,肅肺止咳。背景肺炎是兒科常見的呼吸系統(tǒng)疾病,嚴(yán)重危害兒童健康,世界衛(wèi)生組織將其列為全球3種重要兒科疾病之一。據(jù)統(tǒng)計,在兒童急性下呼吸道感染中,病毒性肺炎所占比例呈上升趨勢,而呼吸道合胞病毒作為其中最重要的病原體之一,可以引起嬰幼兒毛細(xì)支氣管炎、支氣管肺炎、間質(zhì)性肺炎等。呼吸道合胞病毒(respiratory syncytial virus,RSV)感染的發(fā)病機制尚未完全明確,且目前缺乏安全有效的疫苗和藥物進(jìn)行針對性的預(yù)防和治療。中醫(yī)藥因其辨證論治、作用柔和及副作用少等特點,在治療兒童呼吸道病毒感染中具有一定的優(yōu)勢。汪教授已研究兒童病毒性肺炎二十余年,根據(jù)該病特點和關(guān)鍵病機,研制出金欣口服液,作為臨證治療病毒性肺炎的有效驗方,具有宣肺開閉、清熱化痰、止咳平喘的功用。前期大量臨床和實驗研究已表明其可顯著抗RSV感染及調(diào)節(jié)免疫作用。黃芩素是金欣口服液組成藥物黃芩的重要有效成分,研究表明具有廣譜的抗病毒活性。但是,和許多中醫(yī)藥實驗研究一樣,上述研究可能存在諸多缺陷,如指標(biāo)單一、獨立、非同步等,難以全面反映藥物的作用機制。因此,若深入探討其治療作用,應(yīng)當(dāng)引入系統(tǒng)化、整體化的研究技術(shù)方法以綜合分析。代謝組學(xué)是系統(tǒng)生物學(xué)的重要組成部分,在生物體受到各種外界因素刺激時,能即時、靈敏、真實表現(xiàn)出生物體整體功能的應(yīng)答與調(diào)節(jié)。作為一種系統(tǒng)的研究方法,其以機體的整體代謝為研究對象,動態(tài)研究生物體受刺激或者擾動之后,其內(nèi)源性代謝物種類、數(shù)量的變化,可以從較為全面的視角發(fā)現(xiàn)藥物真正的作用機理及其賴以發(fā)揮作用的物質(zhì)基礎(chǔ)。因此,本課題組采用代謝組學(xué)研究方法,嘗試闡明金欣口服液和黃芩素治療RSV感染的作用,以及其中的作用機制。目的研究RSV肺炎BALB/c小鼠血漿、尿液、肺泡灌洗液、脾臟組織及細(xì)胞的代謝特征,進(jìn)而探討金欣口服液以及黃芩素對RSV肺炎小鼠的干預(yù)作用以及其中可能涉及的代謝調(diào)控機制。方法RSV鼻腔吸入法感染BALB/C小鼠之后,分別予以金欣口服液以及黃芩素進(jìn)行干預(yù),并設(shè)正常對照組,分別采集小鼠血漿、尿液、肺泡灌洗液和脾臟組織,行肺部組織病理病理學(xué)分析以觀察肺部病變情況。培養(yǎng)細(xì)胞,予RSV感染1.5-2h后,予黃芩素處理,24h后予以液氮淬滅,以水-甲醇-氯仿提取細(xì)胞內(nèi)代謝物。將上述小鼠樣本和細(xì)胞樣本預(yù)處理后,運用氣相色譜-質(zhì)譜聯(lián)用(Gas Chromatography-Mass Spectrometer,GC-MS)分析小鼠的血漿、尿液、脾臟組織和細(xì)胞的整體代謝變化,運用超高效液相色譜-離子阱質(zhì)譜聯(lián)用(Ultra Performance Liquid Chromatography-LTQ/Orbitrap-Mass Spectrometer,UPLC-LTQ/Orbitrap-MS)研究小鼠肺泡灌洗液中代謝譜變化,利用主成分分析(principal component analysis,PCA)和正交偏最小二乘法判別分析(Orthogonalpartial least squares-discriminant analysis,OPLS-DA)分析所采集的數(shù)據(jù),篩選潛在的血漿、尿液、脾臟、肺泡灌洗液和細(xì)胞內(nèi)的生物標(biāo)記物,分析相關(guān)代謝通路,闡釋金欣口服液和黃芩素對RSV肺炎的可能的代謝調(diào)控機制。結(jié)果1.RSV感染BALB/c小鼠的肺組織病變主要位于肺間質(zhì)部位,可見肺臟可見間質(zhì)多灶性炎細(xì)胞浸潤(++),以單核細(xì)胞、淋巴細(xì)胞為主;肺泡壁輕度充血(+),肺泡壁明顯增厚。分別運用金欣口服液和黃芩素治療后,肺部充血、水腫、炎性浸潤均有不同程度減輕。2.金欣口服液的代謝組學(xué)研究(1)血漿:正常組、RSV肺炎模型組與金欣口服液治療組小鼠的血漿的OPLS-DA分析顯示,三組間能完全分離,無交叉和重疊,模型參數(shù)R2Y=0.934,Q2=0.889,鑒定并篩選了 6個潛在生物標(biāo)記物,分別為乳酸、尿素、谷氨酰胺、1,5-脫水山梨醇、葡萄糖、花生四烯酸。(2)尿液:正常組、RSV肺炎模型組與金欣口服液治療組小鼠的尿液的OPLS-DA分析顯示,三組間能完全分離,無交叉和重疊,模型參數(shù)R2Y=0.85,Q2=0.746,鑒定并篩選了 4個潛在生物標(biāo)記物,分別為乳酸、甘氨酸、硬脂酸、棕櫚酸。(3)脾臟組織:正常組、RSV肺炎模型組與金欣口服液治療組小鼠的脾臟樣本的OPLS-DA分析顯示,三組間能完全分離,無交叉和重疊,模型參數(shù)R2Y=0.959,Q2=0.895,鑒定并篩選了 6個潛在生物標(biāo)記物,分別為L-脯氨酸、L-谷氨酸、纈氨酸、尿素、次黃嘌呤、葡萄糖,(4)肺泡灌洗液:正常組、RSV肺炎模型組與金欣口服液治療組小鼠的肺泡灌洗液樣本的OPLS-DA分析顯示,三組間能完全分離,無交叉和重疊,模型參數(shù)R2Y=0.972,Q2=0.924,鑒定并篩選了 6個潛在生物標(biāo)記物,分別為左旋肉堿、丙酰肉堿、腺苷、二氫神經(jīng)鞘氨醇、白三烯D5和葡萄糖醛酸雌素酮。3.黃芩素的代謝組學(xué)研究(1)細(xì)胞:正常組、RSV肺炎模型組與金欣口服液治療組小鼠的肺泡灌洗液樣本的OPLS-DA分析顯示,三組間能完全分離,無交叉和重疊,模型參數(shù)R2Y=0.974,Q2=0.917,鑒定并篩選了 6個潛在生物標(biāo)記物,5種差異性代謝物,分別為絲氨酸、L-天冬氨酸、L-谷氨酸酸、檸檬酸與甘氨酸。(2)血漿:正常組、RSV肺炎模型組與金欣口服液治療組小鼠的血漿樣本的OPLS-DA分析顯示,三組間能完全分離,無交叉和重疊,模型參數(shù)R2Y=0.912,Q2=0.84,鑒定并篩選了 6個潛在生物標(biāo)記物,乳酸、尿素、甘氨酸、谷氨酰胺、1,5-脫水山梨醇、D-葡萄糖。(3)尿液:正常組、RSV肺炎模型組與金欣口服液治療組小鼠的尿液樣本的OPLS-DA分析顯示,三組間能完全分離,無交叉和重疊,模型參數(shù)R2Y=0.917,Q2=0.767,鑒定并篩選了 4個潛在生物標(biāo)記物,乳酸、蘋果酸、棕櫚酸、硬脂酸。(4)肺泡灌洗液:正常組、RSV肺炎模型組與金欣口服液治療組小鼠的尿液樣本的OPLS-DA分析顯示,三組間能完全分離,無交叉和重疊,模型參數(shù)R2Y=0.954,Q2=0.828,鑒定并篩選了5種差異性代謝物,鑒定結(jié)果分別為谷氨酸、碳酰肉堿、腺苷、葡萄糖苷酰鞘氨醇、白三烯D5。結(jié)論1.運用UPLC/MS和GC-MS分析代謝組學(xué)可以從代謝網(wǎng)絡(luò)的角度闡釋金欣口服液和黃芩素治療RSV感染的作用機制。2.RSV感染BALB/c后,血漿、尿液、肺泡灌洗液及脾臟內(nèi)的內(nèi)源性代謝物發(fā)生紊亂,主要為氨基酸、有機酸及脂肪酸。3.金欣口服液和黃芩素可以治療RSV感染,減輕BALB/c小鼠的肺部炎癥。4.金欣口服液和黃芩素能夠部分調(diào)整RSV感染導(dǎo)致的代謝紊亂,其中金欣口服液涉及谷氨酰胺代謝,丙氨酸、天冬氨酸和谷氨酸代謝,纈氨酸、亮氨酸和異亮氨酸代謝,花生四烯酸代謝,甘氨酸、絲氨酸和蘇氨酸代謝,精氨酸和脯氨酸代謝,以及丙酮酸代謝;黃芩素發(fā)揮治療作用主要與谷氨酰胺代謝,丙氨酸、天冬氨酸和谷氨酸代謝,甘氨酸、絲氨酸和蘇氨酸代謝相關(guān)。
[Abstract]:Background Chinese medicine has some advantages in the treatment of pneumonia and asthma in children. Wang Chuan professor has a significant effect, high safety and less side effects in the treatment of pneumonia and asthma. Therefore, it is necessary to excavate Professor Wang in the treatment of pneumonia and asthma. Methods based on 249 cases of pneumonia and asthma in Professor Wang's outpatient clinic, by using SPSS 19 and Clementine 12 software to cluster and analyze the association rules of 29 kinds of high frequency drugs, the results of the 1. cluster analysis were divided into 4 categories:.C1:, bitter almond, Scutellaria, Polygonum cuspidatum, drapine seed, soda and front. Hu; C2: mulberry leaf, mulberry, loquat leaf, loquat leaf, Magnolia and heavy building; C3: Platycodon, Fructus aurantii, Fritillaria, Trichosanthes, Trichosanthes, garden, hundred, raw gypsum and Salvia; C4:, Radix Astragali, Rhizoma Atractylodes, Alba, calcined oysters,.2. association rules analysis: from the two drug association, the forelaus and ephedra, sago ephedra and almonds, mulberry leaves and mulberry and mulberry bark, the forelahu and Almond, soda and Sophie, Soviet and forelahu, Radix Scutellariae, Scutellaria, Scutellaria, Scutellaria, Scutellaria, cen, Dan Nan star and Cen, Dan Nan star and forelahu, mulberry and scutellaria, and other two common drug combinations; from the correlation of three drugs, the basic manifestation of the treatment of pneumonia and asthma is to declare the lung qi and heat the phlegm as the treatment of the great law. The drugs represent apricot kernel, mulberry skin, loquat leaf, arbor, Sophia, Sophia and so on. Qingfei diarrhoea represents medicine for baicaleum Scutellaria, Polygonum cuspidatum and so on. Yellow, bitter almond, mulberry leaf, mulberry leaf, Scutellaria, Polygonum cuspidatum, sophion, santian, gendahu and Hubei are the core drugs. They are compatible with Platycodon grandiflorum, trifoliate orange, Fritillaria thunbergii, Melon Wilt, aster, 100, gypsum and so on. The background pneumonia is a common respiratory system disease in pediatrics, which seriously endangers children's health. The WHO lists it as 3 of the world. It is one of the most important pediatric diseases. According to the statistics, the proportion of viral pneumonia is rising in children's acute lower respiratory tract infection. As one of the most important pathogens, respiratory syncytial virus can cause bronchiolitis, bronchopneumonia, interstitial pneumonia, and so on. Respiratory syncytial virus (respiratory syncytia). L virus, RSV) the pathogenesis of infection has not been completely clear, and the current lack of safe and effective vaccines and drugs for targeted prevention and treatment. Chinese medicine has a definite advantage in the treatment of children's respiratory virus infection because of its syndrome differentiation, soft effect and less side effects. Professor Wang has studied two children's viral pneumonia. For more than ten years, according to the characteristics of the disease and the key pathogenesis, Jinxin oral liquid was developed as an effective prescription for the treatment of viral pneumonia. It has the function of Xuan lung opening and closing, clearing heat and eliminating phlegm and relieving cough and asthma. A large number of clinical and experimental studies have shown that it can significantly resist RSV infection and regulate the immune function. The important effective component of Scutellaria baicalensis has a broad spectrum of antiviral activity. However, as with many experimental studies of traditional Chinese medicine, there may be many defects, such as single, independent and non synchronous indexes, which are difficult to fully reflect the mechanism of drug action. Therefore, it should be systematized and holistic if the therapeutic effect is discussed in depth. Metabonomics is an important part of system biology. When the organism is stimulated by various external factors, it can instantly, sensitively and truly express the response and regulation of the whole function of the organism. As a systematic research method, it takes the whole metabolism of the body as the research object and dynamic postgraduate. After an object is stimulated or disturbed, the variety and quantity of its endogenous metabolites can be found from a more comprehensive perspective to discover the real mechanism of the drug and the material basis for its function. Therefore, the research group adopts the metabonomics method to try to clarify the effect of Jinxin oral liquid and baicalein on the treatment of RSV infection. Objective to study the metabolic characteristics of RSV pneumonia BALB/c mice plasma, urine, alveolar lavage fluid, spleen tissue and cells, and then explore the intervention effect of Jinxin oral liquid and baicalein on RSV pneumonia mice and the possible metabolic regulation mechanism. Methods RSV nasal inhalation method infected BALB/C mice. Do not give the intervention of Jinxin oral liquid and baicalein, and set up normal control group, collect the mice plasma, urine, alveolar lavage fluid and spleen tissue, the pathological pathological analysis of lung tissue to observe the pathological changes of lung. After RSV infection 1.5-2h, baicalein treatment, 24h after liquid nitrogen quenching, with water methanol and chlorine Gas Chromatography-Mass Spectrometer (GC-MS) was used to analyze the overall metabolic changes in the plasma, urine, spleen tissues and cells of mice after preprocessing of the above mice and cell samples. The ultra high performance liquid chromatography ion trap mass spectrometry (Ultra Performance Liquid) was used. Chromatography-LTQ/Orbitrap-Mass Spectrometer, UPLC-LTQ/Orbitrap-MS) study the changes of metabolic spectrum in mouse alveolar lavage fluid, using the data collected by principal component analysis (principal component analysis, PCA) and orthogonal partial least squares discriminant analysis (Orthogonalpartial least squares-discriminant analysis, OPLS-DA) analysis Select potential plasma, urine, spleen, alveolar lavage fluid and biomarkers in cell, analyze related metabolic pathways, explain the possible metabolic regulation mechanism of Jinxin oral liquid and baicalein on RSV pneumonia. Results the lung tissue lesion of 1.RSV infected BALB/c mice is mainly located in the interstitial area of the lung, and the pulmonary interstitial multifocal inflammatory cells can be seen in the lungs. Infiltration (+ +), mainly monocyte, lymphocyte, alveolar wall mild hyperemia (+), and alveolar wall thickening. After the treatment of Jinxin oral liquid and baicalein, the pulmonary congestion, edema, and inflammatory infiltration of.2. Jinxin oral liquid were alleviated in different degrees (1) plasma: normal group, RSV pneumonia model group and Jinxin oral liquid treatment OPLS-DA analysis in the plasma of the mice showed that the three groups could be completely separated, without cross and overlap, the model parameters R2Y=0.934, Q2=0.889, identified and screened 6 potential biomarkers, respectively, lactic acid, urea, glutamine, 1,5- dehydrated sorbitol, glucose, peanut four eNIC acid. (2) urine: normal group, RSV pneumonia model group and Jinxin oral liquid OPLS-DA analysis of the urine of the mice in the treatment group showed that the three groups could be completely separated, without cross and overlap, the model parameters R2Y=0.85, Q2=0.746, identified and screened 4 potential biomarkers, respectively, lactic acid, glycine, stearic acid, palmitic acid. (3) spleen tissues: normal group, RSV pneumonia model group and Jinxin oral liquid treatment group of mice spleen OPLS-DA analysis showed that the three groups could be completely separated, no cross and overlap, model parameters R2Y=0.959, Q2=0.895, identified and screened 6 potential biomarkers, respectively, L- proline, L- glutamic acid, valine, urea, hypoxanthine, glucose, and (4) alveolar lavage fluid: normal group, RSV pneumonia model group and Jinxin oral liquid treatment group small OPLS-DA analysis of the rats' alveolar lavage samples showed that the three groups could be completely separated, without cross and overlap, the model parameters R2Y=0.972, Q2=0.924, identified and screened 6 potential biomarkers, respectively, L-carnitine, malonyl carnitine, adenosine, two hydrogen neurinosine, leukotriene D5 and glucuronic.3. baicalein. Study (1) cells: normal group, RSV pneumonia model group and Jinxin oral liquid treatment group mice lung alveolar lavage samples OPLS-DA analysis showed that the three groups can be completely separated, no cross and overlap, model parameters R2Y=0.974, Q2=0.917, identification and screening of 6 potential biomarkers, 5 different metabolites, serine, L- aspartate, respectively Acid, L- glutamic acid, citric acid and glycine. (2) plasma: normal group, RSV pneumonia model group and Jin Xin oral liquid treatment group mice plasma samples OPLS-DA analysis showed that three groups can be completely separated, no cross and overlap, model parameters R2Y=0.912, Q2=0.84, identification and screening of 6 potential biomarkers, lactic acid, urea, glycine, glutamine, Amides, 1,5- dehydrated sorbitol, D- glucose. (3) urine: OPLS-DA analysis of urine samples from the normal group, the RSV pneumonia model group and the Jin Xin oral liquid treatment group showed that the three groups could be completely separated, no cross and overlap, the model parameters R2Y=0.917, Q2=0.767, identified and screened 4 potential biomarkers, lactic acid, malic acid, palmitic acid, hard. Lipoic acid. (4) alveolar lavage fluid: OPLS-DA analysis of urine samples from the normal group, RSV pneumonia model group and Jinxin oral liquid treatment group showed that the three groups could be completely separated, no cross and overlap, the model parameters R2Y=0.954, Q2=0.828, identification and screening of 5 different types of metabolites, the identification results were respectively glutamic acid, carnitine, adenosine, grapes, Glucosidyl sphingosine, leukotriene D5. conclusion 1. using UPLC/MS and GC-MS analysis metabolomics can explain the mechanism of Jinxin oral liquid and baicalein in the treatment of RSV infection from the angle of metabolic network.2.RSV infection BALB/c, the endogenous metabolites in plasma, urine, alveolar lavage fluid and spleen are disorder, mainly amino acids, organic acids and Fatty acid.3. Jinxin oral liquid and baicalein can treat RSV infection and reduce the pulmonary inflammation in BALB/c mice,.4. Jinxin oral liquid and baicalein can partly adjust the metabolic disorder caused by RSV infection. Metabolites of four arachidic acids, glycine, serine and threonine metabolism, arginine and proline metabolism, and pyruvate metabolism; baicalein plays a major role in the metabolism of glutamine, alanine, aspartate and glutamate metabolism, glycine, serine, and serine metabolism.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2017
【分類號】：R272

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 呂昌林;自擬麻瀉喘嗽湯治療小兒肺炎喘嗽176例觀察[J];成都醫(yī)藥;2003年03期

2 范中有;自擬芩桑湯加味治療小兒肺炎喘嗽62例[J];四川中醫(yī);2004年06期

3 李惠群;;咳兒寧治療肺炎喘嗽痰熱證59例[J];中醫(yī)雜志;2007年03期

4 李書香;;從肺炎喘嗽談先證而治的思路與方法[J];中醫(yī)兒科雜志;2007年03期

5 張雨;;郁金治療小兒肺炎喘嗽[J];中醫(yī)雜志;2009年04期

6 何麗超;;辨證施治小兒肺炎喘嗽152例[J];云南中醫(yī)中藥雜志;2009年05期

7 楊志華;柳樹英;沈玉鵬;原睿;;從痰瘀論治小兒肺炎喘嗽[J];甘肅中醫(yī);2009年12期

8 毛曉琴;孔繁羽;潘振;;桔白糖漿治療小兒肺炎喘嗽40例[J];中醫(yī)兒科雜志;2012年06期

9 彭兆麟,彭文娟,陳陶后,彭智聰;肺炎喘嗽液治療小兒急性呼吸道感染的臨床及實驗研究[J];中國中西醫(yī)結(jié)合雜志;1998年02期

10 戚波;中醫(yī)治療兒童肺炎喘嗽32例[J];四川中醫(yī);2001年08期

相關(guān)會議論文 前10條

1 楊志華;柳樹英;沈玉鵬;原睿;;從痰瘀論治小兒肺炎喘嗽[A];甘肅省中醫(yī)藥學(xué)會2009年學(xué)術(shù)研討會論文專輯[C];2009年

2 李書香;何楊;;從肺炎喘嗽談先證而治的意義[A];第23屆全國中醫(yī)兒科學(xué)術(shù)研討會暨兒科名中醫(yī)講習(xí)班論文匯編[C];2006年

3 廖鳳燕;;淺談小兒肺炎喘嗽[A];第23屆全國中醫(yī)兒科學(xué)術(shù)研討會暨兒科名中醫(yī)講習(xí)班論文匯編[C];2006年

4 蓋曉麗;;王雪峰教授運用通腑法治療小兒肺炎喘嗽探析[A];第25屆全國中醫(yī)兒科學(xué)術(shù)研討會暨中醫(yī)藥高等教育兒科教學(xué)研究會會議學(xué)術(shù)論文集[C];2008年

5 王延博;孫麗平;馮曉純;;王烈教授治療肺炎喘嗽(支氣管肺炎)驗案[A];全國第26屆中醫(yī)兒科學(xué)術(shù)會暨王烈教授學(xué)術(shù)思想研討會論文集[C];2009年

6 夏樹華;;開肺化痰法治療小兒肺炎喘嗽50例[A];中醫(yī)藥理論與應(yīng)用研究——安徽中醫(yī)藥繼承與創(chuàng)新博士科技論壇論文集[C];2008年

7 冉志玲;馬君蓉;董麗;;以玄府為理探討小兒肺炎喘嗽[A];第二十九次全國中醫(yī)兒科學(xué)術(shù)大會暨“小兒感染性疾病的中醫(yī)藥防治”培訓(xùn)班論文匯編[C];2012年

8 李小可;趙丹丹;莫芳芳;方心;馬越;高思華;;基于臟腑相關(guān)理論的小兒肺炎喘嗽病機與方證應(yīng)用研究[A];第四屆全國中醫(yī)藥博士生優(yōu)秀論文專輯[C];2013年

9 劉燕;;肺炎喘嗽口服液微生物限度檢查法的驗證[A];第二十屆全國兒科藥學(xué)學(xué)術(shù)會議暨首屆全國兒科中青年藥師論文報告會論文集[C];2009年

10 王妍煒;;透藥療法治療小兒肺炎喘嗽的臨床觀察[A];2013年河南省兒科優(yōu)質(zhì)護(hù)理服務(wù)規(guī)范管理培訓(xùn)班及學(xué)術(shù)交流會論文集[C];2013年

相關(guān)重要報紙文章 前2條

1 ;中醫(yī)兒科學(xué)部分[N];中國中醫(yī)藥報;2003年

2 河北省中醫(yī)院 焦平;馬新云：“輕開救”三法定急喘[N];中國中醫(yī)藥報;2013年

相關(guān)碩士學(xué)位論文 前10條

1 焦珞珈;肺炎喘嗽中醫(yī)證治規(guī)律研究[D];湖南中醫(yī)藥大學(xué);2010年

2 步梅琳;加味香砂六君子湯聯(lián)合背部腧穴拔罐治療肺脾氣虛型肺炎喘嗽臨床療效觀察[D];河北醫(yī)科大學(xué);2015年

3 張瑩;濟(jì)南地區(qū)99例小兒肺炎喘嗽痰熱閉肺型癥候相關(guān)因素的研究分析[D];山東中醫(yī)藥大學(xué);2016年

4 吳婷;通腑宣肺湯治療小兒肺炎喘嗽毒熱閉肺證的臨床療效分析[D];河北醫(yī)科大學(xué);2016年

5 孟欣茹;清肺化痰方聯(lián)合西醫(yī)常規(guī)療法治療小兒肺炎喘嗽（痰熱閉肺型）的臨床觀察[D];河北醫(yī)科大學(xué);2016年

6 孫南;中藥外敷治療小兒肺炎喘嗽（痰濕閉肺型）的臨床研究[D];長春中醫(yī)藥大學(xué);2011年

7 范永紅;隔藥灸胸背法佐治小兒肺炎喘嗽的臨床研究[D];山東中醫(yī)藥大學(xué);2004年

8 劉凌伶;肺炎喘嗽住院患兒回顧性分析及前瞻性觀察[D];廣州中醫(yī)藥大學(xué);2012年

9 董倩;311例肺炎喘嗽患兒中醫(yī)證型演變規(guī)律及相關(guān)因素的臨床研究[D];山東中醫(yī)藥大學(xué);2013年

10 馬鐵;中藥敷臍法輔助治療小兒肺炎喘嗽恢復(fù)期的臨床研究[D];山東中醫(yī)藥大學(xué);2010年

，

本文編號：2138706