【摘要】：目的:○1基于我院近10年哮病住院病例的回顧性調(diào)查,分析哮病的中醫(yī)證候分布特點(diǎn),為制定并優(yōu)化哮病中醫(yī)臨床辨證治療提供依據(jù)�！�2了解哮喘大鼠氣道重塑模型的發(fā)病機(jī)理,觀察麻芍平喘湯對(duì)哮喘模型雄性SD大鼠組織形態(tài)學(xué)、肺功能的影響,從細(xì)胞因子及氣道重塑方面探討麻芍平喘湯防治哮喘的作用機(jī)制,為麻芍平喘湯的臨床應(yīng)用提供實(shí)驗(yàn)基礎(chǔ)和依據(jù)。方法:○1通過(guò)查閱相關(guān)文獻(xiàn),制定哮病臨床回顧性調(diào)查表,本研究通過(guò)調(diào)查261例哮喘患者,從一般資料(性別、年齡、職業(yè)、病程長(zhǎng)短等情況)及發(fā)病誘因(煙酒史、過(guò)敏史、遺傳病史、氣候改變、飲食勞累等)與哮病中醫(yī)證型之間的關(guān)系,對(duì)相關(guān)因素進(jìn)行統(tǒng)計(jì)學(xué)分析,以探討哮病的中醫(yī)證候分布特點(diǎn)�！�2將70只雄性SD大鼠,隨機(jī)分為正常組、模型組、麻芍平喘湯低、中、高劑量組、地塞米松組和陽(yáng)和平喘組,每組10只;除正常組外,其余各組于實(shí)驗(yàn)的第0天、第7天和第14天,以10%卵白蛋白加氫氧化鋁干粉10mg,在腹腔及兩側(cè)腹股溝皮下多點(diǎn)注射致敏,并霧化吸入激發(fā)制備大鼠哮喘模型;干預(yù)組均從激發(fā)階段的第7天開(kāi)始給藥,每次激發(fā)前30min灌胃,正常組和模型組以生理鹽水代替,連續(xù)14天;末次激發(fā)24h后腹腔麻醉,予以氣管切開(kāi),行肺功能檢查;肺組織切片行HE染色;計(jì)算機(jī)圖像分析氣道形態(tài)學(xué)參數(shù),衡量氣道重塑程度;免疫組化法檢測(cè)肺組織中TGF-β1、PDGF-BB含量;ELISA法測(cè)血清中IL-5、IL-13含量水平;RT-PCR測(cè)肺組織中TGF-β1m RNA、α-SMAm RNA的表達(dá);Western Blot檢測(cè)TGF-β1和PDGF-BB蛋白含量。SPASS軟件統(tǒng)計(jì)分析結(jié)果。結(jié)果:○1 261例哮喘患者中,冷哮122例,占46.7%,最為多見(jiàn),其次是熱哮87例,占33.3%。其中男性112例,占42.9%,女性149例,占57.1%,女性發(fā)病率略高于男性,并且說(shuō)明了哮喘發(fā)病常見(jiàn)證型癥狀�！�2各組均存在不同程度氣道重塑,麻芍平喘高劑量組大鼠氣道重塑程度(支氣管壁厚度、平滑肌厚度)明顯較地塞米松組為輕(P0.05);麻芍平喘湯高劑量組和陽(yáng)和平喘組對(duì)大鼠肺功能FVC、FEV0.3、PEF的改善最明顯(P0.05),地塞米松組次之;麻芍平喘湯可降低大鼠血清中IL-5和IL-13的表達(dá)(P0.05);麻芍平喘湯高劑量組、地塞米松組與陽(yáng)和平喘組能降低大鼠TGF-β1、PDGF-BB及α-SMA含量。結(jié)論:○1從261哮病證型中冷哮最為多見(jiàn),發(fā)病癥狀常見(jiàn)惡寒發(fā)熱、咳白粘痰、哮鳴音、胸悶、無(wú)胸痛、口不渴、無(wú)汗出、舌苔白膩、脈浮緊。○2在大鼠哮喘模型中,麻芍平喘湯能夠減輕氣道炎癥,緩解氣道重塑,其機(jī)制可能是通過(guò)降低IL-5和IL-13含量,抑制TGF-β1、PDGF-BB及α-SMA的表達(dá)起作用,表明TGF-β1、PDGF-BB及α-SMA與哮喘氣道重塑程度密切相關(guān),可能可以作為衡量氣道重塑嚴(yán)重程度的指標(biāo)之一。
[Abstract]:Objective:Based on the retrospective investigation of inpatients with asthma in our hospital in recent 10 years,to analyze the distribution characteristics of asthma syndrome in traditional Chinese medicine,and to provide the basis for formulating and optimizing the clinical treatment of asthma.02 To understand the pathogenesis of asthma rat airway remodeling model,and to observe the histomorphology and pulmonary function of male SD rats treated with Mashao Pingchuan decoction. Objective:To explore the mechanism of Mashao Pingchuan Decoction in preventing and treating asthma from the aspects of cytokines and airway remodeling, and to provide experimental basis and basis for clinical application of Mashao Pingchuan Decoction.Methods:A retrospective clinical survey of asthma was made by consulting relevant literatures. The relationship between age, occupation, course of disease, predisposing factors (smoking and drinking history, allergic history, hereditary history, climate change, diet fatigue, etc.) and TCM syndromes of asthma was analyzed statistically to explore the distribution characteristics of TCM syndromes of asthma. Decoction low, medium, high dose group, dexamethasone group and Yang Ping Chuan group, 10 rats in each group; Except for the normal group, the other groups were sensitized by 10% ovalbumin and aluminum hydroxide dry powder on the 0th, 7th and 14th day of the experiment, and were subcutaneously injected into abdominal cavity and bilateral inguinal subcutaneously at multiple points, and atomized to induce asthma in the intervention group. At the 7th day of the hair stage, the drug was administered orally 30 minutes before each stimulation, and the normal group and the model group were given saline instead for 14 consecutive days. The contents of TGF-beta 1 and PDGF-BB in lung tissues were measured by ELISA, the levels of IL-5 and IL-13 in serum were measured by ELISA, the expressions of TGF-beta 1m RNA and alpha-SMAm RNA in lung tissues were detected by RT-PCR, and the contents of TGF-beta 1 and PDGF-BB protein were detected by Western Blot. Among them, 112 were male, accounting for 42.9%, 149 were female, accounting for 57.1%. The incidence of female was slightly higher than that of male, indicating the common symptoms of asthma. Mashao Pingchuan Decoction high-dose group and Yang Pingchuan Decoction high-dose group of rats lung function FVC, FEV 0.3, PEF improved most significantly (P 0.05), followed by dexamethasone group; Mashao Pingchuan decoction can reduce the expression of IL-5 and IL-13 in serum of rats (P 0.05); Mashao Pingchuan Decoction high-dose group, dexamethasone group and Yang Pingchuan group can reduce the expression of TGF-beta 1, PDGF-BB and a-SMA in rats. CONCLUSION: Cold asthma is the most common syndrome of 261 asthma. The common symptoms of cold and fever, coughing white phlegm, wheezing, chest tightness, chest pain, thirst-free, no sweating, white greasy tongue coating, pulse tightness are common. 02 In the rat asthma model, Mashao Pingchuan decoction can alleviate airway inflammation and airway remodeling, the mechanism may be through reducing IL-5 and IL-5. The results showed that TGF-beta 1, PDGF-BB and alpha-SMA were closely related to the degree of airway remodeling in asthma, and could be used as one of the indexes to evaluate the severity of airway remodeling.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R256.12

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張朝薔;薄建萍;李江波;;地塞米松對(duì)大鼠支氣管哮喘氣道重塑及PDGF-BB表達(dá)的影響[J];當(dāng)代醫(yī)學(xué);2010年30期

2 張玲麗;王曉敏;杜恒;蘇文;胡愛(ài)霞;徐輝甫;;補(bǔ)肺健脾方對(duì)哮喘大鼠血、肺泡灌洗液中IL-4、IFN-γ及嗜酸性粒細(xì)胞計(jì)數(shù)的影響[J];貴陽(yáng)中醫(yī)學(xué)院學(xué)報(bào);2010年03期

3 羅慶東,于湘春,李素蘭;自擬滌痰定喘湯治療支氣管哮喘急性發(fā)作40例療效觀察[J];黑龍江中醫(yī)藥;2004年04期

4 劉興隆,賈波,黃秀深,張豐華;細(xì)辛藥理研究概況[J];江蘇中醫(yī)藥;2005年07期

5 向楚兵;倪彩霞;陳林;陳鴻平;許福會(huì);黃偉;楊昌林;陳思敏;曾南;劉友平;;赤芍二基原藥材的抗炎、鎮(zhèn)痛作用比較研究[J];中藥與臨床;2011年01期

6 趙杜鵑;;綜合療法治療支氣管哮喘86例臨床觀察[J];遼寧中醫(yī)雜志;2010年01期

7 洪璨;武怡;趙中秀;;NS1619干預(yù)對(duì)哮喘小鼠氣道重塑及氣道平滑肌肌動(dòng)蛋白、血清血小板衍生生長(zhǎng)因子-BB表達(dá)的影響[J];臨床兒科雜志;2014年08期

8 石琛;方永奇;;β-細(xì)辛醚平喘作用的藥效學(xué)研究[J];時(shí)珍國(guó)醫(yī)國(guó)藥;2006年09期

9 楊貴榮,張宏文;支氣管哮喘患者的心理護(hù)理[J];天津護(hù)理;2004年01期

10 許杰紅;曹厚然;陳玉興;;中藥單劑炙麻黃、麻黃對(duì)哮喘大鼠氣道炎癥反應(yīng)的影響[J];新中醫(yī);2014年12期

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