本文關(guān)鍵詞：麻黃附子細(xì)辛湯治療肺氣虛寒型變應(yīng)性鼻炎的研究　出處：《山東中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的:建立豚鼠變應(yīng)性鼻炎及肺氣虛寒癥候二期動(dòng)物模型,觀察麻黃附子細(xì)辛湯及其不同配伍組合對(duì)豚鼠變應(yīng)性鼻炎病情與證候變化的影響,從轉(zhuǎn)錄因子GATA-3調(diào)控Th1和Th2生成的角度探討其組方配伍的合理性及作用機(jī)制。并通過評(píng)價(jià)加味麻黃附子細(xì)辛湯治療肺氣虛寒型變應(yīng)性鼻炎的臨床療效,進(jìn)一步探討其治療變應(yīng)性鼻炎的可行性。方法:1.動(dòng)物實(shí)驗(yàn):以知母:石膏:黃柏:龍膽草=1.5∶2.0∶1.0∶1.2的比例,常規(guī)制成200%煎劑灌胃,后使用煙熏法行肺氣虛寒證候造模。上述造模成功后采用滴鼻法造AR模型。將清潔級(jí)3月齡健康豚鼠37只,隨機(jī)分為6組,即麻黃附子細(xì)辛組7只、麻黃附子組6只、麻黃細(xì)辛組6只、麻黃組6只、地塞米松組6只、模型組6只,記錄癥狀、體征的變化,處死后采用免疫組化法檢測(cè)豚鼠鼻粘膜GATA-3表達(dá)。2.臨床觀察:選擇符合納入標(biāo)準(zhǔn)的30例變應(yīng)性鼻炎病例,給予麻黃附子細(xì)辛湯加味治療,4周為一個(gè)療程,連續(xù)觀察一個(gè)療程。觀察記錄治療前后臨床癥狀及體征變化情況。結(jié)果:1.動(dòng)物實(shí)驗(yàn):(1)豚鼠尿17-羥皮質(zhì)醇(OHCS-17)、血清皮質(zhì)醇(F)的測(cè)定結(jié)果:實(shí)驗(yàn)后,各實(shí)驗(yàn)組除麻黃組,豚鼠尿-17羥皮質(zhì)醇(OHCS-17)較造模后表達(dá)增強(qiáng),并與模型組具有顯著性差異(p0.05)。其中,麻黃附子細(xì)辛組、麻黃附子組、地塞米松組高表達(dá),與其余組差異具有顯著性(p0.05)。實(shí)驗(yàn)后,各實(shí)驗(yàn)組除麻黃組外,血清皮質(zhì)酮(F)較造模后表達(dá)增強(qiáng)(p0.05),并與模型組差異具有顯著性(p0.05)。其中,麻黃附子細(xì)辛組、麻黃附子組、麻黃細(xì)辛組、地塞米松組血清皮質(zhì)酮(F)高表達(dá),與其余組差異具有顯著性(p0.05)。(2)實(shí)驗(yàn)后各組豚鼠鼻粘膜GATA-3免疫組化結(jié)果:半定量統(tǒng)計(jì)GATA-3表達(dá)量(染色指數(shù)+陽性細(xì)胞百分比),其中麻黃附子細(xì)辛組中GATA-3的表達(dá)均低于其他組(p0.01),麻黃附子組、麻黃細(xì)辛組、地塞米松組中表達(dá)低于麻黃組及模型組(p0.01),麻黃附子組、麻黃細(xì)辛組及地塞米松組中GATA-3的表達(dá)無顯著性差異(p0.05),麻黃組與模型組間GATA-3的表達(dá)無顯著性差異(p0.05)。2.臨床觀察:通過對(duì)30例變應(yīng)性鼻炎患者的臨床觀察,治愈率為26.67%,顯效率為53.33%,有效率為16.7%,總有效率為96.70%。經(jīng)統(tǒng)計(jì)學(xué)分析,30例變應(yīng)性鼻炎患者的治療前后癥狀、體征、中醫(yī)證候計(jì)分差異具有顯著性(p0.01)。結(jié)論:1.麻黃附子細(xì)辛湯在一定程度上能提高豚鼠尿-17羥皮質(zhì)醇及血清皮質(zhì)醇分泌,尤其以麻黃及附子兩味藥配伍最為顯著,說明麻黃及附子在一定程度上能提高豚鼠的免疫功能。2.麻黃附子細(xì)辛湯對(duì)Th1/Th2的調(diào)節(jié)作用是在轉(zhuǎn)錄水平通過抑制GATA-3的表達(dá),調(diào)控Th0正常向Th1/Th2分化,從而抑制變應(yīng)性鼻炎Th2細(xì)胞亞群功能亢進(jìn),減輕氣道的炎癥。3.加味麻黃附子細(xì)辛湯能有效緩解或解除肺氣虛寒型變應(yīng)性鼻炎患者鼻癢、打噴嚏、流涕、鼻塞等癥狀,是肺氣虛寒型變應(yīng)性鼻炎的有效治法,值得進(jìn)一步探究。
[Abstract]:Objective: to establish a two-stage animal model of allergic rhinitis and asthenia of lung qi in guinea pigs and to observe the effects of ephedra aconite Asarum decoction and its different combinations on the changes of symptoms and syndromes of allergic rhinitis in guinea pigs. To discuss the rationality and mechanism of the compatibility of Th1 and Th2 by transcription factor GATA-3 in regulating the production of Th1 and Th2, and to evaluate the clinical effect of modified ephedrine aconite Asarum decoction in the treatment of allergic rhinitis with deficiency of lung qi and cold syndrome. The bed works. To further explore the feasibility of its treatment of allergic rhinitis. Methods: 1. Animal experiment: Anemarrhena: gypsum: yellow cypress: Gentianthus gentianensis 1.5: 2.0: 1.0: 1.2. The model of lung qi deficiency cold syndrome was established by fumigation. The AR model was established by nasal drip after the above model was successfully made. 37 healthy guinea pigs of 3 months old of clean grade were randomly divided into 6 groups. There were 7 rats in Asarum ephedra group, 6 in aconite ephedra group, 6 in ephedra asarum group, 6 in ephedra group, 6 in dexamethasone group and 6 in model group. The changes of symptoms and signs were recorded. The expression of GATA-3 in nasal mucosa of guinea pigs was detected by immunohistochemical method. Clinical observation: 30 cases of allergic rhinitis according to the inclusion criteria were selected and treated with ephedra aconite Asarum decoction. The changes of clinical symptoms and signs before and after treatment were observed and recorded. Results: 1. Animal experiment 1) Guinea pig urine 17-hydroxycortisol OHCS-17). Results: after the experiment, the expression of -17 hydroxycortisol OHCS-17 in guinea-pig urine was higher than that after modeling in each experimental group except ephedra. And there was a significant difference between the model group and the model group (p0.05). Among them, Aconitum ephedra group, ephedra aconite group, dexamethasone group were highly expressed, and there was a significant difference between the model group and the other groups (P 0.05). The expression of serum corticosterone in each experimental group was significantly higher than that in model group except Ephedra group, and the difference was significant compared with model group (P 0.05). Among them, Asarum ephedra group. The high expression of corticosterone was observed in ephedra aconite group, ephedra asarum group and dexamethasone group. After the experiment, the GATA-3 immunohistochemical results of nasal mucosa of guinea pigs were as follows: Semi-quantitative statistical GATA-3 expression (P < 0.05). Percentage of staining index positive cells. The expression of GATA-3 in Asarum ephedra group was lower than that in other groups (p0.01). The expression of GATA-3 in Aconitum ephedra group, Asarum ephedra group and dexamethasone group was lower than that in Ephedra group and model group (P 0.01). There was no significant difference in GATA-3 expression in ephedra aconite group, ephedra asarum group and dexamethasone group (p0.05). There was no significant difference in the expression of GATA-3 between the ephedra group and the model group. 2. Clinical observation: the cure rate of 30 cases of allergic rhinitis was 26.67%. The effective rate was 53.33, the effective rate was 16.7am, and the total effective rate was 96.70.The symptoms and signs of 30 patients with allergic rhinitis before and after treatment were analyzed statistically. Conclusion: 1. Ephedra aconite Asarum decoction can improve the secretion of urinary -17 hydroxycortisol and serum cortisol in guinea pigs to a certain extent. Especially in ephedra and aconite two kinds of medicine compatibility is the most significant. The results showed that ephedra and aconite could improve the immune function of guinea pigs to a certain extent. 2. The regulation of ephedrine aconite Asarum decoction on Th1/Th2 was by inhibiting the expression of GATA-3 at the transcriptional level. To regulate the normal differentiation of Th0 into Th1/Th2, thus inhibit the hyperfunction of Th2 cell subsets in allergic rhinitis. Reduce airway inflammation .3. modified ephedra aconite Asarum decoction can effectively alleviate or relieve the lung qi deficiency cold allergic rhinitis patients with nasal itching sneezing runny nasal congestion and other symptoms. It is an effective treatment for allergic rhinitis with deficiency of lung qi and cold.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R276.1

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