本文選題：過敏康　切入點(diǎn)：過敏體質(zhì)　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:尋找過敏體質(zhì)與平和體質(zhì)之間的差異性因子,確立過敏體質(zhì)的特異性分子標(biāo)記;觀察中藥"過敏康"通過調(diào)理過敏體質(zhì)治療過敏性疾病的臨床效果;探索中藥"過敏康"通過調(diào)理過敏體質(zhì)治療過敏性疾病的作用機(jī)制與嗜酸性粒細(xì)胞功能調(diào)控的相關(guān)性,并尋找該機(jī)制的作用靶點(diǎn),以期明確過敏體質(zhì)的微觀作用機(jī)制,為過敏體質(zhì)理念更好的應(yīng)用于臨床提供指導(dǎo)。方法:本研究通過收集門診患者及張貼招募海報(bào)的方式獲取受試者,并依據(jù)中醫(yī)體質(zhì)分類判定標(biāo)準(zhǔn)和過敏性鼻炎診斷標(biāo)準(zhǔn)對受試者進(jìn)行篩選,最終納入受試者52人,男女比例為1:1,年齡在18到40歲之間。其中過敏體質(zhì)32例,平和體質(zhì)20例,分別命名為過敏體質(zhì)組、平和體質(zhì)組。對過敏體質(zhì)組受試者給予中藥"過敏康"干預(yù)三個(gè)月,平和體質(zhì)組作為對照,不采取干預(yù)措施。為實(shí)驗(yàn)描述方便,將治療后的過敏體質(zhì)組命名為干預(yù)后過敏體質(zhì)組,并在后續(xù)實(shí)驗(yàn)中對每組受試者的血液樣本分別進(jìn)行蛋白芯片檢測、ELISA檢測、QGP檢測。三組受試者均在清晨空腹采集血樣,用普通采血管抽取受試者靜脈血20ml,離心后得到血清,運(yùn)用蛋白芯片技術(shù)檢測受試者外周血血清樣本中IL-5、GM-CSF、IL-3、eotaxin、RANTES、IL-4、IL-13、IL-9 蛋白水平,運(yùn)用 ELISA 試劑盒檢測受試者外周血血清樣本中IL-25、IL-33、TLSP、ECP蛋白水平;用乙二胺四乙酸抗凝管(EDTA抗凝管)抽取受試者靜脈血5ml,取36ul全血按照QuantiGene Sample Processing Kit說明書預(yù)處理,以QuantiGene Plex法檢測受試者外周血中IL-5、eotaxin、CCR3mRNA表達(dá)水平。數(shù)據(jù)處理:采用spss22.0軟件處理,平和體質(zhì)者與過敏體質(zhì)者的指標(biāo)差異選用獨(dú)立t檢驗(yàn)方法,過敏體質(zhì)干預(yù)前后的指標(biāo)變化選用配對t檢驗(yàn)方法,數(shù)據(jù)均以X±s表示,P0.05為有統(tǒng)計(jì)學(xué)差異。結(jié)果:1.中藥"過敏康"通過調(diào)理過敏體質(zhì)的方式治療過敏性鼻炎受試者,經(jīng)3個(gè)月的干預(yù)周期后,患者的TNSS、TNNSS、RQLQ評分表的各項(xiàng)分值均有下降,其主要評價(jià)指標(biāo)即TNSS評分表中的鼻塞、鼻癢、流涕、噴嚏這四個(gè)鼻部癥狀在治療第4至8周改善最為明顯,并在之后的4周療程中持續(xù)下降。在試驗(yàn)結(jié)束一年后的回訪中,可發(fā)現(xiàn)患者在服藥后的第二個(gè)過敏季節(jié),過敏癥狀和生活狀態(tài)較試驗(yàn)結(jié)束時(shí)均有顯著改善,且部分患者沒有復(fù)發(fā)。2.過敏體質(zhì)受試者在治療后血清總IgE及相應(yīng)過敏原的特異性IgE均有下降,但不顯著。3.過敏體質(zhì)與平和體質(zhì)的差異性因子:兩組相比,過敏體質(zhì)組受試者外周血中 IL-5、GM-CSF、eotaxin、RANTES、IL-4、IL-13、IL-9、IL-25、IL-33、TLSP、ECP蛋白水平及IL-5、eotaxin、CCR3mRNA水平高于平和體質(zhì)組受試者,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);過敏體質(zhì)組受試者外周血中IL-3蛋白水平高于平和體質(zhì)組受試者,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。4.給予"過敏康"干預(yù)3個(gè)月后,過敏體質(zhì)組受試者外周血中 IL-5、eotaxin、RANTES、IL-4、IL-13、IL-25、TLSP、ECP 蛋白水平及IL-5、eotaxin、CCR3mRNA水平較干預(yù)前降低,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),過敏體質(zhì)組受試者外周血中GM-CSF、IL-9、IL-33蛋白水平較干預(yù)前有降低,但差異沒有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論:1.中藥"過敏康"通過調(diào)理過敏體質(zhì)可有效改善過敏性鼻炎患者的臨床癥狀和生活質(zhì)量,且這種改善具有持續(xù)性。2.IL-5、GM-CSF、eotaxin、RANTES、IL-4、IL-13、IL-9、IL-25、IL-33、TLSP、ECP、CCR3是平和體質(zhì)與過敏體質(zhì)之間的差異性因子。3.中藥"過敏康"調(diào)理過敏體質(zhì)的作用機(jī)制涉及對嗜酸性粒細(xì)胞相關(guān)功能的調(diào)控,IL-5、eotaxin、RANTES、IL-4、IL-13、IL-25、TLSP、ECP、CCR3 可能為"過敏康"調(diào)理過敏體質(zhì)的作用靶點(diǎn)。
[Abstract]:Objective: to find out the differences between the allergic constitution factor with mild constitution, the establishment of specific molecular markers of allergy; to observe the clinical effect of Guominkang by conditioning allergy treatment of allergic diseases; explore traditional Chinese medicine "Guominkang" through the correlation mechanism of conditioning allergy treatment of allergic diseases and eosinophil function the regulation, and look for the targets of the mechanism of the micro mechanism in order to clear the allergy, allergic constitution concept better application in clinical guidance. Methods: This study by collecting outpatient and post recruitment poster access to subjects, and on the basis of TCM constitution classification standards and the allergic rhinitis diagnostic criteria of subjects were screened, the final 52 subjects, male to female ratio was 1:1, at the age of 18 to 40 years old. 32 cases of allergic constitution, and constitution of 20 An example, named allergy group, and physical group. In allergic subjects treated with traditional Chinese medicine "Guominkang" intervention for three months, and constitution as control group without intervention. Description is convenient for the experiment, the allergy group after treatment of allergies named after the intervention group. And in the follow-up experiment subjects blood samples in each group respectively, protein chip detection, ELISA detection, QGP detection. Three groups of subjects were in the early morning fasting blood samples were collected, using ordinary blood drawn venous blood 20ml, serum was obtained after centrifugation, detected by protein chip technology in IL-5, serum samples of week the blood of subjects in GM-CSF, IL-3, eotaxin, RANTES, IL-4, IL-13, IL-9 protein level by ELISA assay IL-25, peripheral blood serum samples of subjects in IL-33, TLSP, ECP protein level; with EDTA anticoagulant tubes (EDTA tubes) by extraction Try to take venous blood 5ml, 36ul blood QuantiGene Sample Processing Kit in accordance with the pretreatment instructions, detected by QuantiGene Plex method by IL-5, peripheral blood eotaxin, the expression level of CCR3mRNA. Data processing: using spss22.0 software, using independent t test method and index difference constitution and allergy, index the change before and after the intervention with allergy paired t test method, the data were expressed as X + s, P0.05 is statistically significant. Results: 1. Chinese medicine "Guominkang" by conditioning the allergy treatment of allergic rhinitis subjects after 3 months after the intervention period, patients with TNSS, TNNSS, RQLQ score the scores were decreased, the main evaluation index TNSS score of nasal congestion, nasal itching, sneezing, runny nose, nasal symptoms of the four improvement in the treatment of fourth to 8 weeks is the most obvious, and continued in the 4 weeks after the treatment under Drop. A year after the end of follow-up in the trial, patients can be found in second after taking a seasonal allergies, allergic symptoms and living condition is improved significantly at the end of the test, and some patients with no recurrence of.2. allergic subjects after treatment serum total IgE and allergen specific IgE were decreased however, no significant differences in factor.3. allergy with mild Constitution: compared to the two groups, allergic subjects IL-5, peripheral blood GM-CSF, eotaxin, RANTES, IL-4, IL-13, IL-9, IL-25, IL-33, TLSP, ECP protein level and IL-5, eotaxin, CCR3mRNA levels higher than normal constitution group of subjects, the difference was statistically significant (P0.05); allergic subjects level of IL-3 protein in the peripheral blood level and physical subjects, there was no statistically significant difference (P0.05.4.) to "Guominkang" after 3 months of intervention, allergic subjects in the peripheral blood of I L-5, eotaxin, RANTES, IL-4, IL-13, IL-25, TLSP, ECP protein level and IL-5, eotaxin, reduce the level of CCR3mRNA compared with before intervention, the difference was statistically significant (P0.05), allergic subjects GM-CSF, peripheral blood IL-9, IL-33 protein levels are lower than those before intervention, but no differences statistical significance (P0.05). Conclusion: 1. Chinese medicine "Guominkang" by conditioning allergy in patients with allergic rhinitis can effectively improve the clinical symptoms and quality of life, and has sustained.2.IL-5, GM-CSF, eotaxin, RANTES, IL-4, IL-13, IL-9, IL-25, IL-33, TLSP, ECP CCR3 is the improvement mechanism of Chinese herbal medicine "the difference between flat and.3. factor of physique and allergy Guominkang" allergy conditioning are involved in regulating eosinophil function, the related IL-5, eotaxin, RANTES, IL-4, IL-13, IL-25, TLSP, ECP, CCR3 might be the targets of conditioning allergy Guominkang. "

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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