本文選題：艾滋病相關(guān)腹瀉　切入點(diǎn)：脾腎陽(yáng)虛證　出處：《河南中醫(yī)藥大學(xué)》2016年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:以脾腎陽(yáng)虛證艾滋病相關(guān)腹瀉患者為研究對(duì)象,通過(guò)隨機(jī)、對(duì)照的研究方法進(jìn)行瀉痢康膠囊干預(yù)治療研究,評(píng)價(jià)瀉痢康膠囊對(duì)脾腎陽(yáng)虛證艾滋病腹瀉患者臨床療效及其對(duì)炎癥細(xì)胞因子IL-17、IL-6等的影響。方法:納入脾腎陽(yáng)虛證艾滋病腹瀉患者60例,隨機(jī)分為瀉痢康膠囊治療組及思密達(dá)顆粒對(duì)照組,治療4周,每周進(jìn)行一次隨訪,記錄病人主癥、次癥、舌脈的信息,觀察治療前后腹瀉相關(guān)臨床癥狀積分變化,同時(shí)留取治療前后外周血,進(jìn)行IL-17、IL-6等細(xì)胞因子檢測(cè),評(píng)價(jià)瀉痢康膠囊對(duì)外周血IL-17相關(guān)細(xì)胞因子的影響。結(jié)果:研究共納入脾腎陽(yáng)虛證艾滋病腹瀉患者60例,治療過(guò)程中脫落6例,其中治療組2例,對(duì)照組4例,完成試驗(yàn)54人。治療組臨床有效率為66.7%,對(duì)照組43.3%,組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。腹瀉次數(shù)癥狀積分均呈下降趨勢(shì),治療組組內(nèi)比較t=2.321,P=0.024;組間比較F=3.372,P=0.0410.05。治療組外周血IL-17由治療前的(1361.43±1676.57)pg/ml上升為(1662.09±1964.34)pg/ml,治療前后比較差異有統(tǒng)計(jì)學(xué)意義,對(duì)照組由治療前的(1097.50±1087.49)pg/ml下降為(794.19±727.54)pg/ml,組間采用協(xié)方差分析,兩組比較差異有統(tǒng)計(jì)學(xué)意義。治療組患者IL-6及IL-23分別由治療前的(13.38±37.41)pg/ml、(11.58±11.24)pg/ml上升為(99.09±113.13)pg/ml、(66.10±41.12)pg/ml,組間比較差異顯著。治療組IL-21采用配對(duì)樣本W(wǎng)ilcoxon檢驗(yàn),治療前后p=0.018,差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:(1)脾腎陽(yáng)虛證艾滋病腹瀉患者感邪日久,疾病過(guò)程中兼有寒濕、痰飲、瘀血等病因,也存在化熱的病機(jī)轉(zhuǎn)變。(2)脾腎陽(yáng)虛證艾滋病腹瀉患者CD4+T淋巴細(xì)胞均值較高但其腹瀉的發(fā)生率并未明顯降低。(3)瀉痢康膠囊治療脾腎陽(yáng)虛證艾滋病腹瀉療效優(yōu)于思密達(dá)顆粒�？擅黠@減少腹瀉患者大便次數(shù)。(4)瀉痢康膠囊可提升脾腎陽(yáng)虛證艾滋病患者外周血IL-17、IL-6、IL-23水平。誘導(dǎo)初始T細(xì)胞向Th17細(xì)胞分化,促進(jìn)Th17細(xì)胞的發(fā)育及增殖,減輕腸道免疫炎癥反應(yīng)。脾腎陽(yáng)虛證艾滋病患者IL-21檢出率低,瀉痢康膠囊可提升患者外周血IL-21水平。
[Abstract]:Objective: to study the intervention therapy of Xielikang capsule in patients with AIDS-related diarrhea due to deficiency of spleen and kidney yang. Objective: to evaluate the clinical effect of Xielikang capsule on patients with AIDS diarrhea due to deficiency of spleen and kidney yang and its effect on the inflammatory cytokines IL-17 and IL-6. Methods: 60 patients with AIDS diarrhea due to deficiency of spleen and kidney yang were included in this study. They were randomly divided into Xielikang capsule treatment group and Simida granule control group. The patients were followed up once a week for 4 weeks to record the information of main symptoms, secondary symptoms and tongue veins, and to observe the changes of clinical symptom scores related to diarrhea before and after treatment. At the same time, the peripheral blood was collected before and after treatment, and the cytokines such as IL-17 and IL-6 were detected to evaluate the effect of Xielikang capsule on the cytokines associated with IL-17 in peripheral blood. Results: 60 patients with diarrhea due to the deficiency of spleen and kidney yang were included in the study. In the course of treatment, 6 cases dropped out, including 2 cases in the treatment group, 4 cases in the control group, 54 cases completed the test. The clinical effective rate of the treatment group was 66.7%, and that of the control group was 43.3%. The difference between the two groups was statistically significant (P 0.05). In the treatment group, the IL-17 of peripheral blood increased from 1361.43 鹵1676.57)pg/ml to 1662.09 鹵1964.34 PG / ml, and the control group decreased from 1097.50 鹵1087.49)pg/ml to 794.19 鹵727.54 渭 g / ml. The IL-6 and IL-23 in the treatment group increased from 13.38 鹵37.41g / ml 11.58 鹵11.24)pg/ml to 99.09 鹵113.13pgml / ml 66.10 鹵41.12g / ml, respectively. The IL-21 of the treatment group was tested by paired sample Wilcoxon. Before and after treatment, the difference was statistically significant. Conclusion: 1) Spleen-Kidney Yang deficiency Syndrome patients with AIDS diarrhea feel evil for a long time, and there are cold and dampness, phlegm and blood stasis in the course of the disease. There is also pathogenesis transformation of heat. 2) the mean value of CD4 T lymphocytes in patients with diarrhea of spleen and kidney yang deficiency is higher but the incidence of diarrhea is not significantly reduced.) Xielikang capsule is better than Si in treating AIDS diarrhea due to deficiency of spleen and kidney yang. Meida granule. It can obviously reduce the defecation times of diarrhea patients.) Xielikang capsule can increase the level of IL-17, IL-6, IL-6 and IL-23 in peripheral blood of AIDS patients with deficiency of spleen and kidney yang, and induce the initial T cells to differentiate into Th17 cells. Promoting the development and proliferation of Th17 cells and alleviating the intestinal immune inflammation. The detection rate of IL-21 was low in the patients with deficiency of spleen and kidney yang. Xielikang capsule could enhance the level of IL-21 in peripheral blood of the patients.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R259

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