本文選題：支氣管哮喘　切入點(diǎn)：哮喘平?jīng)_劑　出處：《安徽中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：1.臨床研究1.1目的:對(duì)142例支氣管哮喘(bronchial asthma,BA)患者進(jìn)行中醫(yī)證候?qū)W調(diào)查,探求哮喘中醫(yī)證候分布規(guī)律,為哮喘的中醫(yī)辨證分型和臨床治療提供理論依據(jù)。1.2方法:參考資料制定哮喘證候表,結(jié)合哮喘控制測(cè)試(ACT)評(píng)分及哮喘控制情況表,對(duì)符合條件的142例哮喘患者的資料利用統(tǒng)計(jì)軟件對(duì)相關(guān)因素進(jìn)行分析,總結(jié)哮喘中醫(yī)證型分布規(guī)律。1.3結(jié)果:142例哮喘患者中寒哮證共有65例(所占比例45.77%),哮喘易感體質(zhì)以陽(yáng)虛質(zhì)和痰濕質(zhì)為主,分別占比35.91%和32.39%,說(shuō)明哮喘的發(fā)病與體質(zhì)因素相關(guān)。2.實(shí)驗(yàn)研究1.1目的:觀察哮喘平?jīng)_劑對(duì)哮喘模型大鼠細(xì)胞因子IL-17、Notch信號(hào)通路的影響,探討哮喘平?jīng)_劑治療哮喘的免疫機(jī)制及分子機(jī)制。1.2方法:將84只健康雄性的SD大鼠隨機(jī)分為7組:正常對(duì)照組、哮喘模型組、潑尼松西藥組、金水寶中成藥組,哮喘平?jīng)_劑低、中、高劑量組,每組12只,常規(guī)喂養(yǎng)7天后開(kāi)始造模。致敏2次,以卵蛋白(Ovalbumin,OVA)噴霧激發(fā),每日1次,共激發(fā)5周。霧化造模結(jié)束后中藥低、中、高劑量組予以哮喘平?jīng)_劑、西藥組予以潑尼松、中成藥組予以金水寶膠囊灌胃治療,正常組、模型組予以等量生理鹽水灌胃,每天一次,連續(xù)2周。其中,中藥高劑量組予以0.625g/kg/d為給藥劑量(相當(dāng)于成人的12.5倍),中藥中劑量組予以0.313g/kg/d為給藥劑量(相當(dāng)于成人的6.25倍),中藥低劑量組予以0.157g/kg/d為給藥劑量(相當(dāng)于成人的3.13倍),西藥組予以0.313g/kg/d為給藥劑量,中成藥組予以0.313g/kg/d為給藥劑量。兩周后取材檢測(cè)血清及肺泡灌洗液IL-17的含量,免疫組化檢測(cè)Notch信號(hào)通路Notch1-4的表達(dá),探討哮喘平?jīng)_劑對(duì)哮喘治療的機(jī)制。1.3結(jié)果:1.3.1大鼠血清IL-17含量:與正常組相比,模型組大鼠血清IL-17含量顯著高于正常組(P0.01)。與模型組相比,各治療組大鼠血清IL-17含量均降低(P0.01)。西藥組與中藥高劑量組相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。中成藥組與中藥低劑量組相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。中藥中劑量組、中藥高劑量組大鼠血清IL-17含量均低于中成藥組(P0.05)。1.3.2大鼠肺泡灌洗液IL-17含量:與正常組相比,模型組大鼠肺泡肺泡灌洗液IL-17含量顯著高于正常組(P0.01)。與模型組相比,各治療組大鼠肺泡肺泡灌洗液IL-17含量均降低(P0.01)。西藥組與中藥高劑量組相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。中成藥組與中藥低劑量組相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。中藥中劑量組、中藥高劑量組大鼠肺泡灌洗液IL-17含量均低于中成藥組(P0.05)。1.3.3免疫組化檢測(cè)各組大鼠肺組織Notch1-4表達(dá):與正常組相比,模型組肺組織Notch1、Notch2平均光密度值顯著高于正常組(P0.01);與模型組相比,治療組各組肺組織Notch1、Notch2平均光密度值均降低(P0.01);中藥高劑量組與西藥組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.0 5),中藥中劑量與中藥低劑量比較,Notch1、Notch2平均光密度值有所降低(P0.05);中藥低劑量與中成藥組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.0 5)。與正常組比較,模型組Notch3平均光密度值有增高(P0.05),其余各組肺組織中Notch3平均光密度值均明顯減弱,且兩組間比較無(wú)明顯差異(P0.0 5)。Notch4平均光密度值在各組中均無(wú)明顯增高。1.3.4 RT-PCR檢測(cè)肺組織Notch1-4 mRNA表達(dá):與正常組相比較,模型組肺組織Notch1、Notch2 m RNA表達(dá)顯著高于正常組(P0.0 1),與模型組相比較,治療組各組肺組織Notch1、Notch2 m RNA表達(dá)均降低(P0.0 5),中藥高劑量組與西藥組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),中藥中劑量組Notch1、Notch2 m RNA表達(dá)較中藥低劑量組降低(P0.0 5),中藥低劑量組與中成藥組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.0 5);Notch3 m RNA在模型組及對(duì)照組各組肺組織中表達(dá)均減弱,兩組比較無(wú)差異(P0.0 5)。Notch4m RNA在模型組肺組織及對(duì)照組肺組織中均表達(dá)不明顯。3.結(jié)論:3.1在所研究的142例哮喘患者中證型以哮喘冷哮證居多。3.2哮喘平?jīng)_劑治療哮喘的免疫機(jī)制可能是抑制白細(xì)胞介素-17(IL-17)的產(chǎn)生,從而減輕氣道炎癥;治療哮喘的分子機(jī)制可能是通過(guò)下調(diào)Notch信號(hào)通路中參與T細(xì)胞分化與激活的Notch1、Notch2的表達(dá),從而延緩哮喘的氣道重塑。
[Abstract]:1. clinical research 1.1 Objective: 142 cases of bronchial asthma (bronchial asthma, BA) in patients with TCM syndrome of asthma survey, explore the distribution regularity of TCM syndromes, and provide a theoretical basis for the.1.2 method for traditional Chinese medicine syndrome type and clinical treatment of asthma: reference for asthma syndrome scale combined with asthma control test (ACT) score and asthma control table, to meet the conditions of 142 cases of patients with asthma data using statistical software to analyze the related factors, summed up the law.1.3 results of TCM syndrome of asthma distribution: 142 asthma patients in cold syndrome were found in 65 cases (accounted for 45.77%), asthma susceptible to yang deficiency and phlegm dampness, accounted for more than 35.91% and 32.39%, indicating the onset of.2. and physical experimental study on related factors of asthma 1.1 Objective: To observe the asthma Granule on asthmatic cytokines in rats with IL-17, the effect of Notch signaling on asthma The immune mechanism and the molecular mechanism of.1.2 granule in treating asthma asthma methods: 84 healthy male SD rats were randomly divided into 7 groups: normal control group, asthma model group, prednisone group, western medicine, Chinese medicine group, Jinshuibao xiaochuanping powder, low, high dose group, 12 rats in each group, routine feeding 7 days after modeling. Sensitized with ovalbumin 2 times (Ovalbumin, OVA) spray excitation, 1 times daily for 5 weeks. Total excitation is low, traditional Chinese medicine atomization after the modeling, the high dose group of xiaochuanping powder, western medicine group was given prednisone, Chinese medicine group was given Jinshuibao capsule gavage treatment and the normal group, model group were given normal saline, once a day for 2 weeks. Among them, high dose of Chinese medicine group were given 0.625g/kg/d dosage (equivalent to 12.5 times the adult), Chinese medicine dose group received 0.313g/kg/d dose (equivalent to 6.25 times a person), Chinese medicine low the 0.157g dose group /kg/d dose (equivalent to 3.13 times the adult), western medicine group received 0.313g/kg/d dose, Chinese medicine group received 0.313g/kg/d dose after two weeks. The content of serum and bronchoalveolar lavage fluid IL-17 detection, immunohistochemical detection of Notch signal pathway in the expression of Notch1-4, to investigate the xiaochuanping powder on the results the mechanism of.1.3 treatment of asthma: the content of IL-17 in serum of 1.3.1 rats: compared with normal group, the content of IL-17 in serum of rats in model group were significantly higher than the normal group (P0.01). Compared with the model group, the content of IL-17 in serum of rats in each treatment group were decreased (P0.01). Compared with the traditional Chinese medicine Western medicine group and high dose group, no significant difference meaning (P0.05). Compared with the traditional Chinese medicine group low dose group, the difference was not statistically significant (P0.05). Chinese medicine dose group, high dose of Chinese medicine group rats serum IL-17 levels were lower than the traditional Chinese medicine group (P0.05).1.3.2 in rat alveolar lavage fluid containing IL-17 Weight: compared with the normal group, model group of rat alveolar alveolar lavage fluid IL-17 was significantly higher than normal group (P0.01). Compared with the model group, the alveolar alveolar lavage fluid of rats in each treatment group IL-17 decreased (P0.01). Compared with the traditional Chinese medicine Western medicine group and high dose group, no significant difference (P0.05) compared with traditional Chinese medicine. Chinese medicine group, low dose group, the difference was not statistically significant (P0.05). Chinese medicine dose group, high dose of Chinese medicine group rat bronchoalveolar lavage fluid IL-17 levels were lower than the traditional Chinese medicine group (P0.05) immunohistochemical detection of.1.3.3 in lung tissue of rats Notch1-4 expression: compared with normal group, model group, lung tissue Notch1 Notch2, the average optical density value is significantly higher than the normal group (P0.01); compared with the model group, treatment group Notch1 lung tissue, the average optical density values of Notch2 were decreased (P0.01); high dose of Chinese medicine group and Western medicine group, the difference was not statistically significant (P0.0 5), Chinese Medicine In comparison, Chinese medicine dose and low dose of Notch1, the average optical density values of Notch2 decreased (P0.05); relatively low dose of traditional Chinese medicine and traditional Chinese medicine group, the difference was not statistically significant (P0.0 5). Compared with the normal group, Notch3 model group, the average optical density increased (P0.05), Notch3 in other groups in the lung tissues of the average light the density values were significantly decreased, and no significant difference between the two groups (P0.0 5) the average optical density values of.Notch4 in each group were not significantly higher expression of Notch1-4 mRNA in lung tissue of.1.3.4 RT-PCR: compared with the normal group, model group, lung tissue Notch1, Notch2 expression of M RNA was significantly higher than the normal group (P0.0 1). Compared with the model group, treatment group Notch1 lung tissue, the expression of Notch2 m and RNA were decreased (P0.0 5), high dose of Chinese medicine group and Western medicine group, the difference was not statistically significant (P0.05), Chinese medicine dose group Notch1, Notch2 m RNA expression compared with the low dose of Chinese medicine group Reduce (P0.0 5), compared with the low-dose group of Chinese medicine and traditional Chinese medicine group, the difference was not statistically significant (P0.0 5); the expression of Notch3 m RNA in the model group and control group in lung tissue were decreased, the two groups have no difference (P0.0 5).Notch4m expression of RNA was not obvious.3. in lung tissue of model group and conclusion the control group in the lung tissues: 3.1 immune mechanism in 142 asthmatic patients in the syndrome type of asthma with cold asthma are.3.2 xiaochuanping powder for the treatment of asthma may be the inhibition of interleukin -17 (IL-17) generation, so as to reduce airway inflammation; molecular mechanism of treating asthma may down regulate the expression of Notch1 T cell differentiation and activation of the Notch signaling pathway involved in the expression of Notch2, thus delaying the airway remodeling of asthma.

【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】：2016
【分類(lèi)號(hào)】：R256.12

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 徐衛(wèi)華,沈華浩;肺泡巨噬細(xì)胞合成轉(zhuǎn)化生長(zhǎng)因子β1在慢性阻塞性肺疾病氣道重塑中的作用[J];中華結(jié)核和呼吸雜志;2005年01期

2 陳玉娟;;氣道重塑的治療研究進(jìn)展[J];新醫(yī)學(xué);2008年03期

3 李麗麗;黃茂;;氣道重塑評(píng)估技術(shù)的研究進(jìn)展[J];中華哮喘雜志(電子版);2009年02期

4 管頻;李偉;;慢性阻塞性肺疾病氣道炎癥與氣道重塑研究進(jìn)展[J];海南醫(yī)學(xué);2010年17期

5 李紅;張沙沙;;氣道重塑與慢性阻塞性肺疾病[J];中國(guó)現(xiàn)代藥物應(yīng)用;2011年20期

6 秦明明;朱薇薇;李峰;;凝血酶與氣道重塑的研究進(jìn)展[J];中國(guó)兒童保健雜志;2012年06期

7 張莉莉;尚莉麗;;神經(jīng)信號(hào)轉(zhuǎn)導(dǎo)通路與氣道重塑[J];臨床肺科雜志;2012年11期

8 劉磊;劉彬;朱莉莉;張薇;;參芎葡萄糖注射液對(duì)特發(fā)性肺間質(zhì)纖維化患者氣道重塑的影響[J];中國(guó)老年學(xué)雜志;2011年22期

9 宋一平;生長(zhǎng)因子在氣道重塑中的作用[J];國(guó)外醫(yī)學(xué).呼吸系統(tǒng)分冊(cè);1999年01期

10 宋一平;崔德健;茅培英;梁延杰;彭瑞云;崔雪梅;王德文;;慢性阻塞性肺疾病大鼠模型氣道重塑病理組織學(xué)表現(xiàn)和細(xì)胞外基質(zhì)變化的研究[J];感染.炎癥.修復(fù);2000年01期

相關(guān)會(huì)議論文 前10條

1 周亮;魯繼榮;馬青山;成煥吉;湯鐘玲;林亞琳;;藥物對(duì)支氣管哮喘氣道重塑模型干預(yù)效果的研究[A];中華醫(yī)學(xué)會(huì)第五次全國(guó)哮喘學(xué)術(shù)會(huì)議暨中國(guó)哮喘聯(lián)盟第一次大會(huì)論文匯編[C];2006年

2 許霞;韓秀迪;王洪超;肖偉;;慢性阻塞性肺疾病大鼠模型肺組織中尿激酶型纖溶酶原激活物系統(tǒng)成分與氣道重塑關(guān)系的研究[A];中華醫(yī)學(xué)會(huì)第七次全國(guó)呼吸病學(xué)術(shù)會(huì)議暨學(xué)習(xí)班論文匯編[C];2006年

3 戴文鑫;羅百靈;王麗靜;;胰島素樣生長(zhǎng)因子Ⅰ在慢性阻塞性肺疾病大鼠小氣道重塑中的作用研究[A];中華醫(yī)學(xué)會(huì)第七次全國(guó)呼吸病學(xué)術(shù)會(huì)議暨學(xué)習(xí)班論文匯編[C];2006年

4 李曉輝;欒斌;;表皮生長(zhǎng)因子受體與支氣管哮喘氣道重塑[A];中華醫(yī)學(xué)會(huì)第十五次全國(guó)兒科學(xué)術(shù)大會(huì)論文匯編（上冊(cè)）[C];2010年

5 朱艷芬;宋澤慶;;哮喘小鼠氣道重塑中α平滑肌肌動(dòng)蛋白的表達(dá)[A];中華醫(yī)學(xué)會(huì)呼吸病學(xué)年會(huì)——2011（第十二次全國(guó)呼吸病學(xué)學(xué)術(shù)會(huì)議）論文匯編[C];2011年

6 李艷萍;;小鼠氣道重塑模型早期核因子κB通路中轉(zhuǎn)化生長(zhǎng)因子β_1表達(dá)的研究[A];中華醫(yī)學(xué)會(huì)第七次全國(guó)呼吸病學(xué)術(shù)會(huì)議暨學(xué)習(xí)班論文匯編[C];2006年

7 王光輝;金發(fā)光;楚東嶺;段麗;;支氣管哮喘豚鼠氣道重塑中的基質(zhì)金屬蛋白酶9及其抑制物的表達(dá)[A];中華醫(yī)學(xué)會(huì)第五次全國(guó)哮喘學(xué)術(shù)會(huì)議暨中國(guó)哮喘聯(lián)盟第一次大會(huì)論文匯編[C];2006年

8 林潔;戴元榮;顏孫舜;吳斌;;成肌纖維細(xì)胞在氣道重塑中的作用及地塞米松對(duì)其影響[A];華東地區(qū)第6屆中青年呼吸醫(yī)師論壇暨浙江省第29屆呼吸疾病學(xué)術(shù)年會(huì)論文匯編[C];2007年

9 王傳夏;李昌崇;羅運(yùn)春;李孟榮;葉樂(lè)平;;肺泡巨噬細(xì)胞在哮喘大鼠氣道重塑中的作用[A];2005年浙江省兒科學(xué)學(xué)術(shù)年會(huì)論文匯編[C];2005年

10 王蘋(píng)莉;張根生;覃雪軍;邱章偉;李娜;李雯;沈華浩;;早期多次卡介苗接種對(duì)哮喘小鼠氣道重塑的影響[A];中華醫(yī)學(xué)會(huì)第七屆全國(guó)哮喘學(xué)術(shù)會(huì)議暨中國(guó)哮喘聯(lián)盟第三次大會(huì)論文匯編[C];2010年

相關(guān)重要報(bào)紙文章 前1條

1 傅俊英;中藥可干預(yù)COPD患者氣道重塑[N];中國(guó)醫(yī)藥報(bào);2008年

相關(guān)博士學(xué)位論文 前10條

1 王桂成;IL-20在支氣管哮喘Th2免疫應(yīng)答及氣道重塑中作用的研究[D];山東大學(xué);2015年

2 沈啟英;七氟醚對(duì)哮喘小鼠氣道炎癥和氣道重塑的影響及機(jī)制探討[D];安徽醫(yī)科大學(xué);2015年

3 蔣婧瑾;TLR3參與COPD氣道重塑的發(fā)生及機(jī)制研究[D];浙江大學(xué);2015年

4 畢玫榮;哮喘大鼠凝血酶活性與氣道重塑的相關(guān)性研究[D];山東大學(xué);2016年

5 王蘋(píng)莉;早期多次卡介苗接種對(duì)哮喘小鼠氣道重塑的影響及相關(guān)免疫機(jī)制研究[D];浙江大學(xué);2010年

6 周亮;關(guān)于兒童哮喘相關(guān)基因與氣道重塑的研究[D];吉林大學(xué);2006年

7 辛?xí)苑?支氣管哮喘氣道重塑的臨床與實(shí)驗(yàn)研究[D];第二軍醫(yī)大學(xué);2006年

8 李艷萍;小鼠氣道重塑模型中NF-κB通路與角質(zhì)細(xì)胞生長(zhǎng)因子和轉(zhuǎn)化生長(zhǎng)因子相關(guān)作用研究[D];四川大學(xué);2007年

9 董亮;轉(zhuǎn)錄因子T-bet/GATA-3調(diào)節(jié)哮喘氣道炎癥及氣道重塑的機(jī)制研究[D];山東大學(xué);2007年

10 林曉冰;加味射麻止喘方對(duì)哮喘大鼠氣道重塑及信號(hào)轉(zhuǎn)導(dǎo)通路的研究[D];廣州中醫(yī)藥大學(xué);2012年

相關(guān)碩士學(xué)位論文 前10條

1 杜彩霞;核心蛋白聚糖對(duì)哮喘小鼠氣道重塑的影響[D];青島大學(xué);2013年

2 徐增梅;哮病中醫(yī)證候分布特點(diǎn)及麻芍平喘湯對(duì)哮喘大鼠模型氣道重塑的干預(yù)研究[D];安徽中醫(yī)藥大學(xué);2015年

3 劉靜;平喘寧調(diào)節(jié)ERK信號(hào)通路相關(guān)蛋白干預(yù)哮喘氣道重塑的效應(yīng)機(jī)制研究[D];安徽中醫(yī)藥大學(xué);2015年

4 李麗;白三烯受體拮抗劑干預(yù)哮喘小鼠氣道重塑中Th17細(xì)胞/CD4~+CD25~+Treg細(xì)胞的動(dòng)態(tài)變化及相關(guān)機(jī)制[D];四川醫(yī)科大學(xué);2015年

5 孟祥珍;聯(lián)合應(yīng)用IL-4MT及sIL-5Rα對(duì)哮喘小鼠氣道重塑及TGF-β1、Act-A的影響[D];第四軍醫(yī)大學(xué);2015年

6 楊文信;玉屏風(fēng)桂枝湯對(duì)肺脹穩(wěn)定期肺氣虛型氣道重塑干預(yù)的療效觀察[D];云南中醫(yī)學(xué)院;2016年

7 楊燕;肺脹中醫(yī)證型與患者氣道重塑HRCT定量的相關(guān)性研究[D];云南中醫(yī)學(xué)院;2016年

8 葉志鵬;四物湯及其藥對(duì)（川芎—當(dāng)歸、熟地—白芍）對(duì)COPD氣道重塑大鼠的實(shí)驗(yàn)研究[D];云南中醫(yī)學(xué)院;2016年

9 劉丹麗;支氣管哮喘證候分布規(guī)律研究及哮喘平?jīng)_劑對(duì)哮喘模型大鼠氣道重塑的影響[D];安徽中醫(yī)藥大學(xué);2016年

10 張倫靜;孕期、哺乳期補(bǔ)充適量1,25-(OH)_2D_3對(duì)哮喘大鼠模型氣道重塑及肺組織中HMGB1、IL-1β的影響[D];南昌大學(xué);2016年

，

本文編號(hào)：1666155