本文選題：哮喘 + 搜風(fēng)愈喘方　； 參考：《河南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:通過(guò)臨床研究評(píng)價(jià)搜風(fēng)愈喘方治療兒童哮喘發(fā)作期的臨床效果;通過(guò)實(shí)驗(yàn)研究探討搜風(fēng)愈喘方對(duì)哮喘模型大鼠氣道重塑和VEGF蛋白的表達(dá)調(diào)控作用,為開(kāi)發(fā)新藥提供實(shí)驗(yàn)依據(jù)。1臨床觀察:1.1方法:將60例患兒按隨機(jī)原則,用隨機(jī)數(shù)字表法分作兩組,治療組服用搜風(fēng)愈喘方聯(lián)合布地奈德、特布他林霧化吸入,對(duì)照組服用定喘湯聯(lián)合布地奈德、特布他林霧化吸入,兩組在治療過(guò)程中均可采用相應(yīng)對(duì)癥治療,療程為7天,觀察兩組用藥前后癥狀、體征及呼氣流速峰值的改變,作出比較,并通過(guò)統(tǒng)計(jì)學(xué)分析了解兩組之間的差異。1.2結(jié)果:經(jīng)過(guò)搜風(fēng)愈喘方治療后,治療組總有效率96.7%,對(duì)照組總有效率89.6%,經(jīng)統(tǒng)計(jì)學(xué)處理有差異(P0.05);治療后兩組患兒與治療前相比,在癥狀積分、體征及PEF值等方面,均有不同程度的改善,其間,治療組前后療效相比改善顯著(P0.01)。1.3結(jié)論:驗(yàn)證了搜風(fēng)愈喘方作用于臨床后的有效性與安全性。2實(shí)驗(yàn)研究:2.1方法:選取Sprague-Dawley(S-D)雄性大鼠60只,體重200±20克,按隨機(jī)數(shù)字表法分成6組,即搜風(fēng)愈喘方低、中、高濃度組、地塞米松組、哮喘模型組、空白對(duì)照組。除去空白對(duì)照組外其它五組大鼠,第1天以卵清蛋白和氫氧化鋁各100mg另加生理鹽水至1ml混合液,腹腔注射致敏;第15天起予以每天超聲霧化吸入2%卵蛋白溶液,連續(xù)造模3周,以維持大鼠的哮喘癥狀�？瞻讓�(duì)照組腹腔注射及霧化均采用生理鹽水。在每次致敏霧化激發(fā)前30min開(kāi)始灌胃,搜風(fēng)愈喘方組分別用不同濃度的中藥濃縮液等容灌胃,地塞米松組用地塞米松注射液等容灌胃,哮喘模型組及空白對(duì)照組予生理鹽水等容灌胃,共21天。2.2結(jié)果:2.2.1一般情況觀察:哮喘模型組:經(jīng)OVA激發(fā)后,大鼠出現(xiàn)毛發(fā)干枯稀疏,精神不振,活動(dòng)減少,身體消瘦,有的表現(xiàn)出不同程度的嗆咳,流涕,呼吸急促,抓鼻撓腮,煩躁不安等哮喘樣表現(xiàn)�？瞻讓�(duì)照組行動(dòng)敏捷,未見(jiàn)異常。中藥不同濃度組和地塞米松組干預(yù)后,各組大鼠哮喘癥狀有不同程度的改善。2.2.2用ELISA法測(cè)血清VEGF含量結(jié)果:與空白對(duì)照相比,哮喘模型組大鼠VEGF含量明顯升高,二者差異有統(tǒng)計(jì)學(xué)差異P0.01㖞;與哮喘模型組比較,搜風(fēng)愈喘方高、中、低濃度組、地塞米松組VEGF含量均有不同程度地降低P0.05㖞;地塞米松組、搜風(fēng)愈喘方中、高濃度組VEGF含量相較,三者差異無(wú)統(tǒng)計(jì)學(xué)差異P0.05)。2.2.3HE染色后肺組織形態(tài)學(xué)觀察:哮喘模型組:支氣管壁及其周圍肺組織基層細(xì)胞增生,平滑肌增厚,排列紊亂,上皮脫落甚至缺如,管腔內(nèi)可見(jiàn)大量的滲出粘液,分泌物,有明顯的炎癥細(xì)胞浸潤(rùn)現(xiàn)象�？瞻讓�(duì)照組:鏡下可見(jiàn)大鼠的支氣管、肺組織結(jié)構(gòu)正常,支氣管平滑肌厚度無(wú)異常,細(xì)胞規(guī)整,未見(jiàn)明顯的炎性細(xì)胞浸潤(rùn)。搜風(fēng)愈喘方高、中、低濃度組及地塞米松組在經(jīng)過(guò)相關(guān)藥物干預(yù)后,肺組織形態(tài)學(xué)狀況較模型組均有不同程度的改善。2.2.4肺組織VEGF結(jié)果:各組總積分光密度值(IOD)測(cè)定表顯示,哮喘模型組較空白對(duì)照組,VEGF蛋白的IOD顯著增高,兩者相比較,有統(tǒng)計(jì)學(xué)差異(P0.01);中藥中、低濃度組較哮喘模型組,VEGF蛋白的IOD明顯下降,兩者相較,有統(tǒng)計(jì)學(xué)差異(P0.01);地塞米松組較哮喘模型組,VEGF的IOD值下降明顯,兩者相較,有統(tǒng)計(jì)學(xué)差異(P0.01);地塞米松組及搜風(fēng)愈喘方中、高濃度組VEGF的IOD值相較,均無(wú)統(tǒng)計(jì)學(xué)差異P0.05)。2.3結(jié)論:VEGF可能通過(guò)一定信號(hào)途徑,參與了哮喘氣道重塑的發(fā)生與發(fā)展,搜風(fēng)愈喘方通過(guò)下調(diào)VEGF實(shí)現(xiàn)對(duì)氣道重塑的抑制。
[Abstract]:Objective: To evaluate the clinical effect of search Feng Yu Chuan prescription in the treatment of childhood asthma attack through a clinical study. Through experimental study, the effect of the expression and regulation of VEGF protein on the airway remodeling of the asthmatic model rats was studied. The experimental basis for the development of new drugs was provided by the.1 clinical observation: 1.1 methods: the random numbers were used in 60 children according to random principles. The treatment group was divided into two groups. The treatment group took the combination of budesonide combined with budesonide and budesonine in the treatment group. The control group was treated with dchuan decoction combined with budesonide and bubutaline inhalation. The two groups were treated with corresponding symptomatic treatment during the treatment process for 7 days. The symptoms, signs and peak expiratory flow velocity changes before and after the two groups were observed. Make a comparison, and through statistical analysis to understand the difference between the two groups.1.2 results: after the treatment, the total effective rate of the treatment group was 96.7%, the total effective rate of the control group was 89.6%, and the difference was statistically treated (P0.05). After the treatment, there were different degrees in the symptom score, the physical sign and the PEF value, and so on. In the meantime, the curative effect of the treatment group was improved significantly (P0.01).1.3 conclusion: the effectiveness and safety.2 experimental study on the effect of search wind Yue Fang on the clinical efficacy and safety: 2.1 methods: 60 male rats of Sprague-Dawley (S-D) were selected and the weight was 200 + 20 grams, which were divided into 6 groups according to the random number table method, namely, the low, middle, high concentration group, and ground plug of the Feng Yu Chuan prescription. The five groups of rats in the other five groups were removed from the control group, and first days were treated with ovalbumin and aluminum hydroxide (100mg) plus the mixture of saline to 1ml and intraperitoneal injection, and the 2% ovalbumin solution was inhaled by ultrasonic atomization for 3 weeks for 3 weeks to maintain the asthmatic symptoms of rats. The intraperitoneal injection and atomization of the group were treated with normal saline. 30min began to gavage before each sensitizing atomization. The group was treated with different concentration of traditional Chinese medicine concentrated solution, and dexamethasone was used to fill the stomach with dexamethasone injection. The asthma model group and the blank control group were given the normal saline for 21 days.2.2 results. 2.2.1 general situation observation: asthma model group: after OVA stimulation, the rats were sparsely withered, depressed, reduced, and thin, some showed different degrees of cough, runny nose, shortness of breath, scratching of the nose, irritability and other asthma like manifestations. The blank control group was agile and unabnormality. Different concentration groups of Chinese medicine and ground plug were found. The results of the symptoms of asthma in each group were improved by.2.2.2 with ELISA method. Compared with the blank control, the VEGF content in the model group was significantly higher than that in the blank control group. The difference between the two groups was statistically significant? P0.01?; compared with the asthma model group, the high, middle, low concentration, and dexamethasone group VEGF contained in the asthma model group. The amount of P0.05?; in dexamethasone group, the content of VEGF in the high concentration group was more than that of the high concentration group. There was no statistical difference between the three groups. P0.05) the pulmonary histomorphology after.2.2.3HE staining: the asthmatic model group: the proliferation of the basal layer cells in the bronchial wall and the surrounding lung tissue, the thickening of the smooth muscle, the disorder of the arrangement of the smooth muscle, the exfoliation of epithelium and even the deficiency. For example, a large number of exudate mucus, secretions, and obvious inflammatory cell infiltration were seen in the cavity. In the blank control group, the bronchus, the structure of the lungs were normal, the thickness of the bronchial smooth muscle was not abnormal, the cell regulation, and no obvious inflammatory cell infiltration. Compared with the model group, the VEGF results of.2.2.4 lung tissue were improved in different degree compared with the model group. The total integral light density value (IOD) of each group showed that the IOD in the model group of asthma was significantly higher than that in the blank control group, and the IOD of the VEGF protein was significantly higher than that in the control group. There was a statistical difference between the two groups (P0.01); the low concentration group was more than the asthma in the traditional Chinese medicine. The IOD of VEGF protein decreased significantly in the model group, and there was a statistical difference (P0.01). The IOD value of VEGF in the dexamethasone group was significantly lower than that in the asthma model group. The difference between the two groups was statistically significant (P0.01); there was no statistical difference between the dexamethasone group and the Feng Yu Chuan prescription, the IOD value of the high concentration group VEGF was not statistically different? P0.05).2.3 conclusion: VEGF may pass A certain signal pathway is involved in the occurrence and development of airway remodeling in asthma. The search wind and asthma formula can inhibit airway remodeling by downregulating VEGF.

【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
【分類號(hào)】：R272

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