本文選題：喘可治 + 溫陽(yáng)補(bǔ)腎�。� 參考：《廣州中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：目的：1.研究溫陽(yáng)補(bǔ)腎法及中藥“喘可治”與特應(yīng)性皮炎相關(guān)性,初步為溫陽(yáng)補(bǔ)腎法及中藥“喘可治”治療特應(yīng)性皮炎提供理論依據(jù)。2.研究2,4-二硝基氟苯(DNFB)外源性誘導(dǎo)方法建立特應(yīng)性皮炎樣小鼠模型可靠性,初步探索特應(yīng)性皮炎樣小鼠模型的生理病理學(xué)特點(diǎn)。3.研究中藥“喘可治”干預(yù)DNFB誘導(dǎo)的特應(yīng)性皮炎樣小鼠模型炎癥形成過(guò)程,初步探索中藥“喘可治”對(duì)特應(yīng)性皮炎的療效及作用機(jī)制。4.研究特應(yīng)性皮炎中醫(yī)證型分布并闡明成人特應(yīng)性皮炎患者腎陽(yáng)不足證型的特點(diǎn),評(píng)價(jià)既往臨床使用中藥“喘可治”治療的成人期特應(yīng)性皮炎的療效,初步為中藥“喘可治”治療特應(yīng)性皮炎提供一定的臨床依據(jù)。5.評(píng)價(jià)中藥“喘可治”對(duì)成人期特應(yīng)性皮炎的臨床療效,為中藥“喘可治”治療特應(yīng)性皮炎提供確切證據(jù)。方法：1.文獻(xiàn)研究方面,對(duì)Pubmed數(shù)據(jù)庫(kù)、Cochrane圖書館、Embase循證醫(yī)學(xué)數(shù)據(jù)庫(kù)、sinoMED數(shù)據(jù)庫(kù),CNKI數(shù)據(jù)庫(kù)、維普數(shù)據(jù)庫(kù)(VIP)、萬(wàn)方數(shù)據(jù)庫(kù)(WANFANG)進(jìn)行檢索,篩選中成藥治療特應(yīng)性皮炎、中藥“喘可治”治療變態(tài)反應(yīng)性疾病、溫陽(yáng)補(bǔ)腎與特應(yīng)性皮炎的文獻(xiàn)進(jìn)行系統(tǒng)分析；對(duì)當(dāng)代皮膚病中醫(yī)臨床家針對(duì)溫陽(yáng)補(bǔ)腎法治療變態(tài)反應(yīng)性皮膚病及免疫性皮膚病論述進(jìn)行整理。2.實(shí)驗(yàn)研究：1)通過(guò)2,4-二硝基氟苯(DNFB)經(jīng)皮膚致敏誘導(dǎo)C57BL/6小鼠建立特應(yīng)性皮炎樣小鼠模型,并檢測(cè)臨床表現(xiàn)、皮膚病理、血清IgE、IL-4、IFN-γ、皮損microRNA-155。2)對(duì)2,4-二硝基氟苯誘導(dǎo)特應(yīng)性皮炎樣小鼠隨機(jī)分為空白組、模型組、喘可治大劑量組、喘可治小劑量組,中藥“喘可治”干預(yù)后對(duì)小鼠臨床表現(xiàn)、皮膚鏡下表現(xiàn)、背部及耳部皮膚普通病理、背部及耳部甲苯胺藍(lán)染色病理、血清IgE、IFN-γ、IL-4水平、皮損IFN-γ、IL-4 mRNA表達(dá)進(jìn)行分析。3.臨床研究：1)采用回顧性研究對(duì)314例特應(yīng)性皮炎患者的一般情況、病情分期、臨床特點(diǎn)、癥候分型等進(jìn)行評(píng)價(jià)。2)采用回顧性研究對(duì)28例使用中藥“喘可治”治療的特應(yīng)性皮炎患者的治療前后SCORAD評(píng)分、研究者整體評(píng)價(jià)(IGA)評(píng)分進(jìn)行評(píng)價(jià)。3)采用前瞻性、隨機(jī)、對(duì)照的治療方案,對(duì)成人期患者隨機(jī)分為喘可治治療組(基礎(chǔ)治療+喘可治)和對(duì)照組(基礎(chǔ)治療),觀察期為4周及隨訪期4周,在治療前、第2周、第4周、第8周對(duì)患者的SCORAD評(píng)分、分層分析(皮損嚴(yán)重程度、皮損面積、瘙癢程度、失眠程度)、研究者整體評(píng)價(jià)(IGA)、畏寒程度、復(fù)發(fā)風(fēng)險(xiǎn)、血清IgE、癥候特點(diǎn)進(jìn)行評(píng)價(jià)。結(jié)果：1.文獻(xiàn)研究發(fā)現(xiàn)存在中藥“喘可治”及溫陽(yáng)補(bǔ)腎法治療特應(yīng)性皮炎相關(guān)研究,中藥“喘可治”具有抗炎、免疫調(diào)節(jié)等方面的藥理作用。2.通過(guò)使用2,4-二硝基氟苯(DNFB)外源性誘導(dǎo)的方法成功建立C57BL/6特應(yīng)性皮炎樣小鼠模型,臨床表現(xiàn)為紅斑、干燥、脫屑、痂皮等表現(xiàn)；病理符合海綿水腫性皮炎改變；血清IgE、IL-4升高,皮損中microRNA-155升高。3.通過(guò)中藥“喘可治”干預(yù)的特應(yīng)性皮炎樣小鼠模型臨床癥狀及皮膚鏡下表現(xiàn)明顯改善；耳部腫脹程度明顯減輕；病理提示背部及耳部皮膚增厚減輕,真皮炎癥細(xì)胞數(shù)目明顯減少；甲苯胺藍(lán)染色提示背部及耳部皮膚真皮肥大細(xì)胞數(shù)目明顯減少；血清IgE、IL-4表達(dá)下降；皮膚中IL-4 mRNA表達(dá)明顯下降。4.臨床回顧性研究發(fā)現(xiàn),特應(yīng)性皮炎患者,尤其是成人期特應(yīng)性皮炎患者中醫(yī)證型中存在兼夾腎陽(yáng)不足證型或以腎陽(yáng)不足為主證的證型；使用中藥“喘可治”治療特應(yīng)性皮炎后,患者SCORAD評(píng)分、IGA評(píng)分下降,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。5.隨機(jī)對(duì)照研究發(fā)現(xiàn),中藥“喘可治”治療組患者較對(duì)照組相比,在SCORAD評(píng)分、分層分析(皮損面積、皮損嚴(yán)重程度、瘙癢程度、失眠程度)、IGA評(píng)分、復(fù)發(fā)風(fēng)險(xiǎn)有明顯改善,差異有統(tǒng)計(jì)學(xué)意義(P0.05),畏寒程度、生活質(zhì)量、血清IgE輕度下降趨勢(shì),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：1.中藥“喘可治”及溫陽(yáng)補(bǔ)腎法治療特應(yīng)性皮炎具有一定的理論依據(jù)。2.中藥“喘可治”對(duì)特應(yīng)性皮炎樣小鼠模型炎癥形成過(guò)程具有明顯抑制作用,其作用機(jī)制可能是通過(guò)調(diào)控Th1/Th2免疫失衡、抑制肥大細(xì)胞等方面發(fā)揮作用。3.中藥“喘可治”對(duì)于成人期特應(yīng)性皮炎具有改善病情,減緩復(fù)發(fā),提高生活質(zhì)量等方面的治療作用。
[Abstract]:Objective: 1. to study the relationship between Warm Yang kidney tonifying method and traditional Chinese medicine "Chuan Kezhi" and atopic dermatitis. It provides a theoretical basis for the treatment of atopic dermatitis by Wenyang tonifying kidney method and traditional Chinese medicine "Chuan Kezhi" in the treatment of atopic dermatitis. The.2. study of 2,4- two nitrofluorobenzene (DNFB) exogenous induction method to establish atopic dermatitis model mice model reliability, preliminary exploration of atopic dermatitis The physiological and pathological characteristics of the mice model.3. study the inflammatory formation of the atopic dermatitis like DNFB induced by Chinese medicine "asthma treatment". The effect and mechanism of traditional Chinese medicine "Chuan Ke" on atopic dermatitis were preliminarily explored. The TCM syndrome type of atopic dermatitis in.4. study was divided and the kidney yang of adult atopic dermatitis was clarified. The characteristics of the foot syndrome type, evaluate the curative effect of adult atopic dermatitis in the past clinical use of traditional Chinese medicine "Chuan Ke Zhi", and provide a certain clinical basis for the treatment of atopic dermatitis by "asthma treatment" in Chinese medicine. The clinical effect of "Chuan Ke treatment" on adult atopic dermatitis is evaluated by.5.. Dermatitis provides definite evidence. Methods: 1. literature research, the Pubmed database, Cochrane library, Embase evidence-based medicine database, sinoMED database, CNKI database, VIP, WANFANG, selected Chinese patent medicine treatment atopic dermatitis, Chinese medicine "asthma treatment" treatment of allergic diseases, temperature A systematic analysis of the literature of Yang tonifying kidney and atopic dermatitis; the.2. experimental study on the treatment of allergic dermatosis and immune dermatosis by Wenyang tonifying kidney method: 1) establishment of atopic dermatitis like mice model by 2,4- two nitrofluoro benzene (DNFB) induced by skin sensitization induced by skin. The clinical manifestations, dermatology, serum IgE, IL-4, IFN- gamma, skin lesion microRNA-155.2) were randomly divided into the blank group, the model group, the large dose group, the small dose group of asthma can be treated, the clinical manifestation, the skin mirror performance, the back and the ear skin of the mice after the "asthma can be treated" after the Chinese medicine "asthma can be treated". Skin pathology, back and auricular toluidine blue staining pathology, serum IgE, IFN- gamma, IL-4 level, IFN- gamma, IL-4 mRNA expression in the analysis of.3. clinical study: 1) retrospective study on the general condition of 314 patients with atopic dermatitis, the stage of the disease, the clinical characteristics, the syndrome classification, and so on, the retrospective study on 28 cases by retrospective study. Patients with atopic dermatitis treated with Chinese medicine were treated with SCORAD score before and after treatment, the overall evaluation of the researchers (IGA) was evaluated by.3) using a prospective, random, controlled treatment scheme. The patients were randomly divided into the asthma treatment group (basic treatment + asthma treatment) and the control group (basic treatment). The observation period was 4 weeks and the follow-up period was followed up. 4 weeks, the SCORAD score of patients before treatment, second weeks, fourth weeks and eighth weeks, stratified analysis (severity of skin lesions, skin lesion area, itching degree, insomnia degree), overall evaluation (IGA), degree of cold, recurrence risk, serum IgE, symptoms of the patients were evaluated. Results: the results of the 1. literature study found the existence of "asthma treatment" and warm yang supplementation in Chinese medicine. The related research on the treatment of atopic dermatitis by kidney method, the pharmacologic action of "asthma can be treated" by Chinese traditional medicine.2. has been successfully established by using the exogenous induction of 2,4- two nitrofluorobenzene (DNFB) to establish a C57BL/6 atopic dermatitis mouse model. The clinical manifestations are erythema, drying, desquamation and scab skin, and the pathology accords with the sponge water. The changes of swollen dermatitis, elevated serum IgE, IL-4, and elevated microRNA-155 in skin lesions, the clinical symptoms and skin microscopic appearance of.3. in the mice with allergic dermatitis intervened by traditional Chinese medicine were obviously improved, the extent of the ear swelling was obviously reduced, and the thickness of the back and ear skin was reduced, and the number of dermis inflammatory cells decreased obviously. Less; toluidine blue staining suggested that the number of mast cells in the skin of the back and ear skin decreased significantly, the expression of serum IgE, IL-4 decreased, and the expression of IL-4 mRNA in the skin decreased obviously in.4. clinical retrospective study found that there was a deficiency of Kidney Yang Syndrome in patients with atopic dermatitis, especially in adult atopic dermatitis. After the treatment of atopic dermatitis, the SCORAD score and IGA score of the patients were decreased, and the difference was statistically significant (P0.05).5. randomized controlled study found that compared with the control group, the patients with "asthma treatment" treatment group were compared with the control group in the SCORAD score, stratified analysis (skin lesion area, skin lesion severity, The degree of itching, the degree of insomnia), the IGA score, the risk of relapse significantly improved, the difference was statistically significant (P0.05), the degree of fear of cold, the quality of life, the slight decreasing trend of serum IgE, the difference was not statistically significant (P0.05). Conclusion: 1. Chinese medicine "asthma can be treated" and warm yang tonifying kidney have a certain theoretical basis for the treatment of atopic dermatitis: ".2. Chinese herbal medicine" Chuan can " Treatment "has an obvious inhibitory effect on the process of inflammation in atopic dermatitis like mice. The mechanism of its action may be by regulating the imbalance of Th1/Th2 immunity and inhibiting mast cells to play the role of.3. Chinese medicine" asthma treatment "for adult atopic dermatitis, which can improve the condition of adult atopic dermatitis, slow down the recurrence and improve the quality of life. Effect.

【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R275.9

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9 李其林;三種病原體與特應(yīng)性皮炎密切相關(guān)[N];中國(guó)中醫(yī)藥報(bào);2003年

10 健康時(shí)報(bào)記者 何佳頤;特應(yīng)性皮炎要遠(yuǎn)離激素[N];健康時(shí)報(bào);2005年

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6 郭亞南;卡介菌多糖核酸對(duì)小鼠特應(yīng)性皮炎模型的影響[D];中南大學(xué);2010年

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