本文選題：穴位貼敷 + 哮喘　； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察穴位貼敷誘發(fā)的接觸性皮炎對(duì)支氣管哮喘復(fù)發(fā)及血清細(xì)胞因子IL-4、IFN-Y含量影響。方法:選取2016年6月至8月于江蘇省中醫(yī)院針灸康復(fù)科夏季穴位貼敷門(mén)診接受治療的支氣管哮喘患者,采用本院穴位貼敷制劑進(jìn)行貼敷治療,穴位貼敷治療過(guò)程中出現(xiàn)接觸性皮炎的患者為有接觸性皮炎組,未出現(xiàn)接觸性皮炎的患者為無(wú)接觸性皮炎組,有接觸性皮炎組20人,無(wú)接觸性皮炎組21人。分別記錄哮喘患者治療前和治療結(jié)束后3個(gè)月、6個(gè)月及治療前1年同時(shí)期哮喘ACT評(píng)分及AQLQ各項(xiàng)評(píng)分,治療前后留取患者靜脈血,采用ELISA法檢測(cè)治療前后血清IL-4、IFN-γ含量的變化,分析兩組患者各項(xiàng)評(píng)分及細(xì)胞因子含量差異性;采用免疫組化雙染法標(biāo)記接觸性皮炎皮損標(biāo)本Th2細(xì)胞,觀察其分布特點(diǎn)。結(jié)果:(1)臨床療效結(jié)果:①有接觸性皮炎組治療結(jié)束后3個(gè)月和6個(gè)月同治療前同期相比ACT評(píng)分升高差異具有統(tǒng)計(jì)學(xué)意義(p0.05);無(wú)接觸性皮炎組治療后3個(gè)月與治療前同期相比ACT評(píng)分升高差異有統(tǒng)計(jì)學(xué)意義(p0.05),而治療后6個(gè)月與治療前同期相比ACT評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05);②兩組患者經(jīng)穴位貼敷治療后3個(gè)月相比治療前同期AQLQ活動(dòng)受限評(píng)分上升差異有統(tǒng)計(jì)學(xué)意義(p0.05),治療后6個(gè)月與治療前同期相比時(shí)差異均無(wú)統(tǒng)計(jì)學(xué)意義(p0.05);③兩組患者經(jīng)穴位貼敷治療后3個(gè)月與6個(gè)月相比治療前同期AQLQ哮喘癥狀評(píng)分、AQLQ心理狀況評(píng)分、AQLQ對(duì)自身健康關(guān)心評(píng)分均有所上升差異具有統(tǒng)計(jì)學(xué)意義(p0.05);④兩組患者經(jīng)穴位貼敷治療后3個(gè)月相比治療前同期AQLQ刺激源反應(yīng)評(píng)分均上升差異具有統(tǒng)計(jì)學(xué)意義(p㩳0.05),兩組患者治療后6個(gè)月與治療前同期相比差異無(wú)統(tǒng)計(jì)學(xué)差異(p0.05);(2)血清細(xì)胞因子檢驗(yàn)結(jié)果與免疫組化結(jié)果:①有接觸性皮炎組治療前后相比血清IL-4含量下降有統(tǒng)計(jì)學(xué)意義(p0.05),無(wú)接觸性皮炎組治療前后相比血清IL-4含量下降無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。兩組患者治療前后血清IFN-γ含量下降均無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。②穴位貼敷誘發(fā)的接觸性皮炎中Th2細(xì)胞主要分布于真皮血管周?chē)?分布數(shù)量和接觸性皮炎的特征相關(guān)。結(jié)論:(1)穴位貼敷治療哮喘有無(wú)接觸性皮炎均可控制哮喘發(fā)作,誘發(fā)接觸性皮炎時(shí)其控制哮喘發(fā)作的作用持續(xù)時(shí)間更持久。(2)穴位貼敷治療哮喘有無(wú)接觸性皮炎均有改善哮喘患者心理狀態(tài)的作用。(3)穴位貼敷治療哮喘有無(wú)接觸性皮炎對(duì)哮喘患者對(duì)刺激源反應(yīng)敏感性的調(diào)節(jié)作用不明顯,僅在短期內(nèi)有一定作用。(4)穴位貼敷治療哮喘可能是通過(guò)降低哮喘患者血清IL-4、IFN-y含量從而改善哮喘發(fā)作情況,誘發(fā)接觸性皮炎比無(wú)接觸性皮炎對(duì)IL-4含量的下降作用更明顯。(5)Th2細(xì)胞參與了穴位貼敷治療哮喘誘發(fā)的皮膚接觸性皮炎。
[Abstract]:Aim: to observe the effect of contact dermatitis induced by acupoint application on the recurrence of bronchial asthma and the level of serum cytokine IL-4 and IFN-Y. Methods: from June to August 2016, the patients with bronchial asthma treated by acupoint application in summer in Department of Rehabilitation of Acupuncture and moxibustion, Jiangsu Provincial Hospital of traditional Chinese Medicine, were treated with acupoint application preparation in our hospital. Contact dermatitis was found in the patients with contact dermatitis, non-contact dermatitis, 20 contact dermatitis and 21 non-contact dermatitis. ACT scores and AQLQ scores of asthma were recorded before treatment, 3 months after treatment, 6 months after treatment and 1 year before treatment. The venous blood samples were collected before and after treatment, and the changes of serum IL-4 and IFN- 緯 levels before and after treatment were detected by Elisa. The difference of the score and cytokine content between the two groups was analyzed. Th2 cells were labeled with immunohistochemical double staining method to observe the distribution of Th2 cells in the skin lesions of contact dermatitis. Results: (1) there were significant differences in ACT score between 3 months and 6 months after treatment and 3 months after treatment in non-contact dermatitis group (p0.05), and 3 months after treatment in non-contact dermatitis group as compared with before treatment (p0.05), while in non-contact dermatitis group there was a significant difference in ACT score between 3 months and 6 months after treatment (p0.05). There was significant difference in ACT score between the two groups (p0.05), but there was no significant difference in ACT score between the two groups after 6 months of treatment and before treatment (p0.05). The AQLQ activity in the two groups was significantly higher than that in the control group after 3 months of acupoint application (p0.05). There was significant difference in motor restriction score (p0.05). There was no significant difference between the six months after treatment and the same period before treatment (p0.05). There was no significant difference between the two groups after treatment (p0.05). The patients in the two groups were treated with acupoint application for 3 months and 6 months after treatment compared with the same period before treatment AQLQ asthma. Asthma symptom score AQLQ psychological status score and AQLQ scores on their own health care were significantly different (p0.05) after acupoint application treatment for 3 months after treatment AQLQ stimulation source response scores were higher in the two groups than in the same period before treatment. There was no significant difference in serum cytokines between the two groups 6 months after treatment and the same period before and after treatment (p0. 05); (2). The results of serum cytokines test were compared with immunohistochemical results before and after treatment in the contact dermatitis group. The level of IL-4 in serum decreased significantly (p0.05), but the level of IL-4 in non-contact dermatitis group was not significantly decreased compared with that in non-contact dermatitis group (p0.05). The decrease of serum IFN- 緯 level in both groups was not statistically significant (p0.05). Th2 cells were mainly distributed around dermis vessels in contact dermatitis induced by acupoint application (p0.05). The distribution of Th2 cells was correlated with the characteristics of contact dermatitis. Conclusion: (1) the treatment of asthma with or without contact dermatitis can control the attack of asthma. (2) acupoint application can improve the psychological state of asthmatic patients with or without contact dermatitis. The effect of dermatitis on the sensitivity of asthmatic patients to stimuli was not obvious. Only in the short term. (4) the treatment of asthma with acupoint application may be by reducing the level of IL-4 and IFN-y in the serum of asthmatic patients to improve the asthma attack. Compared with non-contact dermatitis, the decrease of IL-4 was more obvious. (5) Th2 cells were involved in the treatment of skin contact dermatitis induced by asthma.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R246.1

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