哮病中医证候分布特点及麻芍平喘汤对哮喘大鼠模型气道重塑的干预研究

发布时间：2018-08-28 10:13

【摘要】：目的:○1基于我院近10年哮病住院病例的回顾性调查,分析哮病的中医证候分布特点,为制定并优化哮病中医临床辨证治疗提供依据。○2了解哮喘大鼠气道重塑模型的发病机理,观察麻芍平喘汤对哮喘模型雄性SD大鼠组织形态学、肺功能的影响,从细胞因子及气道重塑方面探讨麻芍平喘汤防治哮喘的作用机制,为麻芍平喘汤的临床应用提供实验基础和依据。方法:○1通过查阅相关文献,制定哮病临床回顾性调查表,本研究通过调查261例哮喘患者,从一般资料(性别、年龄、职业、病程长短等情况)及发病诱因(烟酒史、过敏史、遗传病史、气候改变、饮食劳累等)与哮病中医证型之间的关系,对相关因素进行统计学分析,以探讨哮病的中医证候分布特点。○2将70只雄性SD大鼠,随机分为正常组、模型组、麻芍平喘汤低、中、高剂量组、地塞米松组和阳和平喘组,每组10只;除正常组外,其余各组于实验的第0天、第7天和第14天,以10%卵白蛋白加氢氧化铝干粉10mg,在腹腔及两侧腹股沟皮下多点注射致敏,并雾化吸入激发制备大鼠哮喘模型;干预组均从激发阶段的第7天开始给药,每次激发前30min灌胃,正常组和模型组以生理盐水代替,连续14天;末次激发24h后腹腔麻醉,予以气管切开,行肺功能检查;肺组织切片行HE染色;计算机图像分析气道形态学参数,衡量气道重塑程度;免疫组化法检测肺组织中TGF-β1、PDGF-BB含量;ELISA法测血清中IL-5、IL-13含量水平;RT-PCR测肺组织中TGF-β1m RNA、α-SMAm RNA的表达;Western Blot检测TGF-β1和PDGF-BB蛋白含量。SPASS软件统计分析结果。结果:○1 261例哮喘患者中,冷哮122例,占46.7%,最为多见,其次是热哮87例,占33.3%。其中男性112例,占42.9%,女性149例,占57.1%,女性发病率略高于男性,并且说明了哮喘发病常见证型症状。○2各组均存在不同程度气道重塑,麻芍平喘高剂量组大鼠气道重塑程度(支气管壁厚度、平滑肌厚度)明显较地塞米松组为轻(P0.05);麻芍平喘汤高剂量组和阳和平喘组对大鼠肺功能FVC、FEV0.3、PEF的改善最明显(P0.05),地塞米松组次之;麻芍平喘汤可降低大鼠血清中IL-5和IL-13的表达(P0.05);麻芍平喘汤高剂量组、地塞米松组与阳和平喘组能降低大鼠TGF-β1、PDGF-BB及α-SMA含量。结论:○1从261哮病证型中冷哮最为多见,发病症状常见恶寒发热、咳白粘痰、哮鸣音、胸闷、无胸痛、口不渴、无汗出、舌苔白腻、脉浮紧。○2在大鼠哮喘模型中,麻芍平喘汤能够减轻气道炎症,缓解气道重塑,其机制可能是通过降低IL-5和IL-13含量,抑制TGF-β1、PDGF-BB及α-SMA的表达起作用,表明TGF-β1、PDGF-BB及α-SMA与哮喘气道重塑程度密切相关,可能可以作为衡量气道重塑严重程度的指标之一。
[Abstract]:Objective:Based on the retrospective investigation of inpatients with asthma in our hospital in recent 10 years,to analyze the distribution characteristics of asthma syndrome in traditional Chinese medicine,and to provide the basis for formulating and optimizing the clinical treatment of asthma.02 To understand the pathogenesis of asthma rat airway remodeling model,and to observe the histomorphology and pulmonary function of male SD rats treated with Mashao Pingchuan decoction. Objective:To explore the mechanism of Mashao Pingchuan Decoction in preventing and treating asthma from the aspects of cytokines and airway remodeling, and to provide experimental basis and basis for clinical application of Mashao Pingchuan Decoction.Methods:A retrospective clinical survey of asthma was made by consulting relevant literatures. The relationship between age, occupation, course of disease, predisposing factors (smoking and drinking history, allergic history, hereditary history, climate change, diet fatigue, etc.) and TCM syndromes of asthma was analyzed statistically to explore the distribution characteristics of TCM syndromes of asthma. Decoction low, medium, high dose group, dexamethasone group and Yang Ping Chuan group, 10 rats in each group; Except for the normal group, the other groups were sensitized by 10% ovalbumin and aluminum hydroxide dry powder on the 0th, 7th and 14th day of the experiment, and were subcutaneously injected into abdominal cavity and bilateral inguinal subcutaneously at multiple points, and atomized to induce asthma in the intervention group. At the 7th day of the hair stage, the drug was administered orally 30 minutes before each stimulation, and the normal group and the model group were given saline instead for 14 consecutive days. The contents of TGF-beta 1 and PDGF-BB in lung tissues were measured by ELISA, the levels of IL-5 and IL-13 in serum were measured by ELISA, the expressions of TGF-beta 1m RNA and alpha-SMAm RNA in lung tissues were detected by RT-PCR, and the contents of TGF-beta 1 and PDGF-BB protein were detected by Western Blot. Among them, 112 were male, accounting for 42.9%, 149 were female, accounting for 57.1%. The incidence of female was slightly higher than that of male, indicating the common symptoms of asthma. Mashao Pingchuan Decoction high-dose group and Yang Pingchuan Decoction high-dose group of rats lung function FVC, FEV 0.3, PEF improved most significantly (P 0.05), followed by dexamethasone group; Mashao Pingchuan decoction can reduce the expression of IL-5 and IL-13 in serum of rats (P 0.05); Mashao Pingchuan Decoction high-dose group, dexamethasone group and Yang Pingchuan group can reduce the expression of TGF-beta 1, PDGF-BB and a-SMA in rats. CONCLUSION: Cold asthma is the most common syndrome of 261 asthma. The common symptoms of cold and fever, coughing white phlegm, wheezing, chest tightness, chest pain, thirst-free, no sweating, white greasy tongue coating, pulse tightness are common. 02 In the rat asthma model, Mashao Pingchuan decoction can alleviate airway inflammation and airway remodeling, the mechanism may be through reducing IL-5 and IL-5. The results showed that TGF-beta 1, PDGF-BB and alpha-SMA were closely related to the degree of airway remodeling in asthma, and could be used as one of the indexes to evaluate the severity of airway remodeling.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R256.12

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