基于“耳鼻喉科脾胃论”应用补中益气颗粒对脾气虚型变应性鼻炎大鼠血清IL-3的影响及临床疗效研究

发布时间：2018-01-04 13:23

本文关键词：基于“耳鼻喉科脾胃论”应用补中益气颗粒对脾气虚型变应性鼻炎大鼠血清IL-3的影响及临床疗效研究　出处：《安徽中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：1目的临床与实验共同观察补中益气颗粒是否能成为治疗AR更有效、更安全的药物,探索并总结补中益气颗粒治疗脾气虚型AR的理论基础。2方法2.1临床研究所有病例均来源于2015年3月~2015年10月安徽中医药大学第一附属医院耳鼻喉科门诊,选取其中60例符合标准的脾气虚型AR患者,随机分为补中益气颗粒组(治疗组)30例及依巴斯汀组(对照组)30例,2周为1疗程,分别观察并记录治疗过程中两组鼻部症状、体征及全身症状,分别在治疗前、治疗1周、治疗2周及随访1周的变化,并留意是否有不良反应出现,对所得数据进行统计学分析。2.2实验研究选取48只健康SD大鼠,适应性地饲养2~3天后,随机将它们分为正常对照组12只、AR模型组各12只、脾气虚模型组24只;然后脾气虚模型组经评价造模成功后,再次分为脾气虚AR模型组、脾气虚AR中药模型组,每组12只。采用双抗夹心ELISA法,横坐标为标准品浓度,纵坐标为OD值,绘制标准曲线,并根据血清样品的OD值可在标准曲线上查出其浓度,可以检测出不同分组的大鼠血清IL-3浓度,再使用SPSS17.0软件包,对所得数据进行对比分析。3结果3.1临床观察结果3.1.1治疗1周后,治疗组的有效率却为9.3%,对照组的有效率21.2%。3.1.2治疗2周后,治疗组的有效率为23.6%,而对照组的有效率29.8%。3.1.3随访1周后,治疗组优于对照组,有效率分别为35.5%、16.9%。3.1.4治疗1周后,经Independent-Samples Tests检验,得出流涕、鼻甲肿大、食少纳呆、少气懒言和大便溏稀积分P0.05,有统计学意义,说明两组治疗1周后,在改善流涕、鼻甲肿大、食少纳呆、少气懒言和大便溏稀症状方面,对照组疗效优于治疗组。3.1.5治疗2周后,经Independent-Samples Tests检验,得出喷嚏和食少纳呆积分P0.05,有统计学意义,说明治疗2周后,对照组在改善喷嚏和食少纳呆症状方面,其疗效优于治疗组。3.1.6随访1周后,经Independent-Samples Tests检验,得出喷嚏、鼻痒和食后腹胀积分P0.05,差异具有统计学意义,说明两组在随访1周后,在改善喷嚏、鼻痒和食后腹胀症状方面,治疗组疗效优于对照组。3.2实验研究结果使用SPSS17.0软件,应用Independent-Samples Tests方法得出以下结论。3.2.1正常组与AR组对比,得出P=0.028,P0.05,有统计学意义,由于IL-3浓度(SX±)AR组30.984±22.836大于正常组13.224±12.560,说明AR组大鼠血清IL-3浓度异常,表达过量;3.2.2正常组与脾气虚型AR组对比,得出P=0.003,P0.05,有统计学意义,由于IL-3浓度(SX?)脾气虚型AR组44.803±30.662大于正常组13.224±12.560,说明脾气虚型AR组大鼠血清IL-3浓度异常,表达过量;3.2.3正常组与脾气虚行AR中药组对比,得出P=0.040,P0.05,有统计学意义,由于IL-3浓度(SX?)脾气虚型AR中药组30.075±23.526大于正常组13.224±12.560,说明脾气虚型AR中药组大鼠血清IL-3浓度异常,表达过量。3.2.4观察分析浓度(SX?)数值大小,可以看出正常组大鼠血清IL-3浓度含量明显低于其他三组,脾气虚型AR组浓度最高,脾气虚型AR中药组是脾气虚型AR组通过服用补中益气颗粒后造模获得,而脾气虚型AR中药组浓度却低于AR组和脾气虚型AR组,考虑脾气虚型AR组浓度在服用补中益气颗粒后明显降低,接近并低于AR组浓度,向正常组恢复。4结论4.1临床研究结论4.1.1治疗1周后,在改善流涕、鼻甲肿大、食少纳呆、少气懒言和大便溏稀症状方面,对照组疗效优于治疗组。4.1.2治疗2周后,对照组在改善喷嚏和食少纳呆症状方面,对照组疗效优于治疗组。4.1.3随访1周后,在改善喷嚏、鼻痒和食后腹胀症状方面,治疗组疗效优于对照组。4.1.4随访2周后,对照组治疗AR的远期疗效不理想,病情易反复,症状易复发,而治疗组反复率低,远期疗效可观,疗效具有持续性、稳定性及长远性,临床更具有推广价值。4.2实验研究结论4.2.1造模成功后,大鼠血清IL-3的浓度不同。4.2.2 AR模型组的大鼠血清内可检测到IL-3浓度明显升高,脾气虚AR组IL-3的浓度相较于AR组进一步升高。4.2.3脾气虚AR中药组,IL-3的浓度较高,但相较于脾气虚AR组是有明显下降趋势的,同时也低于AR组。4.2.4应用补中益气颗粒后,可以调节脾气虚AR大鼠血清IL-3的浓度,从而达到治疗脾气虚AR的目的,为补中益气颗粒治疗脾气虚AR提供了实验依据。
[Abstract]:1 the purpose of clinical and experimental observations of Buzhong Yiqi granules can become a more effective treatment of AR, drug safety, and explore the theoretical basis of.2 methods of Buzhong Yiqi granule in treatment of spleen deficiency type AR 2.1 clinical study of all cases were from the First Affiliated Hospital in March 2015 October ~2015 Anhui University of traditional Chinese medicine outpatient department of ENT, select one of the 60 patients with spleen deficiency type AR patients were randomly divided into group of Buzhong Yiqi granules (treatment group) 30 cases and ebastine group (control group) 30 cases, 2 weeks as 1 course of treatment, were observed and recorded in two groups during the treatment of nasal symptoms, signs and symptoms, respectively before treatment, treatment 1 week, change for 2 weeks and 1 weeks follow-up, and pay attention to whether the adverse reactions were statistically analyzed, experimental study of.2.2 selected 48 healthy SD rats of the data, adaptive feeding for 2 ~3 days, it will be random They are divided into 12 rats in normal control group, AR model group with 12 rats in each group, spleen deficiency model group 24 and model group; spleen deficiency by evaluation after the success of the model, again divided into AR model group of spleen deficiency, spleen deficiency AR Chinese medicine model group, 12 rats in each group. With the method of double antibody ELISA abscissa as the standard concentration, the vertical axis is OD, drawing the standard curve, and according to the OD value of serum samples can be found in its concentration on the standard curve, can detect the serum IL-3 concentration of different groups, and then use the SPSS17.0 software package, the analysis of the data of.3 between the results of the 3.1 clinical observation results of 3.1.1 after 1 weeks of treatment and the effective rate of treatment group is 9.3%, the effective rate in the control group 21.2%.3.1.2 after 2 weeks of treatment, the treatment group was 23.6%, while the control group 29.8%.3.1.3 after 1 weeks of follow-up, the treatment group than the control group, respectively 35.5%, 16.9%.3.1.4 after 1 weeks of treatment by I Ndependent-Samples Tests test, the runny nose, nasal swelling, anorexia, less gas lazy words and loose stool score P0.05 was statistically significant, indicating that the two groups after 1 weeks of treatment, in improving runny nose, turbinate swelling, anorexia, less gas lazy words and loose stool symptoms after 2 weeks, the control group efficacy of the treatment group than.3.1.5 treatment by Independent-Samples Tests test, the sneezing and anorexia integral P0.05, have statistical significance, that after 2 weeks of treatment, the control group in improving the symptoms of sneezing and anorexia, its curative effect is better than the treatment group.3.1.6 after 1 weeks of follow-up, the Independent-Samples Tests test, that sneezing, nasal itching after eating and distension P0.05, the difference was statistically significant, indicating that the two groups in the follow-up of 1 weeks, in improving sneezing, nasal itching and hand bloating after eating symptoms, the treatment group than the control group.3.2 experimental results using SPSS17.0 The application of Independent-Samples Tests software, obtained the following conclusions compared to normal.3.2.1 group and AR group reached P=0.028, P0.05, have statistical significance, due to the concentration of IL-3 (SX + AR) = 30.984 + 22.836 + 12.560 13.224 higher than the normal group, the serum IL-3 concentration of rats in group AR were abnormal, excessive expression of 3.2.2 in normal group and temper; the type of deficiency of AR group contrast, obtained P=0.003, P0.05, have statistical significance, due to the concentration of IL-3 (SX?) and spleen deficiency AR group 44.803 + 30.662 + 12.560 13.224 higher than the normal group, serum IL-3 of AR rats and spleen deficiency were abnormal, excessive expression of 3.2.3; the normal group and the spleen deficiency AR group contrast of traditional Chinese medicine come, P=0.040, P0.05, have statistical significance, due to the concentration of IL-3 (SX?) and spleen deficiency AR traditional Chinese medicine group 30.075 + 13.224 + 12.560 23.526 more than the normal group, serum and spleen deficiency AR rats IL-3 abnormal expression of excess.3.2.4 concentration, concentration observation and analysis Degree (SX?) value, can be seen in normal rats serum IL-3 concentration was significantly lower than that of the other three groups, spleen deficiency AR group was the highest, AR traditional Chinese medicine group is spleen qi deficiency and spleen deficiency AR group by taking Buzhong Yiqi granules after modeling, and the spleen deficiency type AR is lower than the concentration of Chinese medicine group AR group and AR group and spleen deficiency, spleen deficiency AR group considered concentration decreased significantly in the use of Buzhong Yiqi granules, close and lower concentration of AR groups, the normal group to restore conclusion conclusion 4.1.4 clinical study of 4.1.1 after 1 weeks of treatment, in improving runny nose, turbinate swelling, anorexia, less gas lazy words and loose stool symptoms after 2 weeks, the control group curative effect is better than that of.4.1.2 in the treatment group, the control group in improving the symptoms of sneezing and anorexia, the control group is better than the treatment group.4.1.3 after 1 weeks of follow-up, in improving sneezing, nasal itching and hand bloating after eating symptoms, the curative effect of treatment group was superior In the control group.4.1.4 after 2 weeks of follow-up, the control group curative effect in the treatment of AR is not ideal, easy to relapse, recurrence symptoms, while the treatment group repeated rate is low, long-term effect is considerable, the effect is persistent, and long-term stability, has more clinical value of.4.2 conclusion the experimental study of 4.2.1 after successful modeling, large the serum IL-3 concentration of different.4.2.2 AR model group rat serum can detect IL-3 concentration obviously, concentration of spleen deficiency AR group IL-3 compared with group AR further increased.4.2.3 of spleen deficiency AR traditional Chinese medicine group, the concentration of IL-3 is higher, but compared to the spleen deficiency AR group is significantly decreased, at the same time lower than the AR group.4.2.4 application of Buzhong Yiqi granules can regulate the serum IL-3 concentration after AR rat spleen deficiency, so as to achieve the treatment of spleen deficiency AR to provide experimental basis for Buzhong Yiqi granule in treatment of spleen deficiency AR.

【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】：2016
【分类号】：R276.1

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