麻黄附子细辛汤治疗肺气虚寒型变应性鼻炎的研究

发布时间：2018-01-10 07:19

本文关键词：麻黄附子细辛汤治疗肺气虚寒型变应性鼻炎的研究　出处：《山东中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:建立豚鼠变应性鼻炎及肺气虚寒症候二期动物模型,观察麻黄附子细辛汤及其不同配伍组合对豚鼠变应性鼻炎病情与证候变化的影响,从转录因子GATA-3调控Th1和Th2生成的角度探讨其组方配伍的合理性及作用机制。并通过评价加味麻黄附子细辛汤治疗肺气虚寒型变应性鼻炎的临床疗效,进一步探讨其治疗变应性鼻炎的可行性。方法:1.动物实验:以知母:石膏:黄柏:龙胆草=1.5∶2.0∶1.0∶1.2的比例,常规制成200%煎剂灌胃,后使用烟熏法行肺气虚寒证候造模。上述造模成功后采用滴鼻法造AR模型。将清洁级3月龄健康豚鼠37只,随机分为6组,即麻黄附子细辛组7只、麻黄附子组6只、麻黄细辛组6只、麻黄组6只、地塞米松组6只、模型组6只,记录症状、体征的变化,处死后采用免疫组化法检测豚鼠鼻粘膜GATA-3表达。2.临床观察:选择符合纳入标准的30例变应性鼻炎病例,给予麻黄附子细辛汤加味治疗,4周为一个疗程,连续观察一个疗程。观察记录治疗前后临床症状及体征变化情况。结果:1.动物实验:(1)豚鼠尿17-羟皮质醇(OHCS-17)、血清皮质醇(F)的测定结果:实验后,各实验组除麻黄组,豚鼠尿-17羟皮质醇(OHCS-17)较造模后表达增强,并与模型组具有显著性差异(p0.05)。其中,麻黄附子细辛组、麻黄附子组、地塞米松组高表达,与其余组差异具有显著性(p0.05)。实验后,各实验组除麻黄组外,血清皮质酮(F)较造模后表达增强(p0.05),并与模型组差异具有显著性(p0.05)。其中,麻黄附子细辛组、麻黄附子组、麻黄细辛组、地塞米松组血清皮质酮(F)高表达,与其余组差异具有显著性(p0.05)。(2)实验后各组豚鼠鼻粘膜GATA-3免疫组化结果:半定量统计GATA-3表达量(染色指数+阳性细胞百分比),其中麻黄附子细辛组中GATA-3的表达均低于其他组(p0.01),麻黄附子组、麻黄细辛组、地塞米松组中表达低于麻黄组及模型组(p0.01),麻黄附子组、麻黄细辛组及地塞米松组中GATA-3的表达无显著性差异(p0.05),麻黄组与模型组间GATA-3的表达无显著性差异(p0.05)。2.临床观察:通过对30例变应性鼻炎患者的临床观察,治愈率为26.67%,显效率为53.33%,有效率为16.7%,总有效率为96.70%。经统计学分析,30例变应性鼻炎患者的治疗前后症状、体征、中医证候计分差异具有显著性(p0.01)。结论:1.麻黄附子细辛汤在一定程度上能提高豚鼠尿-17羟皮质醇及血清皮质醇分泌,尤其以麻黄及附子两味药配伍最为显著,说明麻黄及附子在一定程度上能提高豚鼠的免疫功能。2.麻黄附子细辛汤对Th1/Th2的调节作用是在转录水平通过抑制GATA-3的表达,调控Th0正常向Th1/Th2分化,从而抑制变应性鼻炎Th2细胞亚群功能亢进,减轻气道的炎症。3.加味麻黄附子细辛汤能有效缓解或解除肺气虚寒型变应性鼻炎患者鼻痒、打喷嚏、流涕、鼻塞等症状,是肺气虚寒型变应性鼻炎的有效治法,值得进一步探究。
[Abstract]:Objective: to establish a two-stage animal model of allergic rhinitis and asthenia of lung qi in guinea pigs and to observe the effects of ephedra aconite Asarum decoction and its different combinations on the changes of symptoms and syndromes of allergic rhinitis in guinea pigs. To discuss the rationality and mechanism of the compatibility of Th1 and Th2 by transcription factor GATA-3 in regulating the production of Th1 and Th2, and to evaluate the clinical effect of modified ephedrine aconite Asarum decoction in the treatment of allergic rhinitis with deficiency of lung qi and cold syndrome. The bed works. To further explore the feasibility of its treatment of allergic rhinitis. Methods: 1. Animal experiment: Anemarrhena: gypsum: yellow cypress: Gentianthus gentianensis 1.5: 2.0: 1.0: 1.2. The model of lung qi deficiency cold syndrome was established by fumigation. The AR model was established by nasal drip after the above model was successfully made. 37 healthy guinea pigs of 3 months old of clean grade were randomly divided into 6 groups. There were 7 rats in Asarum ephedra group, 6 in aconite ephedra group, 6 in ephedra asarum group, 6 in ephedra group, 6 in dexamethasone group and 6 in model group. The changes of symptoms and signs were recorded. The expression of GATA-3 in nasal mucosa of guinea pigs was detected by immunohistochemical method. Clinical observation: 30 cases of allergic rhinitis according to the inclusion criteria were selected and treated with ephedra aconite Asarum decoction. The changes of clinical symptoms and signs before and after treatment were observed and recorded. Results: 1. Animal experiment 1) Guinea pig urine 17-hydroxycortisol OHCS-17). Results: after the experiment, the expression of -17 hydroxycortisol OHCS-17 in guinea-pig urine was higher than that after modeling in each experimental group except ephedra. And there was a significant difference between the model group and the model group (p0.05). Among them, Aconitum ephedra group, ephedra aconite group, dexamethasone group were highly expressed, and there was a significant difference between the model group and the other groups (P 0.05). The expression of serum corticosterone in each experimental group was significantly higher than that in model group except Ephedra group, and the difference was significant compared with model group (P 0.05). Among them, Asarum ephedra group. The high expression of corticosterone was observed in ephedra aconite group, ephedra asarum group and dexamethasone group. After the experiment, the GATA-3 immunohistochemical results of nasal mucosa of guinea pigs were as follows: Semi-quantitative statistical GATA-3 expression (P < 0.05). Percentage of staining index positive cells. The expression of GATA-3 in Asarum ephedra group was lower than that in other groups (p0.01). The expression of GATA-3 in Aconitum ephedra group, Asarum ephedra group and dexamethasone group was lower than that in Ephedra group and model group (P 0.01). There was no significant difference in GATA-3 expression in ephedra aconite group, ephedra asarum group and dexamethasone group (p0.05). There was no significant difference in the expression of GATA-3 between the ephedra group and the model group. 2. Clinical observation: the cure rate of 30 cases of allergic rhinitis was 26.67%. The effective rate was 53.33, the effective rate was 16.7am, and the total effective rate was 96.70.The symptoms and signs of 30 patients with allergic rhinitis before and after treatment were analyzed statistically. Conclusion: 1. Ephedra aconite Asarum decoction can improve the secretion of urinary -17 hydroxycortisol and serum cortisol in guinea pigs to a certain extent. Especially in ephedra and aconite two kinds of medicine compatibility is the most significant. The results showed that ephedra and aconite could improve the immune function of guinea pigs to a certain extent. 2. The regulation of ephedrine aconite Asarum decoction on Th1/Th2 was by inhibiting the expression of GATA-3 at the transcriptional level. To regulate the normal differentiation of Th0 into Th1/Th2, thus inhibit the hyperfunction of Th2 cell subsets in allergic rhinitis. Reduce airway inflammation .3. modified ephedra aconite Asarum decoction can effectively alleviate or relieve the lung qi deficiency cold allergic rhinitis patients with nasal itching sneezing runny nasal congestion and other symptoms. It is an effective treatment for allergic rhinitis with deficiency of lung qi and cold.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R276.1

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