“三伏贴”防治支气管哮喘及对患者神经免疫相关细胞因子的影响

发布时间：2018-02-13 23:47

本文关键词： 支气管哮喘 “三伏贴”疗法 Th1/Th2 NGF VIP　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：通过对中医“三伏贴”疗法防治支气管哮喘患者疗效的观察,研究该疗法对患者神经生长因子(NGF).血管活性肠肽(VIP)、Th1/Th2相关细胞因子的影响,初步探讨“三伏贴”防治支气管哮喘的神经免疫学机制。方法：将60例临床缓解期或间歇发作或轻度发作的哮喘患者随机分为“三伏贴”治疗组和对照组,每组30例。治疗组在初伏、中伏、末伏进行穴位敷贴。对照组则按西医常规治疗。观察周期为6个月,观察患者治疗前后临床疗效(哮喘急性发作次数、“肺脾气虚证”证候积分、ACT评分、肺通气功能)、NGF、VIP、Th1/Th2相关细胞因子(IL-2、IFN-γ、IL-4、IL-5)水平。用SPSS 17.0进行数据统计。结果：①急性发作次数：治疗组平均急性发作次数减少至0.13次(P0.01),对照组较前无统计学差异(P0.05),治疗后两组比较有统计学差异(P0.05)。②ACT评分：治疗组平均ACT评分由22.47分提升至24.13分(P0.01)；对照组ACT评分较前无统计学差异(P0.05),治疗后两组比较有统计学差异(P0.05)。③“肺脾气虚证”证候积分：治疗组平均“肺脾气虚证”证候积分由8.70分下降至4.87分(P0.01),对照组“肺脾气虚证”证候积分较前无统计学差异(P0.05),治疗后两组比较有明显差异(P0.01)。④肺通气功能：治疗组FEV1、FEV1占预计值%、FEV1/FVC较前有所提高,但无统计学差异(P0.05),对照组FEV1、FEV1占预计值%、FEV1/FVC较前无统计学差异(P0.05),治疗后两组比较无统计学差异(P0.05)。⑤Th1相关细胞因子：治疗组IL-2较前提高(P0.01),IFN-γ也有所提高(P0.01)；对照组IL-2治疗后较前有所升高(P0.01),IFN-γ较前无统计学差异(P0.05)；治疗后两组比较均有统计学差异(P0.05)。⑥Th2相关细胞因子：治疗组IL-4、IL-5较前下降(P0.01)；对照组IL-4、IL-5较前均有所下降,但无统计学差异(P0.05)；治疗组IL-4较对照组明显降低(P0.01),IL-5低于对照组(P0.05)。⑦NGF水平：治疗组NGF水平有所降低(P0.01)；对照组NGF治疗后较前无统计学差异(P0.05)；治疗后两组比较有统计学差异(P0.05)；⑧VIP水平：治疗组VIP较前有所提升(P0.01)；对照组VIP较前无统计学差异(P0.05)；治疗后两组比较有统计学差异(P0.05)。结论：1.“三伏贴”疗法防治哮喘临床缓解期、慢性持续期间歇及轻度发作患者较单用西药组在改善患者哮喘急性发作次数、ACT评分、“肺脾气虚证”证候积分、稳定肺通气功能方面,均有一定作用。2.“三伏贴”疗法能通过调节IL-2、IFN-γ、IL-4、IL-5调整哮喘患者Th1/Th2水平；3.“三伏贴”疗法能通过改善VIP、NGF水平,对哮喘患者神经-免疫功能有一定调节作用
[Abstract]:Objective: to observe the curative effect of "Sanfu Pian" therapy on patients with bronchial asthma, and to study the effect of this therapy on Th1 / Th2 related cytokines in patients with nerve growth factor (NGF), vasoactive intestinal peptide (VIPP) and Th1 / Th2. To explore the neuroimmunological mechanism of "Sanfu Pian" in the prevention and treatment of bronchial asthma. Methods: sixty patients with asthma in clinical remission period or intermittent or mild attack were randomly divided into "Sanfu paste" treatment group and control group. There were 30 cases in each group. The treatment group was treated with acupoint application at the beginning, middle and last, while the control group was treated with routine western medicine. The observation period was 6 months. To observe the clinical efficacy before and after treatment (frequency of acute attack of asthma, syndrome integral of "lung qi deficiency syndrome" and ACT score), The level of IL-2IFN- 纬 IL-4 IL-5 was measured with SPSS 17.0. Results: the average acute attack times of the treatment group decreased to 0.13 times (P 0.01), while the control group had no significant difference compared with the former group (P0.05A). The average ACT score in the treatment group was raised from 22.47 to 24.13 and there was no significant difference in the ACT score between the control group and the control group (P 0.05). After treatment, there was a significant difference between the two groups (P 0.05.3). In the treatment group, the average syndrome score of "lung qi deficiency syndrome" decreased from 8.70 to 4.87 points (P 0.01), while in the control group, there was no statistical difference between the two groups (P 0.05). After treatment, there was a significant difference in pulmonary ventilation function between the two groups: FEV1, FEV1 and FEV1 in the treatment group. FEV1 / FVC is higher than before. However, there was no statistical difference (P0.05). There was no significant difference in FEV1 / FEV1 / FEV1 / FEV1 / FVC between the two groups after treatment. There was no significant difference between the two groups after treatment. The IL-2 of the treatment group was higher than that of the former, and that of the control group was higher than that of the control group (P0.01- 纬), and that of the control group after IL-2 treatment was higher than that of the control group. There was no significant difference in IFN- 纬 between the two groups after treatment. There was a significant difference between the two groups after treatment. The levels of IL-4, IL-5 and IL-5 in the treatment group were significantly lower than those in the control group, and the levels of IL-4 and IL-5 in the control group were lower than those in the control group. But there was no statistical difference (P 0.05); the level of IL-4 in the treatment group was significantly lower than that in the control group, and the level of IL-5 in the treatment group was significantly lower than that in the control group. The level of NGF in the treatment group was lower than that in the control group (P 0.01); in the control group, there was no significant difference between the two groups after NGF treatment (P 0.05); there was a significant difference between the two groups after treatment. The level of VIP in the treatment group was higher than that in the former group, but there was no significant difference in VIP between the control group and the control group (P 0.05), and there was a significant difference between the two groups after treatment (P 0.05). Conclusion: (1) the "San Fu Tap" therapy can prevent and treat the clinical remission period of asthma. Compared with the western medicine group, the patients with chronic duration and mild attack improved the ACT score, the syndrome score of "deficiency of the lung temper", and stabilized the pulmonary ventilation function, compared with the western medicine group alone. "Sanfu paste" therapy can regulate the level of Th1/Th2 in asthmatic patients by regulating IL-2n- 纬 -IL-4 IL-5. "Sanfu paste" therapy can regulate the neuro-immune function of asthmatic patients by improving the level of VIP-NGF.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1

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