搜风愈喘方治疗儿童哮喘发作期的临床与实验研究

发布时间：2018-04-25 16:14

本文选题：哮喘 + 搜风愈喘方　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:通过临床研究评价搜风愈喘方治疗儿童哮喘发作期的临床效果;通过实验研究探讨搜风愈喘方对哮喘模型大鼠气道重塑和VEGF蛋白的表达调控作用,为开发新药提供实验依据。1临床观察:1.1方法:将60例患儿按随机原则,用随机数字表法分作两组,治疗组服用搜风愈喘方联合布地奈德、特布他林雾化吸入,对照组服用定喘汤联合布地奈德、特布他林雾化吸入,两组在治疗过程中均可采用相应对症治疗,疗程为7天,观察两组用药前后症状、体征及呼气流速峰值的改变,作出比较,并通过统计学分析了解两组之间的差异。1.2结果:经过搜风愈喘方治疗后,治疗组总有效率96.7%,对照组总有效率89.6%,经统计学处理有差异(P0.05);治疗后两组患儿与治疗前相比,在症状积分、体征及PEF值等方面,均有不同程度的改善,其间,治疗组前后疗效相比改善显著(P0.01)。1.3结论:验证了搜风愈喘方作用于临床后的有效性与安全性。2实验研究:2.1方法:选取Sprague-Dawley(S-D)雄性大鼠60只,体重200±20克,按随机数字表法分成6组,即搜风愈喘方低、中、高浓度组、地塞米松组、哮喘模型组、空白对照组。除去空白对照组外其它五组大鼠,第1天以卵清蛋白和氢氧化铝各100mg另加生理盐水至1ml混合液,腹腔注射致敏;第15天起予以每天超声雾化吸入2%卵蛋白溶液,连续造模3周,以维持大鼠的哮喘症状。空白对照组腹腔注射及雾化均采用生理盐水。在每次致敏雾化激发前30min开始灌胃,搜风愈喘方组分别用不同浓度的中药浓缩液等容灌胃,地塞米松组用地塞米松注射液等容灌胃,哮喘模型组及空白对照组予生理盐水等容灌胃,共21天。2.2结果:2.2.1一般情况观察:哮喘模型组:经OVA激发后,大鼠出现毛发干枯稀疏,精神不振,活动减少,身体消瘦,有的表现出不同程度的呛咳,流涕,呼吸急促,抓鼻挠腮,烦躁不安等哮喘样表现。空白对照组行动敏捷,未见异常。中药不同浓度组和地塞米松组干预后,各组大鼠哮喘症状有不同程度的改善。2.2.2用ELISA法测血清VEGF含量结果:与空白对照相比,哮喘模型组大鼠VEGF含量明显升高,二者差异有统计学差异龴P0.01㖞;与哮喘模型组比较,搜风愈喘方高、中、低浓度组、地塞米松组VEGF含量均有不同程度地降低龴P0.05㖞;地塞米松组、搜风愈喘方中、高浓度组VEGF含量相较,三者差异无统计学差异龴P0.05)。2.2.3HE染色后肺组织形态学观察:哮喘模型组:支气管壁及其周围肺组织基层细胞增生,平滑肌增厚,排列紊乱,上皮脱落甚至缺如,管腔内可见大量的渗出粘液,分泌物,有明显的炎症细胞浸润现象。空白对照组:镜下可见大鼠的支气管、肺组织结构正常,支气管平滑肌厚度无异常,细胞规整,未见明显的炎性细胞浸润。搜风愈喘方高、中、低浓度组及地塞米松组在经过相关药物干预后,肺组织形态学状况较模型组均有不同程度的改善。2.2.4肺组织VEGF结果:各组总积分光密度值(IOD)测定表显示,哮喘模型组较空白对照组,VEGF蛋白的IOD显著增高,两者相比较,有统计学差异(P0.01);中药中、低浓度组较哮喘模型组,VEGF蛋白的IOD明显下降,两者相较,有统计学差异(P0.01);地塞米松组较哮喘模型组,VEGF的IOD值下降明显,两者相较,有统计学差异(P0.01);地塞米松组及搜风愈喘方中、高浓度组VEGF的IOD值相较,均无统计学差异龴P0.05)。2.3结论:VEGF可能通过一定信号途径,参与了哮喘气道重塑的发生与发展,搜风愈喘方通过下调VEGF实现对气道重塑的抑制。
[Abstract]:Objective: To evaluate the clinical effect of search Feng Yu Chuan prescription in the treatment of childhood asthma attack through a clinical study. Through experimental study, the effect of the expression and regulation of VEGF protein on the airway remodeling of the asthmatic model rats was studied. The experimental basis for the development of new drugs was provided by the.1 clinical observation: 1.1 methods: the random numbers were used in 60 children according to random principles. The treatment group was divided into two groups. The treatment group took the combination of budesonide combined with budesonide and budesonine in the treatment group. The control group was treated with dchuan decoction combined with budesonide and bubutaline inhalation. The two groups were treated with corresponding symptomatic treatment during the treatment process for 7 days. The symptoms, signs and peak expiratory flow velocity changes before and after the two groups were observed. Make a comparison, and through statistical analysis to understand the difference between the two groups.1.2 results: after the treatment, the total effective rate of the treatment group was 96.7%, the total effective rate of the control group was 89.6%, and the difference was statistically treated (P0.05). After the treatment, there were different degrees in the symptom score, the physical sign and the PEF value, and so on. In the meantime, the curative effect of the treatment group was improved significantly (P0.01).1.3 conclusion: the effectiveness and safety.2 experimental study on the effect of search wind Yue Fang on the clinical efficacy and safety: 2.1 methods: 60 male rats of Sprague-Dawley (S-D) were selected and the weight was 200 + 20 grams, which were divided into 6 groups according to the random number table method, namely, the low, middle, high concentration group, and ground plug of the Feng Yu Chuan prescription. The five groups of rats in the other five groups were removed from the control group, and first days were treated with ovalbumin and aluminum hydroxide (100mg) plus the mixture of saline to 1ml and intraperitoneal injection, and the 2% ovalbumin solution was inhaled by ultrasonic atomization for 3 weeks for 3 weeks to maintain the asthmatic symptoms of rats. The intraperitoneal injection and atomization of the group were treated with normal saline. 30min began to gavage before each sensitizing atomization. The group was treated with different concentration of traditional Chinese medicine concentrated solution, and dexamethasone was used to fill the stomach with dexamethasone injection. The asthma model group and the blank control group were given the normal saline for 21 days.2.2 results. 2.2.1 general situation observation: asthma model group: after OVA stimulation, the rats were sparsely withered, depressed, reduced, and thin, some showed different degrees of cough, runny nose, shortness of breath, scratching of the nose, irritability and other asthma like manifestations. The blank control group was agile and unabnormality. Different concentration groups of Chinese medicine and ground plug were found. The results of the symptoms of asthma in each group were improved by.2.2.2 with ELISA method. Compared with the blank control, the VEGF content in the model group was significantly higher than that in the blank control group. The difference between the two groups was statistically significant? P0.01?; compared with the asthma model group, the high, middle, low concentration, and dexamethasone group VEGF contained in the asthma model group. The amount of P0.05?; in dexamethasone group, the content of VEGF in the high concentration group was more than that of the high concentration group. There was no statistical difference between the three groups. P0.05) the pulmonary histomorphology after.2.2.3HE staining: the asthmatic model group: the proliferation of the basal layer cells in the bronchial wall and the surrounding lung tissue, the thickening of the smooth muscle, the disorder of the arrangement of the smooth muscle, the exfoliation of epithelium and even the deficiency. For example, a large number of exudate mucus, secretions, and obvious inflammatory cell infiltration were seen in the cavity. In the blank control group, the bronchus, the structure of the lungs were normal, the thickness of the bronchial smooth muscle was not abnormal, the cell regulation, and no obvious inflammatory cell infiltration. Compared with the model group, the VEGF results of.2.2.4 lung tissue were improved in different degree compared with the model group. The total integral light density value (IOD) of each group showed that the IOD in the model group of asthma was significantly higher than that in the blank control group, and the IOD of the VEGF protein was significantly higher than that in the control group. There was a statistical difference between the two groups (P0.01); the low concentration group was more than the asthma in the traditional Chinese medicine. The IOD of VEGF protein decreased significantly in the model group, and there was a statistical difference (P0.01). The IOD value of VEGF in the dexamethasone group was significantly lower than that in the asthma model group. The difference between the two groups was statistically significant (P0.01); there was no statistical difference between the dexamethasone group and the Feng Yu Chuan prescription, the IOD value of the high concentration group VEGF was not statistically different? P0.05).2.3 conclusion: VEGF may pass A certain signal pathway is involved in the occurrence and development of airway remodeling in asthma. The search wind and asthma formula can inhibit airway remodeling by downregulating VEGF.

【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R272

【相似文献】