穴位贴敷诱发的接触性皮炎对哮喘复发及血清IL-4、IFN-γ影响的研究
本文选题:穴位贴敷 + 哮喘 ; 参考:《南京中医药大学》2017年硕士论文
【摘要】:目的:观察穴位贴敷诱发的接触性皮炎对支气管哮喘复发及血清细胞因子IL-4、IFN-Y含量影响。方法:选取2016年6月至8月于江苏省中医院针灸康复科夏季穴位贴敷门诊接受治疗的支气管哮喘患者,采用本院穴位贴敷制剂进行贴敷治疗,穴位贴敷治疗过程中出现接触性皮炎的患者为有接触性皮炎组,未出现接触性皮炎的患者为无接触性皮炎组,有接触性皮炎组20人,无接触性皮炎组21人。分别记录哮喘患者治疗前和治疗结束后3个月、6个月及治疗前1年同时期哮喘ACT评分及AQLQ各项评分,治疗前后留取患者静脉血,采用ELISA法检测治疗前后血清IL-4、IFN-γ含量的变化,分析两组患者各项评分及细胞因子含量差异性;采用免疫组化双染法标记接触性皮炎皮损标本Th2细胞,观察其分布特点。结果:(1)临床疗效结果:①有接触性皮炎组治疗结束后3个月和6个月同治疗前同期相比ACT评分升高差异具有统计学意义(p0.05);无接触性皮炎组治疗后3个月与治疗前同期相比ACT评分升高差异有统计学意义(p0.05),而治疗后6个月与治疗前同期相比ACT评分差异无统计学意义(p0.05);②两组患者经穴位贴敷治疗后3个月相比治疗前同期AQLQ活动受限评分上升差异有统计学意义(p0.05),治疗后6个月与治疗前同期相比时差异均无统计学意义(p0.05);③两组患者经穴位贴敷治疗后3个月与6个月相比治疗前同期AQLQ哮喘症状评分、AQLQ心理状况评分、AQLQ对自身健康关心评分均有所上升差异具有统计学意义(p0.05);④两组患者经穴位贴敷治疗后3个月相比治疗前同期AQLQ刺激源反应评分均上升差异具有统计学意义(p㩳0.05),两组患者治疗后6个月与治疗前同期相比差异无统计学差异(p0.05);(2)血清细胞因子检验结果与免疫组化结果:①有接触性皮炎组治疗前后相比血清IL-4含量下降有统计学意义(p0.05),无接触性皮炎组治疗前后相比血清IL-4含量下降无统计学意义(p0.05)。两组患者治疗前后血清IFN-γ含量下降均无统计学意义(p0.05)。②穴位贴敷诱发的接触性皮炎中Th2细胞主要分布于真皮血管周围,分布数量和接触性皮炎的特征相关。结论:(1)穴位贴敷治疗哮喘有无接触性皮炎均可控制哮喘发作,诱发接触性皮炎时其控制哮喘发作的作用持续时间更持久。(2)穴位贴敷治疗哮喘有无接触性皮炎均有改善哮喘患者心理状态的作用。(3)穴位贴敷治疗哮喘有无接触性皮炎对哮喘患者对刺激源反应敏感性的调节作用不明显,仅在短期内有一定作用。(4)穴位贴敷治疗哮喘可能是通过降低哮喘患者血清IL-4、IFN-y含量从而改善哮喘发作情况,诱发接触性皮炎比无接触性皮炎对IL-4含量的下降作用更明显。(5)Th2细胞参与了穴位贴敷治疗哮喘诱发的皮肤接触性皮炎。
[Abstract]:Aim: to observe the effect of contact dermatitis induced by acupoint application on the recurrence of bronchial asthma and the level of serum cytokine IL-4 and IFN-Y. Methods: from June to August 2016, the patients with bronchial asthma treated by acupoint application in summer in Department of Rehabilitation of Acupuncture and moxibustion, Jiangsu Provincial Hospital of traditional Chinese Medicine, were treated with acupoint application preparation in our hospital. Contact dermatitis was found in the patients with contact dermatitis, non-contact dermatitis, 20 contact dermatitis and 21 non-contact dermatitis. ACT scores and AQLQ scores of asthma were recorded before treatment, 3 months after treatment, 6 months after treatment and 1 year before treatment. The venous blood samples were collected before and after treatment, and the changes of serum IL-4 and IFN- 纬 levels before and after treatment were detected by Elisa. The difference of the score and cytokine content between the two groups was analyzed. Th2 cells were labeled with immunohistochemical double staining method to observe the distribution of Th2 cells in the skin lesions of contact dermatitis. Results: (1) there were significant differences in ACT score between 3 months and 6 months after treatment and 3 months after treatment in non-contact dermatitis group (p0.05), and 3 months after treatment in non-contact dermatitis group as compared with before treatment (p0.05), while in non-contact dermatitis group there was a significant difference in ACT score between 3 months and 6 months after treatment (p0.05). There was significant difference in ACT score between the two groups (p0.05), but there was no significant difference in ACT score between the two groups after 6 months of treatment and before treatment (p0.05). The AQLQ activity in the two groups was significantly higher than that in the control group after 3 months of acupoint application (p0.05). There was significant difference in motor restriction score (p0.05). There was no significant difference between the six months after treatment and the same period before treatment (p0.05). There was no significant difference between the two groups after treatment (p0.05). The patients in the two groups were treated with acupoint application for 3 months and 6 months after treatment compared with the same period before treatment AQLQ asthma. Asthma symptom score AQLQ psychological status score and AQLQ scores on their own health care were significantly different (p0.05) after acupoint application treatment for 3 months after treatment AQLQ stimulation source response scores were higher in the two groups than in the same period before treatment. There was no significant difference in serum cytokines between the two groups 6 months after treatment and the same period before and after treatment (p0. 05); (2). The results of serum cytokines test were compared with immunohistochemical results before and after treatment in the contact dermatitis group. The level of IL-4 in serum decreased significantly (p0.05), but the level of IL-4 in non-contact dermatitis group was not significantly decreased compared with that in non-contact dermatitis group (p0.05). The decrease of serum IFN- 纬 level in both groups was not statistically significant (p0.05). Th2 cells were mainly distributed around dermis vessels in contact dermatitis induced by acupoint application (p0.05). The distribution of Th2 cells was correlated with the characteristics of contact dermatitis. Conclusion: (1) the treatment of asthma with or without contact dermatitis can control the attack of asthma. (2) acupoint application can improve the psychological state of asthmatic patients with or without contact dermatitis. The effect of dermatitis on the sensitivity of asthmatic patients to stimuli was not obvious. Only in the short term. (4) the treatment of asthma with acupoint application may be by reducing the level of IL-4 and IFN-y in the serum of asthmatic patients to improve the asthma attack. Compared with non-contact dermatitis, the decrease of IL-4 was more obvious. (5) Th2 cells were involved in the treatment of skin contact dermatitis induced by asthma.
【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】:2017
【分类号】:R246.1
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