【作者】 乔赟；

【导师】 周小青；

【作者基本信息】 湖南中医药大学 ， 中医诊断学， 2012， 博士

【摘要】 目的：揭示“肺鼻同治”及痰瘀伏肺的科学内涵,探讨龙脷平喘汤抗痰瘀证小儿哮喘气道炎症的作用机制。方法：1、动物分组：72只小鼠、48只大鼠按体重性别分别分为空白组、模型组、地塞米松组、龙脷平喘汤高、中、低剂量组,每组12只、8只；2、造模：空白组用生理盐水ip和雾化激发,其余各组ipOVA致敏和雾化激发;3、给药方法：小鼠、大鼠龙脷平喘汤高、中、低剂量分别为105.6g·kg·d、52.8g·kg·d、26.4g·kg·d和74.8g·kg·d、37.4g·kg·d、18.7g·kg·d,小、大鼠地塞米松剂量3mg·kg·d、1mg·kg·d, ig容量分别为20ml/kg和15ml/kg,连续1周。结果：1、痰瘀证哮喘模型造模成功。2、鼻炎粘膜与肺组织具有共同的炎性反应机制、相似的病理形态学改变。3、模型组肺组织中见大量炎性细胞渗出和浸润,气管壁结构破坏,上皮脱落,泡壁毛细血管扩张、充血。4、龙删平喘汤有效控制鼻炎和哮喘症状,降低外血周EOS浓度、延长引喘潜伏期。5、龙脷平喘汤有效提高FasmRNA表达,降低Bcl-2mRNA表达,诱导炎症细胞凋亡;上调IFN-γ,下调IL-4,逆转IFN-γ/IL-4比例失调；降低全血粘度和红细胞压积指标。结论：1、论证了肺鼻同病、“肺鼻同治”的科学性；2、痰瘀伏肺是小儿哮喘病理演变的核心,气道炎症为小儿哮喘的关键病理机制,痰瘀伏肺的实质涵盖了气道炎症,气道炎症为痰瘀伏肺病理机制中的一个重要环节,阐述了痰瘀伏肺及其与气道炎症的内在本质,部分揭示了痰瘀伏肺的科学内涵。3、龙脷平喘汤抗痰瘀证小儿哮喘气道炎症的作用机制与其促进炎症细胞凋亡,逆转IFN-γ/IL-4平衡失调,纠正血液循环障碍相关更多还原

【Abstract】 Objective:To reveal the scientific connotation of phlegm and blood stasis stagnating lung、treating lung and nose disease simultaneously in the pediatric asthma and allergic rhinitis, investigate the effect mechanism of anti-airway inflammation of asthma in children with phlegm and blood stasis syndrome of Longli Pinchuan Tang.Research methods:1.Group division:72mice、48rats were respectively divided into blank group、 model group、dexamethasone group and Longli Pinchuan Tang high、medium and low dose group by weight and gender, with12mice、8rats each group.2.Modeling:Blank group was intraperitoneal injected and atomized excitation with saline water, other groups were sensitized by injecting the fresh albumin and aluminum hydroxide solution and atomized excitation with OVA as allergen.3. Medication method:The dose of Longli Pinchuan Tang high、medium and low of the mice and rats were respectively105.6g·kg·d、52.8g-kg-d.26.4g-kg-d and74.8g·kg·d、37.4g·kg·d、18.7g·kg·d,the dose of dexamethasone of the mice and rats were respectively3mg-kg-d、1mg·kg-d, ig capacity were respectively20ml/kg和15ml/kg,for one week.Result:1、we successfully replicated the models of asthma with phlegm and blood stasis syndrome with OVA as allergen.2、Rhinitis mucosa and lung tissue had the common inflammatory reaction mechanism and the similar pathologic morphological changes between the nasal mucosa and lung tissue of asthmatic rat.3、a large number of inflammatory cells exudation and infiltration in the lung tissues of model group,the bronchial wall structure was destroyed, epithelium shedding, alveolar wall capillary dilation congestion;4、Longli Pinchuan Tang effectively controled allergic rhinitis and asthma symptoms, reduce peripheral blood EOS concentration,significantly prolonged the latent period of asthma;5、Longli Pinchuan Tang effectively improved the expression of FasmRNA, reducing the expression of Bcl-2mRNA, induced apoptosis of inflammation cells, significantly up-regulate IFN-y level,downregulate IL-4level,reverse IFN-γ/IL-4ratio imbalance, rapidly correct abnormal elevation of the whole blood viscosity and hematocrit of asthmatic rats. Conclusion:1、The results demonstrated the scientific nature of the same pathological changes of both lung and nose、treating lung and nose disease simultaneously in the pediatric asthma and allergic rhinitis;2、The study suggested that the main pathological mechanisms of children in asthma in onset stage were invasion of exogenous pathogens、the same pathological changes of both lung and nose、phlegm and blood stasis stagnating lung, expounded that phlegm and blood stasis stagnating lung and its the inherent essence relationship between phlegm and blood stasis stagnating lung and airway inflammation, revealed part of the scientific connotation of phlegm and blood stasis stagnating lung;3、The effect mechanism of anti-airway inflammation of asthma in children with phlegm and blood stasis syndrome of Longli Pinchuan Tang was related to promoting inflammation cell apoptosis,reversing IFN-γ/IL-4ratio imbalance, correcting blood circulation disorders.更多还原