【作者】 韩冰虹；

【导师】 孙伟正；

【作者基本信息】 黑龙江中医药大学 ， 中医内科学， 2004， 博士

【摘要】 [目的] 为规范过敏性紫癜的中医药研究，建立相关的实验动物模型和探讨其临床症状分级量化标准。 [方法] 1．建立过敏性紫癜实验动物模型：以麦胶蛋白作为饮食抗原，加用印度墨水封闭网状内皮系统的动物造模方法，使模型小鼠在网状内皮系统清除功能缺陷的前提下，持续抗原刺激粘膜免疫系统，建立HSP实验动物模型。 2．“化斑颗粒剂”防治过敏性紫癜的实验研究：通过对过敏性紫癜模型小鼠镜下血尿、尿蛋白定量和RES功能、CIC、免疫病理等指标的观察，以甲氰咪胍作为对照药物，进行不同剂量“化斑颗粒剂”对过敏性紫癜防治作用的研究。 3．过敏性紫癜症状分级量化标准的探讨：按中药新药临床研究指导原则的要求，采用专家评分法，筛选出主要临床指标。根据主症和次症在证侯诊断中的贡献大小，确定其权重和进行可靠性评估。然后，判断病情的轻、中、重程度，制定症状分级量化标准。 [结果] 1．成功地建立了HSP实验动物模型。 2．动物实验证明，化斑颗粒剂治疗HSP的药效学特点，可能在于对HSP的免疫调节上；中西药联合应用，预防为主，防治结合是治疗和防治HSP肾损伤的关键。 3．确定了HSP实热证的症状分级量化标准和其病情程度的界限。 [结论] 1．麦胶蛋白IgA肾病模型可以作为HSP实验动物模型。 2．化斑颗粒剂防治HSP有肯定的疗效，对HSP的免疫调节可能是其作用机制之一。 3．制定HSP中医临床症状分级量化标准，为中医药治疗HSP研究黑龙江中医药大学博士学位论文的规范化奠定了基础。更多还原

【Abstract】 Objective:In order to make the study on Henoch-schonlein purpura(HSP) of TCM standardization,establish the experimental animal model and discuss its clinical symptomatic grading and quantifying standards. Methods:i)Establishing the animal model of HSP :Gliadin being taken as food antigen,meanwhile reticuloendothelial system being blocked by India ink,these two methods were applied to make mouse under the condition of clearance deficiency in reticuloendthelial system and mucosal immunological system continously stimulated ,so HSP animal model was finished.ii) Experimental study on HSP prevented and treated with huaban granule:Different dosages huaban granule was applied to prevent and treat HSP,indexes such as microscopic hematuria,quantitative examination of urinary protein,RES function,CIC and immunopathology,etc.were tested,the control group was given Cimetidine.iii)Discussion on the symptomatic grading and quantifying standards of HSP:Applying the method of experts’ evaluation,screening the main clinical indexes according to instructive principle of clinical study on traditional and new Chinese medicine,defining their weight and making estimation about their reliability based on the contribution of main and minor symptoms,then judging patient’s condition and classifying into three grades :light,middle and severe,making the symptomatic grading and quantifying standards.Results:i)HSP model was established successfully.ii)The pharmacodynamic characteristic of HSP treated with huabangranule might be the regulation on the immunological efffect,thekey to prevent and treat injury of kidney induced by HSP wascombing prevention and treatment,prevention was the first,Chineseherbs and Westernal medicine were combined to apply in theclinical treatment of HSP.iii) The symptomatic grading and quantifying standards of HSPbelonged to heat of excess type was set up,the patient’s conditionwas classified clearly.Conclusion:i)IGA nephrosis model caused by gliadin can be taken as the modelof HSP.ii)Huaban granule can effectively prevent HSP and the regulationon immunological effect maybe one of the machanism.iii)The making of symptomatic grading and quantifying standardsprovides the basis for the standardization of clinical study on HSP.更多还原