黄芩汤预防和治疗变态反应病的实验研究

【作者】 赵鲲鹏；

【导师】 傅延龄；

【作者基本信息】 北京中医药大学 ， 中医临床基础， 2002， 硕士

【摘要】 变态反应病是指一切由变态反应机制导致的疾病。近年来，随着人类生活方式的改变，变态反应病的发病率又有逐年上升的趋势。变态反应病的发病因素较多，病理生理学机制复杂，有些发病机制迄今仍未明确。西医治疗变态反应病疗效虽然满意，但难以克服副作用多、复发率高的缺点，且临床上缺乏有效的预防药物。中医药具有安全、高效的特点，且能综合调整人体机能，因而很受重视。本研究在系统地整理古今文献的基础上，结合变态反应病的病因病机特点和导师的临床经验，对黄芩汤（HuangQin Tang elements compound,以下简称为HEC）治疗变态反应病的理论基础和现代医学机制作了较为深入的研究。并从黄芩汤中抽取每一味药的抗变态反应的主要功效成分来进行再配伍。观察其疗效以及与原方的差异，从而探寻有效的预防变态反应药物。本课题研究分为理论研究和实验研究两个部分。理论研究首先探索了现代医学对变态反应病的认识，防治思路及最新研究进展。其次探讨了中医药防治变态反应病的防治思路、辨证规律、专病专方研究以及其它治疗手段。对中医药防治变态反应病的优势和不足都进行了分析。然后对黄芩汤的古今文献进行了分析、归纳。对黄芩汤防治变态反应病的机理进行了探讨。实验研究主要进行了两个方面的工作。一、制剂学研究：首先规范黄芩汤的剂量、药源、煎煮方法，对加水量、煎煮时间、火候都进行了精确的控制；其次采用高效液相法对各功效成分的含量进行测定，实测得每100ml黄芩汤中含黄芩甙0.789g、白芍总甙0.420g、甘草酸0.600g，与国家2000版药典符合；然后依照此比例，配制功效成分小复方。二、药效学研究：（1）HEC对巴豆油致小鼠耳廓肿胀的作用，结果表明：黄芩汤各组对巴豆油所致的小鼠耳廓炎症均具有显著的抑制作用，与对照组比较，功效成分组二有显著差异, P＜0.05。（2）HEC对大鼠毛细血管通透性增加的抑制作用，结果表明黄芩汤各组对组胺所致的毛细血管通透性增加均有一定的抑制作用，其中以功效成分组二较明显,与对照组比较, P＜0.05。（3）HEC对药物所致动物皮肤瘙痒的作用，结果表明，黄芩汤各组均能明显提高组胺致痒豚鼠的致痒阈，其中以功效成分组二较明显, 与对照组比较, P＜0.01.（4）HEC对小鼠耳异种被动皮肤过敏的影响(PCA)，结果表明，黄芩汤对抗原引起的小鼠耳异种被动皮肤过敏均有一定的抑制作用。与对照组比较，功效成分组一有显著差异，P＜0.01。（5）HEC对组胺喷雾引起豚鼠哮喘的影响，结果显示，黄芩汤各组均能延长由组胺喷雾所致豚鼠哮喘的引喘潜伏期，与对照组比较，功效成分组二有显著差异, P<0.05。（6）HEC对致敏引起豚鼠哮喘的影响，结果显示，黄芩汤各组均能延长由过敏所致豚鼠哮喘的引喘潜伏期，与对照组比较，功效成分组二有显著差异，P＜0.05。（7）HEC对DNCB致敏小鼠免疫器官的影响，三个观察<WP=3>组对DNCB致敏小鼠胸腺指数和脾脏指数组均有显著升高作用。与对照组比较，功效成分组二有显著差异，P＜0.05。结论：黄芩汤具有很好的抗炎，抗过敏作用。其作用主要与其中的黄芩甙、甘草酸、白芍总甙有关。在实验中，功效成分组与黄芩汤水提物组的效果大致相当。且与对照组相比较都有显著差异。显然：功效成分组在防治变态反应病方面可以替代黄芩汤使用。采用这种二次配伍的功效成分小复方不仅可以保证疗效，而且可以减少服药量，减轻肝肾和胃肠负担，因而在变态反应病的防治方面极具优势。更多还原

【Abstract】 Allergic disease is a kind of disease which can be caused by any allergic mechanism. These days, accompanied with the varied life style of people, the incidence of allergic disease has a rising tendency year by year. Allergic disease has many origins, and the pathophysiological mechanisms are so complicated that some mechanism have not known up to now. Although western medicine has good curative effect, it has many side effects. A kind of medicine which can be used to prevent allergy is in great need. Chinese medicine has the characteristics of safe and effective, furthermore, it can adjust the whole function of body synthetically. This research has arranged all the document, at the same time, based on the characteristics of allergic disease and the clinical experience of Porofessor Fu Yanling. We have studied the theory foundation and pathophysiological mechanisms of allergic disease. As a result, we choose Scutellaria Decoction (Huangqin Tang) to cure the disease. In order to improve the curative effect, we have arranged to take each main effective ingredient to fill a new prescription. Thereby, we hope to find a safe and effective medicine to cure and provent allergic disease.This paper has two parts: theoretical study and experimental research.The former includes there parts: first, we have discussed the new view of modern medicine on allergic disease, prevention and cure approach, and the newest study progress. Then, we have discussed the treatment based on the syndrome differentiation and other treatment of chinese medicine. On this foundation, we have analyzed all the superiority and insufficient of chinese medicine on the treatment of allergic disease. After that, we have analyzed all the literature about Scutellaria Decoction, and discussed the prevention and cure mechanism of Scutellaria Decoction on the treatment of allergic disease.Experimental research has two parts: Chinese Materia Medica preparation research and the pharmacodynamics study of Scutellaria Decoction on allergic disease. The preparation research includes there parts: first, we have standarded the dosage, source of each Chinese Materia Medica, and the method of making herb decoctions. Then, we have measured each main effective ingredient of Scutellaria Decoction by HPLC. The result is that every 100 ml contained BaiCalin 0.789g, Paeoniflorin 0.420g, Glycyrrhizic acid 0.600g . This result is similar to National Medicine Law. After that, we have produced composite formula of ingredient according to the result.The pharmacodynamics study of Scutellaria Decoction on allergic disease: ① The auricular inflammation of the animal caused by DMSO and croton oil, the result indicated that the effective ingredient group Ⅱ can reduce the auricular inflammation markedly. (Compared with the control group, P＜0.05). ② In the animal skin capillary permeability test, its effect of anti-exudation was observed obviously. The result indicated that the effective ingredient group Ⅱ can reduce the exudation markedly. (Compared with the control group, P＜0.05 ). ③ In the the animal skin pruritus test, the results indicated that the effective ingredient group Ⅱ can inhibit the animal <WP=5>skin pruritus induced by hitamine significantly. (Compared with the control group, P＜0.01). ④ In the passive cutaneous anaphylaxis test, the result indicated that the effective ingredient group Ⅱ can inhibited the passive cutaneous anaphylaxis greatly. (Compared with the control group, P＜0.01). ⑤ In the bronchospasm test caused by the mixture of histamine and acetylcholine, the result indicated that each group of HEC had significant antagonistic effect on the cough caused by mixture of histamine and acetylcholine in normal guinea pigs and prolong the latent period of asthma significantly in guinea pigs. (Compared with the control group, P＜0.01). ⑥ In the bronchospasm test caused by egg-albumin induced sensitization，the result indicated that each group of HEC had significant antagonistic effect ,and prolong the latent period of asthma significantly in更多还原