用户名: 密码: 验证码:
清胆泻热法治疗鼻渊机理研究
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的:通过动物实验在分子生物学、形态学等方面,从基因水平上探讨清胆泻热法治疗鼻渊的作用机制,从而更准确地指导临床用药。
     方法:将健康SD大鼠随机分为①空白组;②模型组:③中药低剂量组;④中药中剂量组;⑤中药高剂量组;⑥青霉素Ⅴ钾组。急性鼻-鼻窦炎模型依据叶菁报道的方法造模。造模7天后,空白组和模型组按5ml·kg~(-1)·d~(-1)灌服无菌水,其余各组分别灌服相应的药物。从造模第1天开始,观察动物一般情况变化,pH值、体温及体重变化等,着重观察鼻部症状、鼻分泌量。用药7天后,处死动物,每组随机选取6只大鼠。用ELISA法检测各组大鼠血清中C-反应蛋白(CRP)浓度。在超净工作台上取鼻黏膜后,提取mRNA,并逆转录为cDNA,用RT-PCR法测定白细胞介素2mRNA(IL-2 mRNA)、白细胞介素4 mRNA(IL-4 mRNA)、白细胞介素10 mRNA(IL-10 mRNA)、干扰素-γ(IFN-γmRNA)的表达.在透射电镜下观察鼻黏膜的病理形态变化。
     结果:
     1.模型组大鼠鼻腔分泌物pH值与空白组相比,有显著性升高(P<0.01)。用药7天后,各治疗组药物均能降低鼻腔分泌物pH值。其中以中药低剂量组效果最明显(P<0.01)。
     2.模型组大鼠血清CRP浓度与空白组相比,有显著性升高(P<0.01)。用药7天后,各治疗组药物均能降低血清CRP浓度。其中以中药低、中剂量组效果最明显(P<0.01).
     3.用药7天后,除中药高剂量组外,其余各治疗组药物均能使鼻黏膜组织IL-2 mRNA及IL-10 mRNA的相对表达量升高,以中药低剂量组及青霉素Ⅴ钾组效果最明显(P<0.01)。
     4.用药7天后,除中药高剂量组外,其余各治疗组药物均能使鼻黏膜组织IL-4 mRNA的相对表达量升高,以中药低剂量组效果最明显(P<0.01)。
     5.用药7天后,各治疗组物均能使鼻黏膜组织的IFN-γmRNA相对表达量降低,以中药低、中剂量组效果最明显(P<0.01)。
     6.用药7天后,透射电镜观察显示:除中药高剂量组外,其余各治疗组药物均能使鼻黏膜纤毛形态结构逐步恢复正常,以中药低、中剂量组效果最明显。
     结论:
     1.清胆泻热可以降低鼻分泌物pH值至接近正常值,以保证保鼻腔内环境的协调。
     2.清胆泻热可以降低血清CRP浓度,抑制或杀死病原微生物,消除炎症反应.
     3.清胆泻热可以增强鼻黏膜IL-2 mRNA的表达,作用于T细胞,增强细胞免疫,提高机体抗感染能力.
     4.清胆泻热可以增强鼻黏膜IL-4 mRNA和IL-10 mRNA的表达,发挥其抗炎活性.
     5.清胆泻热可以抑制鼻黏膜IFN-γmRNA的表达,从而抑制相关炎性因子的合成。
     6.清胆泻热可以减轻内质网扩张、线粒体肿胀,促进鼻黏液纤毛传输系统恢复正常.
     我们推测吉雷开窍汤可能以清胆泻热法通过改善机体内环境:扶助正气、驱邪外出,发挥治疗作用。
Objective:To study the mechanism of action about the method of clearing gallbladder and purging heat to Bi Yuan at the gene level on molecular biology and molecular biology by animal experiment,then to guide the clinical medication more accurately.
     Methods:Group the healthy SD rats into the following six parts randomly:blank group,model group,Ji Lei Kai Qiao Tang low-dose group,Ji Lei Kai Qiao Tang middle-dose,Ji Lei Kai Qiao Tang high-dose and penicillinum v potassium group. According to the method reported by YE Jing we made the Acute Rhinosinusitis model.In the following seven days we drenched the blank group and the model group 5ml·kg~(-1)·d~(-1) with the sterile water(SW),and the other four groups with corresponding medicine.All these days we observed the changes of the rats about the pH value,body temperature,and body weight,especially the nose symptom and secretory volume. After seven days we killed these rats and chose six in each group randomly.We measured the C-reactive protein(CRP) concentration in the SD rats' blood serum using the ELISA method.First we took out of the mucous membrane of nose at the superclean bench,after that we extracted the mRNA and reversed transcription to cDNA,then we measured the expressions of IL-2 mRNA,IL-4 mRNA,IL-10 mRNA and IFN-γmRNA by using the RT-PCR method.At last we observed the morphologic changes of the mucous membrane of nose under the electron microscope.
     Results:
     1.Comparing with the blank group,the pH value of the model group's nasal cavity secretion substance has improved significantly(P<0.01).The nasal cavity secretion substance's pH values of all the therapy groups have declined,especially the Ji Lei Kai Qiao Tang low-dose group.
     2.Comparing with the blank group,the blood serum CRP concentration of the model group has improved significantly(P<0.01).The blood serum CRP concentrations of all the therapy groups have declined especially the Ji Lei Kai Qiao Tang low-dose group and the middle-dose group(P<0.01).
     3.After seven days medication,except the Ji Lei Kai Qiao Tang high-dose group, the expressions of IL-2 mRNA and IL-10 mRNA of all the therapy groups have improved especially the Ji Lei Kai Qiao Tang low-dose group and the penicillinum v potassium group(P<0.01).
     4.After seven days medication,except the Ji Lei Kai Qiao Tang high-dose group, the expressions of IL-4 mRNA of all the therapy groups have improved especially the Ji Lei Kai Qiao Tang low-dose group(P<0.01).
     5.After seven days medication,the expressions of IFN-γmRNA of all the therapy groups have declined especially the Ji Lei Kai Qiao Tang low-close group and the middle-dose group(P<0.01).
     6.After seven days medication,through the transmission electron microscope we find that except the Ji Lei Kai Qiao Tang high-dose group,the membrane of nose cilia of all the therapy groups have returned to normal gradually especially the Ji Lei Kai Qiao Tang low-dose group and the middle-dose group.
     Conclusion:
     1.By falling the Nasal discharge pH value to normal,clearing gallbladder and purging heat can make the internal environment concordance of the nasal cavity.
     2.Clearing gallbladder and purging heat can reduce the CRP concentration of the blood serum,depression or kill the causative organism,and eliminate the inflammatory reaction.
     3.Clearing gallbladder and purging heat can strengthen the expression of the nasal mucosa IL-2 mRNA,act on the T cell to strengthen the cell immunity and improve the anti-infection ability of the organism.
     4.Clearing gallbladder and purging heat can strengthen the expression of the nasal mucosa IL-4 mRNA and IL-10 mRNA,as a result to educe the anti-inflammatory activity.
     5.Clearing gallbladder and purging heat can restrain the expression of the nasal mucosa IFN-γmRNA,as a result to restrain the synthesization of the correlated inflammatory factor.
     6.Clearing gallbladder and purging heat can lighten the broaden of the endocytoplasmic reticulum and the engorgement of the mitochondria,as a result to promote the nasal Mucus cilia transmission system to return to normal.
     We suppose that Ji Lei Kai Qiao Tang can improve organism internal environment by the method of clearing gallbladder and purging heat,strengthening vital qi to eliminate pathogenic factor.
引文
1.Anon JB,Jacobs MR,Poole MD,et al.Antimicrobial treatment guidelines for acute bacterial rhinosinusitis.Otolaryngol Head Neck Surg,2004,130(1 Suppl):1-45
    2.Spector S J,Bemstein 1 L,Li JT,et al.Parameters for the diagnosis and management of sinusitis.J Allergy Clin Immunol,1998,102(6 Pt 2):S107-144.
    3.董金叶,李娜,时光刚.鼻窦炎与解剖异常的相关性研究.山东大学耳鼻喉眼学报,2007,25(5):436
    4.杨宇华.中医药治疗慢性鼻窦炎复方分析和证治规律研究.河北中医,2007,9(2):175
    5.江银安.鼻舒丸制备与临床应用.中国当代医学,2006,5(14):122
    6.叶菁,余洪猛,李华伟,等.运用Merocel止血棉与肺炎链球菌建立大鼠急性鼻腔鼻窦炎模型.中国眼耳鼻喉科杂志,2006,6(4):214
    7.Usama G,Sung WY,Sue B,et.CS7BV6 and BALB/c mice have simil-neutrephil response to acute streptococcus pneumoniae sinus infections.Arch Otolaryngol Head Neck Stag,2001,127:985-990
    8.徐淑云,卞如濂,陈修主编.药理实验方法学.第三版.北京:人民卫生出版社,2005:1861
    9.黄红彦.慢性鼻窦炎患者钩突组织的超微结构观察.临床耳鼻咽喉科杂志,1997,11(5):206-208
    10.刘静溪,孙海波.鼻炎的动物模型国内研究进展.中国中医药杂志,2007,5(4):35-37
    11.Menzies-Cow A,Robinson DS.Eosinophilis eosinop:hilis cyto-kines(interleukin-5)and antieosinophil ic therapy in asthma[J].Curr pin Med,2002,8:33-38.
    12.knowlton CD,McGregor GW,How and when the mucous membrance of the maxillary sinus regenerates.Arch Otolaryngol 1928,8:647-656
    13.Coates GM,Ersner Ms.Regeneration of the mucous membrane of the frontal sinus after its surgical removal(in the dog).Arch Otolaryngol 1930,12:642-648
    14.Hiding A.Experimental surgery of the nose and sinuses.Arch otolaryngol,1933,17:321-327
    15.Hiding A.Experimental sinus surgery:effect of operative windows on normal sinuses.Ann Otol Rhinol laryngol,1941,50:379-392
    16.Johansson P,Kumlien J,Soderlund K,Hultman E,Experimental acute sinusitis in rabbits. Acta Otolaryngol(stockh),1988,106:460-467
    17.Drettner B,Johansson P,Kumlien J.Experimentally induced sinusitis:the importance of casomotor.Arch Otorhinolaryngol,1989,246:315-317
    18.Bomer K,Brichta A,K Baroody F,et al.A mouse model of acute bacterial rhinosinusitis,Arch Otorhinolaryngol Head Neck Surg.1998,124:1227-1232
    19.谢民强.重组活化基因1缺陷鼠和C57BL/6小鼠急性细菌性鼻窦炎模型的比较研究.中华耳鼻咽喉科杂志,2002,37(1):23-26
    20.王鹏举,沈莹.兔鼻源性急性鼻窦炎动物模型.临床耳鼻咽喉头颈外科杂志,2007,21(8):366
    21.Steven C.Marks.MD.Acute sinusitis in the rabbit Model.Histologic Analysis Laryngoscope,1998,3:320-325
    22.Abraham Jacob,MD;Brian T.Faddis,PhD;Richard A,cholc,MD,PhD.Chronic bacterial rhinosinusitis:description of a mouse model.Arch Otolaryngol Head Neck Surg 2001,127:657-663
    23.Y.Ge,T Tsukatani,T Nishimura,M Furukawa and T Miwa.Cell Death of Olfactory Receptor Neurons in a Rat with Nasosinusitis Infected Artificially with Staphylococcus[J].Chem Senses,2002,27(6):521-527
    24.Y.Ge,T Tsukatani,T Nishimura,M Furukawa and T Miwa.Cell Death of Olfactory Receptor Neurons in a Rat with Nasosinusitis Infected Artificially with Staphylococcus[J].Chem Senses,2002,27(6):521-527
    25.刘永革.鼻腔pH值的测定.中国中西医结合耳鼻咽喉科杂志,2001,9(2):84
    26.Irvin CG.Sinusitis and asthma:an animal model J Allergy Clin Immunol,1992,90:521-533
    27.Kumlien JA,Schiratzki H,Drettner B.BLOOD flow in the rabbit maxillary sinus mucosa.Acta Otolaryngol(stockh) 1985,99:144-53
    28.Hinni ML,Mccaffrey TV,Kasperbauer JL,Early rnucosal changes in experimental sinusitis.Otolaryngol Head Neck Surg.1992,107(4):537-548
    29.Steven C Marks.MD.Acute sinusitis in the rabbit:a new rhinogenic model Laryngoscope,1997,12:1579-1585
    30.Shikani AH.Use of antibiotics for expansion of the Merocel packing following endoscopic sinus surgery.Ear Nose Throat J,1996,75:524-528.
    31.左可军.急、慢性鼻.鼻窦炎的细菌学研究进展.中国眼耳鼻喉科杂志,2006,6(2):126
    32.Meltzere EO,Hamilos DL,Hadley JA,et al.Rhinosinusitis:Establishing definitions for clinical research and patient care.Otolaryngol Head Neck Surg,2004,131(6 Suppl):S1-62
    33.黄帝内经.北京:中国画报出版社,2008:109
    34.王德鉴主编.中医耳鼻咽喉科学.上海:上海科学技术出版社,1985:32
    35.沈金螯.杂病源流犀烛.上海:上海科学技术出版社,1962:624
    36.陈梦雷.济生方·古今图书集成·医部全录(4).北京:人民卫生出版社,1959:1312
    37.宋·赵诘.圣济总录.北京:人民卫生出版社,1982:106
    38.朱震亨.丹溪心法.上海:上海科学技术出版社,1959:287
    39.黄帝内经.北京:中国画报出版社,2008:272
    40.巢元方.诸病源侯论.北京:人民卫生出版社,1955:258
    41.李梃.医学入门.天津:天津科学技术出版社,2000:129
    42.虞抟.医学正传.北京:人民卫生出版社,1981:45
    43.戴原礼.秘传证治要诀及类方.北京:人民卫生出版社,1989:151
    44.费伯雄.医醇剩义.上海:上海科技出版社,1963:35
    45.熊大经.实用中医耳鼻咽喉口齿科学.上海:上海科学技术出版社,2001:211
    46.李云英.耳鼻咽喉科专病中医临床诊治.北京:人民卫生出版社,2000:201
    47.符之武.清窦汤加减治急、慢性鼻窦炎53例小结[J].新中医,1995(S1):50
    48.王涛,崔仁明.自拟清渊汤合氯嘛合剂治疗慢性鼻窦炎200例[J].安徽中医临床杂志,2003,15(5):401
    49.刘永革.六味鼻渊汤治疗慢性鼻窦炎612例[J].中国民间疗法,2004,12(1):39-44
    50.梁巧瑾,吕建刚.藿丹白辛汤治疗慢性鼻窦炎的疗效观察[J].中国初级卫生保健,2003,17(2):86
    51.宋明会.祛风活血法在鼻窦炎治疗中的应用.山东中医杂志,1995,14(4):148-149
    52.金慧鸣.中医药治疗鼻窦炎40例小结.北京中医药大学学报,1995,18(12):61
    53.李洪,高国绪.鼻炎汤治疗鼻炎、鼻窦炎.新中医,2007,39(3):3
    54.宋若会,刘钢,高士俊.滴鼻灵对鼻黏膜纤毛清除率的影响.中国中西医结合耳鼻咽喉科杂志,2005,13(1):17
    55.广东中医学院编.中医方药学.广州:广东人民出版社,1976:71
    56.周大兴,张红霞,李昌煜,等.辛夷油抗慢反应物及其他过敏作用研究初探.中草药,1991,(2):81
    57.高中洪,黄开勋,徐辉碧.黄芩中黄酮类化合物活性的研究进展.中国药学杂志,1998,12:705
    58.[日]西洋芳量.黄芩甙元对人体末梢血淋巴细胞的抗原特异性IL-2反应的影响.国 外医学中医中药分册,1992,3:40
    59.国家中医药管理局《中华本草》编辑委员会.中华本草.上海:上海科技出版社,1999:771
    60.江苏新医学院编.中药大辞典.上海:上海人民出版社,1997:1128-1129
    61.王东方,吴雪萍,干祖望,等.慢性鼻炎鼻腔纤毛输送功能与气虚相关性研究.辽宁中医杂志,1996,23(9):392
    62.黄选兆,汪吉宝,孔维佳主编.实用耳鼻咽喉头颈外科学.第二版.北京:人民卫生出版社,2008:152
    63.顾之燕.呼吸道炎症反应.中华耳鼻咽喉科杂志,2001,36(5):397-399
    64.Polye PW,Wood ham JD.Evaluation of microbiology of chronic ethmoid sinusitis.J Clin Microbiol.1991.29:396
    65.Hartoy B,Degener JE,van Benthem PP.Microbiology of chronic sinusitis in adults:Isolated asolated aerobic anaerobic.Acta O.laryngol(stockh),1995.115:672
    66.Polye PW,Woodham JD.Evaluation of microbiology of chronic ethmoid sinusitis.J Clin Micrnbiol.1991.29:396
    67.王中植,张小柏主编.耳鼻咽喉科治疗学.北京:北京医科大学、协和医科大学联合出版社,1997:413
    68.田勇泉主编.耳鼻咽喉.头颈外科学.第六版.北京:人民卫生出版社,2005:93
    69.王彤,朱瑾编译.急性鼻.鼻窦炎抗生素治疗指南-美国鼻窦变态反应健康协会推荐.国外医学耳鼻咽喉科学分册,2005,29(1):52-53
    70.黄帝内经.北京:中国画报出版社,2008:22
    71.黄帝内经.北京:中国画报出版社,2008:31
    72.明·王肯堂.证治准绳(一)杂病.北京:人民卫生出版社,1991:87
    73.黄帝内经.北京:中国画报出版社,2008:406
    74.隋·巢元方原著,丁光迪主编.诸病源候论校注.北京:人民卫生出版社,1991:1372
    75.黄帝内经.北京:中国画报出版社,2008:365
    76.黄帝内经.北京:中国画报出版社,2008:332
    77.黄帝内经.北京:中国画报出版社,2008:29
    78.黄帝内经.北京:中国画报出版社,2008:243
    79.明·李时珍.本草纲目.北京:中国中医药出版社,1999:323
    80.徐树楠,牛兵古编著.神农本草经.石家庄:河北科学技术出版社,1996:27
    81.明·李时珍.本草纲目.北京:中国中医药出版社,1999:364
    82.樊忠,天铎.实用耳鼻喉科学.济南:山东科学技术出版社,1998.
    83.[英]R欣奇克利夫,等著,陈玉琰,主译.耳鼻喉科学基础.上海科学技术出版社,1985:297
    84.Barone F C,Avin B.White RF.et al.Tumor nectosis factor-α a mediator of focal ischemic brain injury.Stroke.1997,28:1233
    85.汪银凤,叶非常,王名山.功能性鼻窦内窥镜手术对不同型期鼻窦炎鼻黏膜纤毛清除率的影响.临床耳鼻咽喉杂志,2000,14(8):340
    86.鹿道温.中西医临床耳鼻咽喉科学.北京:中国中医药出版社,1998:174
    87.AtsutaS.Ann Otol Rninol Laryngol.1998,107(1):47-51
    88.王荣光.临床鼻科学.石家庄:河北科学技术出版社,1995:47
    89.冯仁丰.急性相和C-反应蛋白.上海医学检验杂志,1999,14-258-260
    90.郑建华.白介素.2研究进展.海峡医学,2006(18)4:1
    91.Malek TR,Bayer AL.Tolerance,not immunity,crucially depends on IL-2.Nat Rev Immunol,2004:4:665-674
    92.张腾龙,谢彦晖,王缨,林果为.白介素2抑制T细胞特异性免疫应答机制的研究.中国实验血液学杂志,2007,15(3):573-574
    93.Gesbert Fet al.J Clin Immun,1998,18:307
    94.张景迎,陈诗书.白介素-2受体及其介导的信号转导.生命的化学,1999(19)3:127
    95.赵武述编著.免疫平衡研究及其临床意义.北京:科学出版社,2005:53
    96.窦肇华,张远强,郭顺根主编.免疫细胞学与疾病.北京:中国医药科技出版社,2004:203
    97.梁雄均,马泽粦,曾雅静.白介素4和17在溃疡性结肠炎发生发展中的作用.右江医学,2005(33)1:6
    98.郝微微,马贵同,张晓峰,等.中药清肠栓对溃疡性结肠炎大鼠白细胞介素4及10mRNA表达的影响.2007(15)3:177
    99.周世新,刘谨,徐永健等.白介素4在Th细胞信号转导机制中的作用.国外医学呼吸系统分册,2005(25)3:182
    100.Wurster AL,Withers D J,Uchida T,et al.Stat6 and IRS-2 cooperate in interleukin-4(IL-4)-induced proliferation and differentiation but are dispensable for IL-4-dependent rescue from apoptosis.Moi Cell Biol,2002,22(1):117-126
    101.任人宾,孙仁宇.白介素-10的抗炎功能及其分子机制.国外医学呼吸系统分册,2005,25(3):175
    102.Goff WL,Johnson WC,Parish SM,et al.IL-4 and IL-10 inhibition of IFN-gamma-and TNF-alpha-dependent nitric oxide production from bovine mononuclear phagocytes exposed to Babesia bovis merozoites.Vet Immunol Immunopathol,2002,84(3-4):237-251
    103.Pousset F,Cremona S,Dantzer R,et ai.IL-10 and IL-4 regulate,type-Ⅰ and type-II IL-1receptors expression on IL-1 beta activated mouse primary astrocytes.J Neurochem,2001,79(4):726-736
    104.Buechler C,Ritter M,Orso E,et al.Regulation of scavenger receptor CD 163 expression in human monocytes and macrophages by pro-and anti-inflammatory stimuli.J Leukoc Biol,2000,67(1):97-103
    105.Leonard WJ.Role ofJak kinases and STATs in cytokine signal transduction.Int J Hematol,2001,73(3):271-277
    106.Cooney RN.Suppressors of cytokine signaling(SOCS):inhibitors of the JAK/STAT pathway.Shock,2002,17(2):83-90
    107.Kile BT,Alexander WS.The suppressors of cytokine signaling(SOCS).Cell Mol Life Sci,2001,58(11):1627-1635
    108.Di Leo V,Yang PC,Berin MC,Perdue MH.Factors regulating the effect of IL-4 on intestinal epithelial barrier function.Int Arch Allergy Immunol,2002,129(3):219-227
    109.Tumpey TM,Cheng H,Yan XT,et al.[J].J Leukoe Biol,1998,63(4):486-492
    110.吴克复主编.细胞通讯与疾病.北京:科学出版社,2006:180
    111.朱幼芙,贺玉凯.干扰素的作用机制.中华肝脏病杂志,2007,(15)11:845
    112.Huang YX,Chert XY,Li Z.The relationship between the gene polymorphism of antiviral protein induced by interferon and the antiviral efectiveness.Guoji Bingduxue Zazhi,2007,14:1-4
    113.Stark GR.How cells respond to interferons revisited:From early history to current complexity.Cytokine Growth Factor Rev,2007,18:419-423
    114.Chelbi-Alix MK,Vidy A,El Bougrini J,et al.Rabies viral mechanisms to escape the IFN system:the viral protein P interferes with IRF-3.Statl,and PML nuclear bodies.J Interferon CytokineRes,2006,26:27 1-280
    115.Tan SL,Katze MG.The emerging role of the interferon-induced PKR protein kinase as a apoptotic efecter:a new face of death.J Interferon cytokine Res,1999,19:543-554
    116.Gabriele L,Ozato K.The role of the interferon regulatory factor(IRF) family in dendritic cell development andfunction.Cytokine Growth FactorRev.2007,18:503-510
    117.Ryman KD,Meier KC,Gardner CL,et al.Non-pathogenic Sindbis virus causes hemorrhagic fever in the absence of alpha/beta and gamma interferons.Virology,2007,[Epub ahead of print]
    118.Chinsangaram J,Piccone ME,Grubman MJ.Ability of foot-and-mouth disease virus to form plaques in cell culture is associated with suppression of alpha / beta interferon.J Viro,1999,73:9891-9898
    119.Le Bon A,Tough DF.Links between innate and adaptive immunity via type Ⅰinterferon.CurrOpinlmmunol,2002,14:432-436
    120.黄文林,朱孝峰主编.信号转导.北京:人民卫生出版社,2005:17
    121.肖良,赵海丹.纤毛的研究进展.海军总医院学报,2006,(19)1:32
    122.张罗,韩德民,王琪.鼻腔黏液纤毛传输系统的组成和纤毛运动状况评估.中国医学文摘耳鼻咽喉科学,2006,(21)3:141
    123.Wanner A,Salathe M,O'Riordan TG.Mucociliary clearance in the airways.Am J Respir Crit Care Med,1996,154(6 Pt1):1868-1902
    124.Widdicombe JH.Regulation of the depth and composition of airway surface liquid.J Anat,2002,201:313-318
    125.Rusznak C,DevaliaJL,Lozewicz S,et al.The assessment of nasal mucociliary clearance and the effect of drugs.Respir Med,1994,88:89-101
    126.Knowles MR,Boucher RC.Mucus clearance as a primary innate defense mechanism for mammalian airways.J Clin Invest,2002,109:571-577
    127.张罗,韩德民,王琪.鼻腔黏液纤毛传输系统功能的评估.中国耳鼻咽喉头颈外科,2006,(13)7:507
    128.韩德民,王向东,周兵,等.鼻黏膜纤毛系统的研究进展.中华医学杂志,2003,(83)2:172
    129.Wanner A,Salathe M,O' Riordan TG.Mucociliary clerance in the airways.Am J Respir Crit Care Med,1996,154:pp 1868-1902
    130.郭仁,张和君,董德祥,等.分子细胞生物学.北京:北京医科大学中国协和医科大学联合出版社,1990:263-265
    131.EvansTC,Nelso DL.The cilia of Paramecium tetraurelia contain both Ca2+-dependent and Ca2+-inhibitable calimodulin-binding proteins.Biochem J,1989,259:385-396
    132.Boucher RC.Human airway ion transport.Part two Am J Respir Crit Care Med,1994,150:581-593
    133.Gatto LA.Cholinergic and adrenergic stimulation of mucociliary transport in the rat trachea.RespirPhysiol,1993,92:209-217
    134.关丽英,许彩民,潘华珍.内质网应激介导的细胞凋亡.生物化学与生物物理进展,2007,34(11):1136
    135.仇万山,陈亦江.线粒体结构、功能和常用研究方法.国际麻醉学与复苏杂志,2007, (28):282
    136.黄帝内经.北京:中国画报出版社,2008:16
    137.黄帝内经.北京:中国画报出版社,2008:398
    138.Olmsted,J.M.D..Claude Bernard,Physiologist.Harper and Brothers Pub lishers,New York and London,1938.
    139.王志均.内环境恒定概念的提出.生物学通报,2007,42(9):56
    140.赵淑兰.内环境稳态与阴阳平衡浅识.国医论坛,2007,22(4):51
    141.Mills R,Bhatt DL.The Yin and Yang of Arterial Inflammation[J].J Am Coil Cardiol,2004,44(1):50-52.
    142.叶子坚.人体内环境pH值的相对稳定及其调节.萍乡高等专科学校学报(自然科学版),1994,4:44
    143.黄帝内经.北京:中国画报出版社,2008:158
    144.黄帝内经.北京:中国画报出版社,2008:164
    145.金·刘完素.素问玄机原病式.北京:人民卫生出版社,1956:25
    146.王明杰.玄府论[J].成都中医学院学报,1985,8(3):1-4
    147.常富业,王永炎,高颖,等.论开通玄府.中国临床康复,2005,9(39):128
    148.刘克林.王明杰教授开通玄府学术思想与用药经验.四川中医,2007,25(11):6
    149.常富业,王永炎,高颖,等.水淫玄府与隐性水肿假说.山东中医杂志,2004,23(11):643-645
    150.张志锋.辨病证论治是中医学基本特点之浅探.中华现代中医学杂志,2007,3(1):39-40
    1.Anon JB,Jacobs MR,Poole MD,et al.Antimicrobial treatment guidelines for acute bacterial rhinosinusitis.Otolaryngol Head Neck Surg,2004,130(1 Suppl):1-45
    2.Spector S J,Bemstein IL,Li JT,et al.Parameters for the diagnosis and management of sinusitis.J Allergy Clin Immunol 1998,102(6 Pt 2):S107-144.
    3.邱建华,乔莉,林颖.头颈耳鼻咽喉外科学进展.2005年临床医学进展回顾,2005
    4.王向东.国外鼻-鼻窦炎的概念和分型方案.国际耳鼻咽喉头颈外科杂志,2006,30(2):144-146
    5.European position paper on rhinosinusitis and nasal polyps.Rhinol Supp,1 2005;(18):1-87
    6.左可军.急、慢性鼻-鼻窦炎的细菌学研究进展.中国眼耳鼻喉科杂志,2006,6(2):126-128
    7.Van Cauwenberge PB.The microbiology of acute and chronic sinusitis and otitis media:a review.EurARShOtorhino l_aryngol,1993,250:83-86
    8.Gwahney JM.Acute community-acquired sinusitis.Clin Inefect Dis.1996,23:1209-1211
    9.Adachi M,Furuta S,Suzuki S,et,7.Bacl al examination of sinusitis using antral puncture and gation.Nippon JibfinkokaGakkai Klliho,2002,105:925-930
    10.Brook I.Acute and chronic frontal sinusitis.Curt Opin Pulm Med,2003,9:171.174.
    11.Almadori G,Bastianinil L,Bistoni F,et al.Microbial flora of nose and plmmasai sinuses in chronic maxillary sinusitis.Rhinology,1986,24:257-264.
    12.Brook I.Bacteriology of chronic maxilary sinusitis in adults.Ann Otol Rifinol Laryngol,1989,98:426-428.
    13.Suzuki K,Nishiyama Y,Sugiyama K,et ol.Recent trends in clinical isolates from p ranasal sinusitis.Acta Otdaryngol suppl,1996,525:51-55.
    14.Ahmed SI,Thompson J,son JM,et al.Studieson the experssionofendothelin,its receptor subtypes,and converting enzylnes in lung cancer and in human bronchial epithelium.AM J RespirCell Mol Biol,2000,22:422-431.
    15.Busaba NY,Siegel N,Salman SD.Bacteriology of non- ic In Uary sinus mucoceles vel-ons chronic sinusitis.Laryngoscope,2000,110:969-971.
    16.Brook I.Microbiology and management ofsinusitis.Jotolaryngol,1996,25:249-256.
    17.彭德嘉,邱建华,黄维国.慢性鼻窦炎的细菌学研究进展.临床耳鼻咽喉科杂志,2006,20(4):187
    18.Schlosser R L,London S D,Gwaltney J M,et al.Microbiology of chronic frontal sinusitis.Laryngoscope,2001,118:1330-1332.
    19.谢民强主编.耳鼻咽喉头颈部感染性疾病.北京:人民卫生出版社,2005:211
    20.Ranladan HH,Sanclement JA,Thomas JG.ChltDnic riftnesinusitis and biollms.Otolaryngol Head Neck Surg,2005,132:414-417
    21.都基荣,叶景贤,刘铁玲.鼻窦炎的预防与治疗.中华临床医学研究杂志,2007,13(20):3038
    22.王彤,朱瑾编译.急性鼻-鼻窦炎抗生素治疗指南--美国鼻窦变态反应健康协会推荐.国外医学耳鼻咽喉科学分册,2005,29(1):52-53
    23.董震.加强基础研究提高慢性鼻-鼻窦炎综合治疗水平.中华耳鼻咽喉头颈外科杂志,2006,41(3):161
    24.Benninger MS,Fergusen B J,Hadley JA,et al.Adult chronic rhinosinusitis:definitions,diagnosis,epidemiology,and pathophysiology.Otolaryngol Head Neck Surg,2003,129(3Suppl):S1-32.
    25.Meltzer EO,Hamilos DL,Hadley JA,et al.Rhinosinusitis:Establishing definitions for clinical research and patient cflu Otolaryngol Head Neck Surg,2004,131(6 Suppl):S1-62.
    26.林彬,林心强.鼻窦炎的动物模型.中国中西医结合耳鼻咽喉科杂志,2004,12(1):46
    27.丁国强,郑春泉.鼻窦炎的实验动物造模.国际耳鼻咽喉头颈外科杂志,2006,30(4):255
    28.叶菁,余洪猛.运用Merocel止血棉与肺炎链球菌建立大鼠急性鼻腔鼻窦炎模型.中国眼耳鼻喉科杂志,2006,6(4):214
    29.牟逊业,苏士峥,张军.锁孔技术治疗鼻窦炎的临床研究.山东大学耳鼻喉眼学报,2007,21(3):214
    30.董金叶,李娜,时光刚.鼻窦炎与解剖异常的相关性研究.山东大学耳鼻喉眼学报,2007,21(5):436
    31.赵红,魏永祥,苗旭涛,等.嗅觉障碍与慢性鼻-鼻窦炎患者鼻腔鼻窦形态的相关性研究.临床耳鼻咽喉头颈外科杂志,2007,21(17):771

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700