特应性皮炎中医辨证分型与HLA-DR基因的相关性探讨
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摘要
目的:通过对AD中医各证型的有关理化指标观察,分析其与AD证候的相关性。采用PCR-SSP技术对HLA—Ⅱ类基因进行基因分型,探讨AD中医辨证分型与HLA—Ⅱ类基因分型的相关性。同时用SCORAD评分法分析AD证候与该评分值之间的相关性。为AD的中医辨证提供客观科学的依据,以期从多方面为AD中医辨证规范化提供有益的帮助。
方法:首先通过收集整理有关文献,确定AD的基本证型,即风湿蕴肤型、湿热浸淫型和血虚风燥型。基本证型确定后,选取35例广东籍符合“康克菲”诊断标准及中医征候诊断标准的AD病例。另选54例无血缘关系的广东籍健康者54例作为健康对照组。对所有纳入研究的患者和健康对照组均进行了血清总IgE、甲皱微循环检查。同时分别对AD各中医证型进行了相关实验室检查,如肝肾功能、血清总IgE、甲皱微循环及SCORAD评分等,并对各结果的分值或出现频率经统计学处理分析,总结以上结果与AD各中医证型之间的关系。建立AD的DNA资源库,采用PCR-SSP技术对HLA—Ⅱ类基因进行基因分型,同时对两组进行了HLA-DR基因分布频率分析,观察AD辨证分型与HLA-DR的相关性。
结果:AD组血清总IgE显著高于正常对照组(P<0.05),三组中又以湿热蕴肤型最高。观察发现AD患者存在明显的甲皱微循环异常,说明AD患者普遍存在“血瘀”现象。部分AD患者存在肝肾功能异常,可能与其原发或继发感染有关。AD各中医证型中血清总IgE、SCORAD评分方面存在明显差异。我们尚采用PCR-SSP方法对广东籍AD患者及健康对照组进行了HLA-DR基因分型,发现患者组DRB1*15及DR7基因频率较正常对照组增高(P<0.05)。AD各中医证型中DR7基因频率湿热浸淫型较风湿蕴肤型显著增高(Pc<0.05),其它各等位基因在各型间比较无统计学意义。
结论:
1.通过查阅有关文献并结合临床,将风湿蕴肤、湿热浸淫及血虚风燥三型确定为AD的基本证型,此三型基本能概括临床所有证型。
2.部分实验室指标和功能性检测指标与AD辨证分型有一定的相关性,如TIgE值湿热浸淫型显著高于其它两型(P<0.05)。肝肾功能异常较常见于湿热浸淫型。以SCORAD评分对AD严重程度分级,发现不同的积分与AD中医不同分型有较高的符合率,以上检查结果或可作为AD辨证分型的参考指标。
3.HLA-DR基因频率分析结果,患者组DRB1*15及DR7基因频率较正常对照组增高
Objective To confirm the basic type of syndrome based on an overall analysis of signs and symptoms of AD in TCM and to investigate the relationship between HLA-DR genes and the type of syndrome of AD.Methods We confirm the basic type of syndrome of AD based on an overall analysis of signs and symptoms in TCM by reviewing literature and collection of clinic data.We used Polymerase chain reaction-Sequence specific primer technique to type HLA-DR sub-region in patients with AD and matched control subjects of healthy, unrelated in blood relationship of Han nationality from Guangdong province, to study the relationship between typing of diagnosis based on an overall analysis of signs and symptoms of AD in TCM and HLA-DR gene.We also observe blood serum total IgE, ALT/AST,BUN/Cr and the microcirculation in nail wrinkle in patients with AD and control subjects, to study the relationship between typing of diagnosis based on an overall analysis of signs and symptoms of AD in TCM and blood serum total IgE, ALT/AST,BUN/Cr. The severe scoring of atopic dermatitis was also observed in patients with AD.Results The allele frequencies of DRB1*15, DR7 were higher in AD patients than those in normal controls (P<0.05) .The allele frequency of DR7 was significantly higher in members with the type of accumulated of damp-heat in the skin than those in the other two types. The blood serum total IgE were higher in AD patients than those in normal controls ( P<0.05) the type of accumulated of damp-heat in the skin was the highest. the score of SCORAD were also significantly difference in all types. The result of the microcirculation in nail wrinkle in patients with AD were abnormity.Conclusion The basic type of syndrome of AD based on an overall analysis of signs and symptoms in TCM include the type of accumulated of wind-witness evil in the
skin, the accumulated of damp-heat in the skin and the type of blood deficiency and wind-dryness. The result indicated the blood serum total IgE and the score of SCORAD can be looked as the judgment marker of the type of accumulated of damp-heat in the skin. The result also indicated The allele of DRB1*15? DR7 probably are the predisposing genes of AD and the DR7 genes probably is the predisposing genes of the type of accumulated of damp-heat in the skin. Above index can be used as the objective index of differentiation of symptoms and signs for classification syndrome of AD.
方法:首先通过收集整理有关文献,确定AD的基本证型,即风湿蕴肤型、湿热浸淫型和血虚风燥型。基本证型确定后,选取35例广东籍符合“康克菲”诊断标准及中医征候诊断标准的AD病例。另选54例无血缘关系的广东籍健康者54例作为健康对照组。对所有纳入研究的患者和健康对照组均进行了血清总IgE、甲皱微循环检查。同时分别对AD各中医证型进行了相关实验室检查,如肝肾功能、血清总IgE、甲皱微循环及SCORAD评分等,并对各结果的分值或出现频率经统计学处理分析,总结以上结果与AD各中医证型之间的关系。建立AD的DNA资源库,采用PCR-SSP技术对HLA—Ⅱ类基因进行基因分型,同时对两组进行了HLA-DR基因分布频率分析,观察AD辨证分型与HLA-DR的相关性。
结果:AD组血清总IgE显著高于正常对照组(P<0.05),三组中又以湿热蕴肤型最高。观察发现AD患者存在明显的甲皱微循环异常,说明AD患者普遍存在“血瘀”现象。部分AD患者存在肝肾功能异常,可能与其原发或继发感染有关。AD各中医证型中血清总IgE、SCORAD评分方面存在明显差异。我们尚采用PCR-SSP方法对广东籍AD患者及健康对照组进行了HLA-DR基因分型,发现患者组DRB1*15及DR7基因频率较正常对照组增高(P<0.05)。AD各中医证型中DR7基因频率湿热浸淫型较风湿蕴肤型显著增高(Pc<0.05),其它各等位基因在各型间比较无统计学意义。
结论:
1.通过查阅有关文献并结合临床,将风湿蕴肤、湿热浸淫及血虚风燥三型确定为AD的基本证型,此三型基本能概括临床所有证型。
2.部分实验室指标和功能性检测指标与AD辨证分型有一定的相关性,如TIgE值湿热浸淫型显著高于其它两型(P<0.05)。肝肾功能异常较常见于湿热浸淫型。以SCORAD评分对AD严重程度分级,发现不同的积分与AD中医不同分型有较高的符合率,以上检查结果或可作为AD辨证分型的参考指标。
3.HLA-DR基因频率分析结果,患者组DRB1*15及DR7基因频率较正常对照组增高
Objective To confirm the basic type of syndrome based on an overall analysis of signs and symptoms of AD in TCM and to investigate the relationship between HLA-DR genes and the type of syndrome of AD.Methods We confirm the basic type of syndrome of AD based on an overall analysis of signs and symptoms in TCM by reviewing literature and collection of clinic data.We used Polymerase chain reaction-Sequence specific primer technique to type HLA-DR sub-region in patients with AD and matched control subjects of healthy, unrelated in blood relationship of Han nationality from Guangdong province, to study the relationship between typing of diagnosis based on an overall analysis of signs and symptoms of AD in TCM and HLA-DR gene.We also observe blood serum total IgE, ALT/AST,BUN/Cr and the microcirculation in nail wrinkle in patients with AD and control subjects, to study the relationship between typing of diagnosis based on an overall analysis of signs and symptoms of AD in TCM and blood serum total IgE, ALT/AST,BUN/Cr. The severe scoring of atopic dermatitis was also observed in patients with AD.Results The allele frequencies of DRB1*15, DR7 were higher in AD patients than those in normal controls (P<0.05) .The allele frequency of DR7 was significantly higher in members with the type of accumulated of damp-heat in the skin than those in the other two types. The blood serum total IgE were higher in AD patients than those in normal controls ( P<0.05) the type of accumulated of damp-heat in the skin was the highest. the score of SCORAD were also significantly difference in all types. The result of the microcirculation in nail wrinkle in patients with AD were abnormity.Conclusion The basic type of syndrome of AD based on an overall analysis of signs and symptoms in TCM include the type of accumulated of wind-witness evil in the
skin, the accumulated of damp-heat in the skin and the type of blood deficiency and wind-dryness. The result indicated the blood serum total IgE and the score of SCORAD can be looked as the judgment marker of the type of accumulated of damp-heat in the skin. The result also indicated The allele of DRB1*15? DR7 probably are the predisposing genes of AD and the DR7 genes probably is the predisposing genes of the type of accumulated of damp-heat in the skin. Above index can be used as the objective index of differentiation of symptoms and signs for classification syndrome of AD.
引文
[1] 柳会,顾海等.皮肤性病免疫学.人民卫生出版社,186-187
[2] 邓铁涛,靳士英.日本汉方对异位性皮炎的研究进展.新中医,1998,3(1):61-62
[3] 徐恩波.浅谈湿疹的证治.浙江中医学院学报,1995,19(6):8
[4] 瞿幸.中医辨证治疗湿疹85例.中医杂志,1995,36(10):615
[5] 车武.异位性皮炎的病因研究.河北中医,2005,11(2):189-189
[6] Diepen TL, Fartasch M.Recent epidemiological and genetic studies in atopic dermatitis Acta Derm Venereol (Stockh), 1992, 176 (suppl): 13-18
[7] Cookson W.The alliance of genes and environment in asthma and allgery.Nature, 1999, 402 (suppl 25): B5
[8] ColemanRatal. Lancet, 1992, 340:381-384
[9] WalanobeMeal. Arch Dermatl, 1991, 127: 1689-1692
[10] Berth--Jones J at al. Lancet, 1993, 341: 1557-1560
[11] 曼玲(2004).“吸烟环境对儿童异位性皮炎的影响.”中华医学信息导报 19(5):7-7.
[12] 周文明,张学军.特应性皮炎的环境因素.国外医学皮肤性病学分册,2003,29(2):91-93
[13] Olesen AB. Role of the early environment of atopic dermatitis. J Am AcadDermatol. 2001, 45 (1 Suppl): S37--S40
[14] Youn BS, Zhang SM, et al. Chracaterization of Ckbete8 and Ckbete8-1.. two altermatively spliced forms of human bete-chemokine , chmoattractants for neutronphils, monocytes, and lymphocytes, and potent agonists at CC chemokinereceptor 1, 1998, 91 (9): 3118-3126
[15] 叶冬青.皮肤病流行病学.人民卫生出版社,2001,356-358
[16] Thestrup-Pedersen K J. Eur Acad Dermatol Venereol. 1996, 7 ( Suppl): s3-s7
[17] 王懿娜,方红.P物质在特应性皮炎发病机制中的地位.国外医学皮肤性病学分册,2002,28(3):157-159
[18] 阮劲峰、谢汝汉.四物汤加减治疗32例儿童异位性皮炎的疗效.现代医院,4(6):73-74
[19] 车武.四虫止痒汤治疗成人异位性皮炎62例.承德医学院学报.22(1):38-39
[20] 王晓哲,王宝章,复方甘草酸苷片治疗小儿异位性皮炎60例疗效观察.中国药房,15(2):748-749
[21] 黄咏菁,陈达灿,莫秀梅.健脾渗湿冲剂治疗儿童异位性皮炎脾虚证的临床观察,陕西中医,25(5):396-398
[22] 吕飞,周春燕.辨证治疗异位性皮炎,中国民间疗法,12(6):8-9
[23] 陈可.穴位注射治疗异位性皮炎35例,上海针灸杂志,23(6):25-27
[24] Raport CJ, Gosling J, Schweickart VL, et al,Molecular cloning and functional characterization of a novel human CC chemokine receptor (CCR5) for RENTES, MIP-lbata, and MIP-lalpha.J Biol Chem, 1996, 271 (29): 17161-17166
[25] Rotmman JB, Smith TL, Genley KG, et al.Potential role of the chemoline receptor CXCR3, CCR4, and the integrin αEβ7 in the pathogenesis of psoriasis. Lab Invest, 2001, 81 (3): 335-347
[26] Noh GW, Lee KY.Blood eosinophils and serum IgE as predictors for prognosis of interferon-gamma therapy in atopic dermatitis .Allergy, 1998, 53: 1202-1207
[27] Noh G, Lozano F.Intravenous immuneglobulin effects on serum-soluble CD5 levels inatopic dermatitis.Clin Exp Allergy, 2001, 31:1932-1938
[28] Dittmar HC, Pflieger D, Schopf E, et al.UVA1 phototherapy.Piot study of dose finding in acute exacerbated atopic dermatitis. Hautarzt, 2001, 52: 423-427
[29] Richter HI, Billmann-Eberwein C, Grewe M, et al. Successful monotherapy of severe and intractable atopic dermatitis by photopheresis. J Am Acad Dermatol, 1998, 38: 585-588
[30] 秦伯未.中医辨证论治概说.江苏中医,1957,(1):2
[31] 朱颜.中国古典医学证候治疗的一般规律.中华医学杂志,1954,(9):734
[32] 任应秋.谈谈中医的辨证论治.陕西新医药,1976,(1):55
[33] 方药中.论《伤寒论》中的辨病辨证及其相互关系问题.中医杂志,1986,(5):53
[34] 袁肇凯.中医心病气血辨证临床病征计量诊断研究.中国医药学报,1998,13(6):18-21
[35] 黎敬波等.从六项放免指标及相关经穴辐射热诊断肺胃寒热六证的 计量化研究.中国中医基础医学杂志,1998,4(4):32-34
[36] 贺运河,郭振球.脑梗死患者血清肌酐、尿素氮、心肌酶变化与中医证型关系的临床分析.现代中西医结合杂志,2003,12(21):2288-2289
[37] 陈志伟,顾美华,邓迎苏等.206例系统性红斑狼疮患者中医证型与免疫学指标的相关性研究.中医杂志,2000,41(4):234-236
[38] 余朝骏等.慢性胃病中医证候的消化道X线征象研究.成都中医药大学学报,1998,21(4):14-17
[39] 李翰敏等.肝病血热血瘀兼湿热证与门脉血流量相关性研究.中医研究,1999,12(2):9-10
[40] 余朝骏,侯键,吴永康等.中风急性期中医辨证与头颅CT征象相关性研究.成都中医药大学学报,2000,23(3):7-9
[41] 王冬生,袁肇凯,魏经汉等.冠心病痰瘀辨证与冠状动脉造影的相关性研究.中医杂志,2003,44(12):937-938
[42] 刘福春,丁光霞,李菊仙等.淫羊藿多糖对羟基脲所致的“阳虚”动物骨髓细胞DNA合成率的影响.中国中药杂志,1991,16(10):621-622
[43] 杨维益,陈家旭,王天芳等.对中医辨证论治与辨病论治的思考.北京中医药大学学报,1996,19(2):13-15
[44] DeFronzo Ra, Ferrannini E. Insulin-resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertensoion, dyslipidemia and atherosclerotic cardiovascular disease. Diabetes Care, 1991, 14 (3): 173-194
[45] 陈小野主编.实用中医证候动物模型学.北京:北京医科大学中国协和医科大学联合出版社,1993
[46] 莫飞智等.大鼠高血压性痴呆模型的建立及其证候分析.广西中医学院学报,2000,17(1):46-49
[47] 王庆其.中医证候病理学.上海:上海科学普及出版社,1995,56-60
[48] 张玉环,陈保疆,焦振山等.脾虚湿盛型异位性皮炎和支气管哮喘患者的细胞因子IFN-γ和IL-4的mRNA的表达 中华现代皮肤科学杂志,2004,(3):203-205
[49] 曾迎红,赵蕊,叶志纯等,儿童异位性皮炎血清IL-4 IL-5及IgE水平的测定 中国当代儿科杂志 2004,6(5):407-408
[50] 吴江,曾仁山,异位性皮炎患者外周血Th2细胞分化偏态性分析,中国麻风皮肤病杂志,2004,21(8):616-617
[51] 任香玉,张丽萍,张民夫等,异位性皮炎皮损中ICAM-3的表达及临 床意义,世界感染杂志,2003,4(2):141-143
[52] 黄卫宁,侯显曾,卢浩锵等,异位性皮炎血清嗜酸细胞阳离子蛋白水平的检测及意义,华中医学杂志,2005,29(3):151-152
[53] 阳忠辉,张玉环,HLA与异位性皮炎的相关研究进展,中国临床医药研究杂志,2003,10(7):54-56
[54] Barker, J. N.MacDonald, D. M. Epidermal class Ⅱ human lymphocyte antigen expression in atopic dermatitis: a comparison with experimental allergic contact dermatitis J Am Acad Dermatol 1987, 16 (6): 1175-1179
[55] Goudemand, J.Defrenne, C.Desmons, F. HLA antigens and atopic dermatitis Monogr Allergy , 1977, 11:24-29
[56] Khosrotehrani, K.Le Danff, C.Reynaud-Mendel, B.Dubertret, L.Carosella, E. D.Aractingi, S. HLA-G expression in atopic dermatitis, J Invest Dermatol, 2001, 117 (3): 750-752
[57] 张玉环.异位性疾病研究新进展.天津中医,2002,19(4):9
[58] Laughter D, Istvan JA, Tofte SJ, et. The prevalence of atopic dermatitis in origon schoolchildren. J Am Acad Dermatol, 2000, 43 (4): 649-655
[59] 顾恒,颜艳,陈祥生等.我国特应性皮炎流行病学调查.中华皮肤科杂志,2000,23(6):359-362
[60] Sheehan MP, Rustin, MH, Atherton DJ, Buckley C, Harris DJ, Brostoff J, and Dawson A. Efficacy of traditional Chinese herbal therapy in adult atopic dermatitis. Lancet. 1992,340:13-17
[61] Sheeehen MP, Atherton DJ. One-year follow up of children treated with Chinese medicinal herbs for atopic eczema. Br J Dermatol 1994, 130: 488-493
[62] Vendre RB. Alternative treatment for atopic dermatitis: a selected review.Skin Therapy Lett,2002,7(2): 1
[63] Yuan R, Lin Y. Tranditional Chinese medicine: an approach to scientific proof and clinical validation. Pharmacol Ther.2000,86(2): 191
[64] 吕仁和,蔡光先等.慢性。肾炎(前期)中医证候规范化研究.北京中医,1996,(1):10-12
[65] 任占利.中风病证候诊断标准的研究.北京中医药大学学报,1996,19(4):49-50
[66] 李冠勇,冯磊,尹瑜等.银屑病辨证分型与血小板凝血酶敏感蛋白及CD36分子表达的关系.中国中西医结合杂志,2004,24(5):456-457
[67] 张慕慧,赵树华,王长宏.胃溃疡中医辨证分型与血管内皮生长因子相关性研究.中国医学杂志,2004,2(3):95-97
[68] 匡钱华,董林,沈敏娟.皮肤电子镜辅助皮肤病辨证分型诊断标准的研究.中国中医药信息杂志,2004,11(5):425-426
[69] Lee HJ, Ha S J, Han H, et al.Distribution of HLA-A, B alleles and polymerphisms of TAP and LMP genes in Korean patients with atopic dermatitis.J Clin Exp Allergy, 2000, 31 (12): 1867--1874
[70] Aron Y, desmazes--Dufeu N, Matran R, et al.Evidence of a strong positive association between atopy and the HLA class Ⅱ alleles DR4 and DR7.J Clin Exp Allergy, 1996, 26 (7): 821--828
[71] Hollowway JW, Doull I, Begishvili B, et al.Lack of evidence of association between HLA--DR, DQ and DP genotypes and atopy in families with HDM allergy .J Clin Exp Allergy, 1996, 26 (10): 1142 -- 1149
[72] Pomonkos AN. Andrew's diseases of the skin in clinical dermatology. 7th Ed.Philadelphia: Saunders.1982.75-82
[2] 邓铁涛,靳士英.日本汉方对异位性皮炎的研究进展.新中医,1998,3(1):61-62
[3] 徐恩波.浅谈湿疹的证治.浙江中医学院学报,1995,19(6):8
[4] 瞿幸.中医辨证治疗湿疹85例.中医杂志,1995,36(10):615
[5] 车武.异位性皮炎的病因研究.河北中医,2005,11(2):189-189
[6] Diepen TL, Fartasch M.Recent epidemiological and genetic studies in atopic dermatitis Acta Derm Venereol (Stockh), 1992, 176 (suppl): 13-18
[7] Cookson W.The alliance of genes and environment in asthma and allgery.Nature, 1999, 402 (suppl 25): B5
[8] ColemanRatal. Lancet, 1992, 340:381-384
[9] WalanobeMeal. Arch Dermatl, 1991, 127: 1689-1692
[10] Berth--Jones J at al. Lancet, 1993, 341: 1557-1560
[11] 曼玲(2004).“吸烟环境对儿童异位性皮炎的影响.”中华医学信息导报 19(5):7-7.
[12] 周文明,张学军.特应性皮炎的环境因素.国外医学皮肤性病学分册,2003,29(2):91-93
[13] Olesen AB. Role of the early environment of atopic dermatitis. J Am AcadDermatol. 2001, 45 (1 Suppl): S37--S40
[14] Youn BS, Zhang SM, et al. Chracaterization of Ckbete8 and Ckbete8-1.. two altermatively spliced forms of human bete-chemokine , chmoattractants for neutronphils, monocytes, and lymphocytes, and potent agonists at CC chemokinereceptor 1, 1998, 91 (9): 3118-3126
[15] 叶冬青.皮肤病流行病学.人民卫生出版社,2001,356-358
[16] Thestrup-Pedersen K J. Eur Acad Dermatol Venereol. 1996, 7 ( Suppl): s3-s7
[17] 王懿娜,方红.P物质在特应性皮炎发病机制中的地位.国外医学皮肤性病学分册,2002,28(3):157-159
[18] 阮劲峰、谢汝汉.四物汤加减治疗32例儿童异位性皮炎的疗效.现代医院,4(6):73-74
[19] 车武.四虫止痒汤治疗成人异位性皮炎62例.承德医学院学报.22(1):38-39
[20] 王晓哲,王宝章,复方甘草酸苷片治疗小儿异位性皮炎60例疗效观察.中国药房,15(2):748-749
[21] 黄咏菁,陈达灿,莫秀梅.健脾渗湿冲剂治疗儿童异位性皮炎脾虚证的临床观察,陕西中医,25(5):396-398
[22] 吕飞,周春燕.辨证治疗异位性皮炎,中国民间疗法,12(6):8-9
[23] 陈可.穴位注射治疗异位性皮炎35例,上海针灸杂志,23(6):25-27
[24] Raport CJ, Gosling J, Schweickart VL, et al,Molecular cloning and functional characterization of a novel human CC chemokine receptor (CCR5) for RENTES, MIP-lbata, and MIP-lalpha.J Biol Chem, 1996, 271 (29): 17161-17166
[25] Rotmman JB, Smith TL, Genley KG, et al.Potential role of the chemoline receptor CXCR3, CCR4, and the integrin αEβ7 in the pathogenesis of psoriasis. Lab Invest, 2001, 81 (3): 335-347
[26] Noh GW, Lee KY.Blood eosinophils and serum IgE as predictors for prognosis of interferon-gamma therapy in atopic dermatitis .Allergy, 1998, 53: 1202-1207
[27] Noh G, Lozano F.Intravenous immuneglobulin effects on serum-soluble CD5 levels inatopic dermatitis.Clin Exp Allergy, 2001, 31:1932-1938
[28] Dittmar HC, Pflieger D, Schopf E, et al.UVA1 phototherapy.Piot study of dose finding in acute exacerbated atopic dermatitis. Hautarzt, 2001, 52: 423-427
[29] Richter HI, Billmann-Eberwein C, Grewe M, et al. Successful monotherapy of severe and intractable atopic dermatitis by photopheresis. J Am Acad Dermatol, 1998, 38: 585-588
[30] 秦伯未.中医辨证论治概说.江苏中医,1957,(1):2
[31] 朱颜.中国古典医学证候治疗的一般规律.中华医学杂志,1954,(9):734
[32] 任应秋.谈谈中医的辨证论治.陕西新医药,1976,(1):55
[33] 方药中.论《伤寒论》中的辨病辨证及其相互关系问题.中医杂志,1986,(5):53
[34] 袁肇凯.中医心病气血辨证临床病征计量诊断研究.中国医药学报,1998,13(6):18-21
[35] 黎敬波等.从六项放免指标及相关经穴辐射热诊断肺胃寒热六证的 计量化研究.中国中医基础医学杂志,1998,4(4):32-34
[36] 贺运河,郭振球.脑梗死患者血清肌酐、尿素氮、心肌酶变化与中医证型关系的临床分析.现代中西医结合杂志,2003,12(21):2288-2289
[37] 陈志伟,顾美华,邓迎苏等.206例系统性红斑狼疮患者中医证型与免疫学指标的相关性研究.中医杂志,2000,41(4):234-236
[38] 余朝骏等.慢性胃病中医证候的消化道X线征象研究.成都中医药大学学报,1998,21(4):14-17
[39] 李翰敏等.肝病血热血瘀兼湿热证与门脉血流量相关性研究.中医研究,1999,12(2):9-10
[40] 余朝骏,侯键,吴永康等.中风急性期中医辨证与头颅CT征象相关性研究.成都中医药大学学报,2000,23(3):7-9
[41] 王冬生,袁肇凯,魏经汉等.冠心病痰瘀辨证与冠状动脉造影的相关性研究.中医杂志,2003,44(12):937-938
[42] 刘福春,丁光霞,李菊仙等.淫羊藿多糖对羟基脲所致的“阳虚”动物骨髓细胞DNA合成率的影响.中国中药杂志,1991,16(10):621-622
[43] 杨维益,陈家旭,王天芳等.对中医辨证论治与辨病论治的思考.北京中医药大学学报,1996,19(2):13-15
[44] DeFronzo Ra, Ferrannini E. Insulin-resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertensoion, dyslipidemia and atherosclerotic cardiovascular disease. Diabetes Care, 1991, 14 (3): 173-194
[45] 陈小野主编.实用中医证候动物模型学.北京:北京医科大学中国协和医科大学联合出版社,1993
[46] 莫飞智等.大鼠高血压性痴呆模型的建立及其证候分析.广西中医学院学报,2000,17(1):46-49
[47] 王庆其.中医证候病理学.上海:上海科学普及出版社,1995,56-60
[48] 张玉环,陈保疆,焦振山等.脾虚湿盛型异位性皮炎和支气管哮喘患者的细胞因子IFN-γ和IL-4的mRNA的表达 中华现代皮肤科学杂志,2004,(3):203-205
[49] 曾迎红,赵蕊,叶志纯等,儿童异位性皮炎血清IL-4 IL-5及IgE水平的测定 中国当代儿科杂志 2004,6(5):407-408
[50] 吴江,曾仁山,异位性皮炎患者外周血Th2细胞分化偏态性分析,中国麻风皮肤病杂志,2004,21(8):616-617
[51] 任香玉,张丽萍,张民夫等,异位性皮炎皮损中ICAM-3的表达及临 床意义,世界感染杂志,2003,4(2):141-143
[52] 黄卫宁,侯显曾,卢浩锵等,异位性皮炎血清嗜酸细胞阳离子蛋白水平的检测及意义,华中医学杂志,2005,29(3):151-152
[53] 阳忠辉,张玉环,HLA与异位性皮炎的相关研究进展,中国临床医药研究杂志,2003,10(7):54-56
[54] Barker, J. N.MacDonald, D. M. Epidermal class Ⅱ human lymphocyte antigen expression in atopic dermatitis: a comparison with experimental allergic contact dermatitis J Am Acad Dermatol 1987, 16 (6): 1175-1179
[55] Goudemand, J.Defrenne, C.Desmons, F. HLA antigens and atopic dermatitis Monogr Allergy , 1977, 11:24-29
[56] Khosrotehrani, K.Le Danff, C.Reynaud-Mendel, B.Dubertret, L.Carosella, E. D.Aractingi, S. HLA-G expression in atopic dermatitis, J Invest Dermatol, 2001, 117 (3): 750-752
[57] 张玉环.异位性疾病研究新进展.天津中医,2002,19(4):9
[58] Laughter D, Istvan JA, Tofte SJ, et. The prevalence of atopic dermatitis in origon schoolchildren. J Am Acad Dermatol, 2000, 43 (4): 649-655
[59] 顾恒,颜艳,陈祥生等.我国特应性皮炎流行病学调查.中华皮肤科杂志,2000,23(6):359-362
[60] Sheehan MP, Rustin, MH, Atherton DJ, Buckley C, Harris DJ, Brostoff J, and Dawson A. Efficacy of traditional Chinese herbal therapy in adult atopic dermatitis. Lancet. 1992,340:13-17
[61] Sheeehen MP, Atherton DJ. One-year follow up of children treated with Chinese medicinal herbs for atopic eczema. Br J Dermatol 1994, 130: 488-493
[62] Vendre RB. Alternative treatment for atopic dermatitis: a selected review.Skin Therapy Lett,2002,7(2): 1
[63] Yuan R, Lin Y. Tranditional Chinese medicine: an approach to scientific proof and clinical validation. Pharmacol Ther.2000,86(2): 191
[64] 吕仁和,蔡光先等.慢性。肾炎(前期)中医证候规范化研究.北京中医,1996,(1):10-12
[65] 任占利.中风病证候诊断标准的研究.北京中医药大学学报,1996,19(4):49-50
[66] 李冠勇,冯磊,尹瑜等.银屑病辨证分型与血小板凝血酶敏感蛋白及CD36分子表达的关系.中国中西医结合杂志,2004,24(5):456-457
[67] 张慕慧,赵树华,王长宏.胃溃疡中医辨证分型与血管内皮生长因子相关性研究.中国医学杂志,2004,2(3):95-97
[68] 匡钱华,董林,沈敏娟.皮肤电子镜辅助皮肤病辨证分型诊断标准的研究.中国中医药信息杂志,2004,11(5):425-426
[69] Lee HJ, Ha S J, Han H, et al.Distribution of HLA-A, B alleles and polymerphisms of TAP and LMP genes in Korean patients with atopic dermatitis.J Clin Exp Allergy, 2000, 31 (12): 1867--1874
[70] Aron Y, desmazes--Dufeu N, Matran R, et al.Evidence of a strong positive association between atopy and the HLA class Ⅱ alleles DR4 and DR7.J Clin Exp Allergy, 1996, 26 (7): 821--828
[71] Hollowway JW, Doull I, Begishvili B, et al.Lack of evidence of association between HLA--DR, DQ and DP genotypes and atopy in families with HDM allergy .J Clin Exp Allergy, 1996, 26 (10): 1142 -- 1149
[72] Pomonkos AN. Andrew's diseases of the skin in clinical dermatology. 7th Ed.Philadelphia: Saunders.1982.75-82