固本平喘汤对哮喘豚鼠气道ECP、MBP影响的研究
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】在临床应用固本平喘汤防治支气管哮喘并取得良好疗效的基础上,进一步研究该方对哮喘动物模型气道嗜酸性阳离子蛋白(ECP)、碱性蛋白(MBP)以及嗜酸性粒细胞(EOS)计数的影响,探讨固本平喘汤治疗支气管哮喘的作用机制,为临床应用提供理论依据。
     【方法】体重250-300g豚鼠60只,雌雄各30只,随机分为正常对照组(A组)、模型组(B组)、西药对照(地塞米松)组(C组)、中药小剂量治疗组(D1组)、中药大剂量治疗组(D2组),每组12只。造模采用Underwood法加以改进,在实验第1天,给B、C、D1、D2每只豚鼠腹腔注射临时配制OVA10mg加氢氧化铝干粉100mg与灭活百日咳菌苗5×10~9个配制而成的混悬液1mL注射液以致敏,A组则以等量生理盐水进行腹腔注射;第15天将致敏豚鼠置于14升透明玻璃钟罩内,给予1%OVA对豚鼠进行超声雾化吸入(雾化量由小到大)激发15-20秒,然后自然吸入30min,每天1次,在激发前60min给予苯海拉明10mg/kg腹腔注射,预防豚鼠因过敏反应而死亡。A组则以等量生理盐水进行超声雾化;即在每次激发时记录其豚鼠一般情况。哮喘造模成功标准为:头、面部搔痒,呼吸加深、加快、少动,弓背,前肢缩抬,点头呼吸,咳嗽,鼻煽,抽搐,呈哮喘样表现。一般情况包括:精神、活动、饮食、体重、排便、皮毛、病情以及死亡情况。此后,每天以1%OVA雾化诱喘,按最大雾化量,自然吸入30min,使哮喘反复发作,连续3天;在第一次诱喘后24小时,即从第16天开始分别用软管胃饲给药,A组及B组均予等体积胃饲生理盐水,C组予地塞米松注射液(1mg/kg)胃饲;D1、D2组分别予固本平喘汤(炙麻黄、杏仁、甘草、苏子、白芥子、莱菔子、黄芩、地龙、仙灵脾等组成)浓缩液(每毫升含生药2g)D1组(2.5g/kg)及D2组(7.5g/kg)胃饲治疗7天。观察造模前后及药物治疗后豚鼠一般情况;疗程结束后,处死动物,收集各组动物BALF、颈动脉血及肺组织标本,观察BALF中细胞总数及细胞分类含量变化、肺组织形态及病理学改变,采用酶联免疫吸附测试法测定血清ECP含量,用HE染色观察EOS情况,进行支气管平滑肌的MBPmRNART-PCR半定量分析。结果采用统计软件SPSS13.0进行数据统计分析处理;计数资料以(?)±s表示,用t检验比较。计量资料用x~2检验。
     【结果】A组豚鼠体重自然增加,一般情况良好,无死亡。致敏后的豚鼠普遍精神较差,活动减少,进食及饮水量明显下降。1-2天后逐渐恢复正常。第16天哮喘B组3只豚鼠,C组4只豚鼠,D1组2只豚鼠亦出现明显皮毛蓬松现象。第二次诱喘时,B组3只豚鼠哮喘发作严重后死亡。用药后各组豚鼠情况均较哮喘模型组明显改善,但不能恢复到A组的水平。D2组豚鼠肺组织血管损伤修复,肺泡间隔变窄,上皮增生明显改善,炎症细胞明显减少,肺泡腔清晰。与B组比较,气道炎性细胞侵润显著减少,与C组相当;BALF中细胞总数及嗜酸性粒细胞以及淋巴细胞侵润明显减少,与B组比较有显著性差异(P<0.01),与C组相当(P>0.05);哮喘豚鼠血清ECP的分布明显降低,与B组比较亦有显著性差异(P<0.05)。治疗前后MBPmRNA,与B组比较有显著性差异(P<0.01)。
     【结论】固本平喘汤能诱导或促进哮喘豚鼠气道EOS减少,从而减轻气道炎性细胞侵润,控制气道慢性炎症,以达到防治哮喘的目的。其作用机制可能是通过改变ECP及MBP在哮喘豚鼠肺组织的表达,及减少肺组织中ECP及MBP的含量,从而诱导EOS的凋亡,使BALF中及肺组织侵润的嗜酸性粒细胞数量显著减少、淋巴细胞亦显著减少,以达到防治哮喘的目的。
【Objectives】At the base of good therapeutic effect of gubenpingchuantang in preventing and curing bronchial asthma.We did further research to observe therapeutic influence of gubenpingchuantang on animal model of asthma in some indicators such as ECP、MBP and EOS etc.In order to discuss mechanism of action of this compound on treatment of asthma and provide theoretical evidence for clinical application.
     【Methods】60 guinea pigs(Half male and female)weight 250-300g were randomly divided into normal control group(A group),model group(B group),western medicine control group(dexamethasone) group(C group),Chinese medicine treatment of low-dose group(01 group),Chinese high-dose treatment group(D2 group),12 in each group,we used the model Underwood made and and improved it.In the first day of experiment,each guinea pig in group B,C,D1,02 was given intraperitoneal injection of 10ml suspl,consists of OVA10mg、100mg dry powder aluminum hydroxide and inactivated pertussis vaccine 5×10~9mL to allergize,guinea pig in group was injected equal volume of normal saline for instead;In the 15th day we seted guinea pigs needed to be allergized in a 14 liters transparent glass Bell,and gave them 1%OVA ultrasonic atomizing inhalation(aerosol volume from small to big) about 15-20 seconds,then made them natural inhalation 30min,once every day,60min before excitation every guinea pig was given intraperitoneal injection of 10mg/kg of diphenhydramine to prevent allergic reactions which would cause death,guinea pigs in group A was ultrasonic atomized equal volume of normal saline for instead;The standard of successful asthma model is asthma-like performance emerge such as:head,facial pruritus,breathing deepen,less moving,camponotus,reduced forelimb lift,head to breathe,cough,nasal fan,convulsions and so on.From the Beginning of the 16th day guinea pigs in treatment groups were administration by gastric tube,guinea pigs group A and group B were feed with equal volume of normal saline,which in group C were feed with injection of dexamethasone(1mg/kg);which in group D1,D2 were feed with concentrated liquid of gubenpingchuantang(SunburnEphedra,Almond,Licorice,erillaseed, White mustard seed,Raphani,semen,Scutellaria,HERBA EPIMEDII etc.)(2g crude drug per ml) D1 group(2.5g / kg) and the D2 group (7.5g/kg) the treatment of administration last about 7 days.After the treatment,animals in every group were killed to collect BALF, carotid artery and lung tissue samples in order to observe the total number of BALF cells and quantity changes in various types of it, we observed morphology and pathological changes in lung tissue, used enzyme-linked immunosorbent assay test for determining content of serum ECP,we observed EOS after HE staining and did MBPmRNA RT-PCR semi-quantitative analysis of bronchial smooth muscle,we used statistical software of SPSS13.0 for for data statistical analysis;count data expressed with(?)±s,compared with test.measurement data used X~2 test for statistical analysis.
     【Results】Guinea pigs in group A were in good condition,no one was died.Sensitized guinea pigs were poor-spirited,less moving, food and water intake decreased significantly,and returned to normal in 1-2 days.In the 16th day,3 guinea pigs in group B,4 guinea pigs in group C,2 guinea pigs in group D1 emerge the phenomenon of fluffying fur.When the second Induced asthma,3 guinea pigs in group B died after a serious asthma attack.After treating by administration the situation of Guinea pigs improved, but it can not restore to the level of the group A,lung tissue blood vessels damage of guinea pigs in group D2 repaired,alveolar septal became narrow,epithelial hyperplasia improved and reduced inflammatory cells,alveolar space is clear.Compare With the group B,airway inflammatory cell infiltration was significantly reduced, just like group C;The total number of BALF cells,eosinophils and lymphocyte infiltration decreased,compared with group B there were significantly different(P<0.01);The distribution of serum gcP in asthmatic guinea pigs were significantly decreased compared with the group B there were also significant differences(P<0.05).so was MBPmRNA(P<0.01).
     【Conclusions】Gubenpingchuantang can induce or promote reducing airway EOS of asthmatic guinea pigs which reduce the airway inflammatory cell infiltration and control of chronic airway inflammation,and achieve the purpose of prevention and treatment of asthma.Its mechanism are possibly by changing the expression of the ECP and MBP in lung tissue of asthmatic guinea pigs,and reduce content of ECP and MBP in lung tissue,and induce EOS apoptosis, so that infiltration of eosinophils cells in BALF of lung tissue significantly reducedand the number of lymphocytes is significantly reduced,which reached the purpose of prevention and treatment of asthma.
引文
[1]Underwood SL,Raeburn D,Lawrence C,et al anovel,airways selective GlucocortiCoid:effects againstantigen induced CD4+T lymphocyte accumulation and cytokine gene expression in the Borwn Norway rat Lung[J]Br J Pharmacol,1997,122:439.
    [2]陆再英,钟南山等.西医内科学[M].北京:人民卫生出版社,第七版69-78.
    [3]Venge P.Serum measurements of Eosinophilic cationic protrin in asthma bronchial.CLin Exp ALLerg,1993,23:3.
    [4]赵印,李树桐,高保华,等.淋巴细胞分离液在脱落细胞中的应用[J].诊断病理学杂志,2000,7(4):304.
    [5]GartnerI.Separation of human Eosinophils in density gradients of polyvinyl phrrolidone - coated silica gel(percoll)[J].Immunol,1980,40(1):133.
    [6]郭晓明,王长征,赖克方,等.雷公藤对哮喘豚鼠嗜酸细胞凋亡及IL-5和GMOCSFmRNA表达的研究[J].第三军医大学学报,1999,21(9):627.
    [7]白勇刚,王智杰.支气管哮喘的中医药治疗[J].内蒙古中医,2001,20(2):14.
    [8]李晓君,田美香,程淑华,等.川芎嗪注射液治疗支气管哮喘疗效观察[J].现代中西医结合杂志,2006,22(15):3084.
    [9]朱金凤,孙劲松,柯新桥,等.固本防喘胶囊对哮喘豚鼠气道嗜酸性细胞凋亡的影响[J].山西中医,2007,23(2):64-66.
    [10]欧阳忠兴,柯新桥,主编.中医呼吸病学[M].中国医药科技出版社,1994,172-177.
    [11]薛建敏.一氧化氮对致敏大鼠气道炎症及淋巴细胞功能的影响[J].中华结核和呼吸杂志,1998,21(11):689.
    [12]Venge P.Serum measurements of eosinophil cationic protein(ECP) in bronchia lasthma[J].Clin Exp Allergy,1993,23(Supp12):3-7.
    [13]黄海鹭,孙宝清等.37℃凝血温度下正常人和哮喘患者血清ECP 水平的测定[J].中华微生物学和免疫学杂志,1997,17(5):394-395.
    [14]王鸿程,唐凤鸣,李万成,等.血粒-巨噬细胞集落刺激因子、嗜酸粒细胞联合检测对哮喘气道炎症的评价[J].中国呼吸与危重监护杂志,2005,4(2):95-145.
    [15]Bames P J.Neural control of hunab aiways in health and disease[J].Am Rev Respir Dis,1986,134(6):1289-314.
    [16]Patel HJ,BarnesPJ.Evidence for prejunctional muscarinic autoreceptors human and guinea pig trachea[J].Am J Respir Crit CareMed,1995,152(3):872-878.
    [17]Gleich G J,Mechanisms of eosinophil-associated in flammation [J].J Allergy Olin Immunol,2000,105(4):651-663.
    [18]Evans C M,Fryer A D,Jacoby D B,eral Pretreament with antibody to eosinophil major basic protein prevents hyperres ponsiveness by protecting neuronal M2 muscarinic receptors in antigen-challenged guinea pigs[J].J Clin Invest,1997,100(9):2254-2262.
    [19]林琳,要全保,于素霞,等.止喘胶囊对实验性哮喘动物模型气道重建的影响[J].中国中西医结合杂志,2001,21(8):599-601.
    [1]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.COPD诊治指南(2007年修订版).继续医学教育,2007,21(2):31-42.
    [2]闫治达.慢性气管炎阻塞性肺气肿的中医辨治体会[J].天津中医学院学报,2000,19(1):20.
    [3]王国忠,胡驰雄,丁美群,等.热喘平合剂治疗慢性阻塞性肺疾病痰热证82例观察[J].浙江中医杂志,2002,(7):318-319.
    [4]刘宏敏,孙太振.中西医结合治疗慢性阻塞性肺病(COPD)52例分析[J].中医药学刊,2003,21(12):2132.
    [5]丹溪心法 咳嗽
    [6]孙志佳.活血祛瘀法治疗慢性阻塞性肺疾病理论依据及临床应用[J].陕西中医,2005(4):341-342.
    [7]吕英,张慧琪,王昭杰.化痰清肺汤治疗慢性阻塞性肺病急性加重期临床观察[J].中草药,2007,38(6):903-904.
    [8]毛先明,孙洁民,罗光伟,等.痰热清注射液治疗慢性阻塞性肺疾病急性加重期临床观察[J].临床肺科杂志,2007,12(6):641-642.
    [9]郑洁.“治肺不远温”在慢性阻塞性肺疾病(COPD)急性发作期的临床研究[J].江西中医药,2000,31(6):20-21.
    [10]林琳,方泓.加味已椒苈黄汤治疗COPD肺动脉高压的临床研究[J].上海中医药杂志,2005,39(6):24-25.
    [11]钟进生,洪良南.血塞通治疗慢性阻塞性肺疾病急性加重期55例[J].江西中医药,2007,4(38):25.
    [12]秦素真.脉络宁治疗慢性阻塞性肺病高黏滞综合征疗效观察[J].现代中西医结合杂志,2007,16(15):2073-2074.
    [13]黄美虹,韩云.川芎嗪注射液对慢性阻塞性肺疾病急性加重期主要结局指标的影响[J].现代中西医结合杂志,2004,13(15):2002-2003.
    [14]崔焱,梁直英,董竞成,等.活血化瘀方治疗慢性阻塞性肺疾病急 性加重期的临床观察[J].中国中西医结合杂志,2005,25(4):327-329.
    [15]张元兵,洪广祥.“肺与大肠相表里”理论在慢性阻塞性肺疾病急性发作期的应用[J].江西中医,2000,31(3):41-42.
    [16]林嫵钊,韩云,李芳,等.通下法配合无创通气治疗慢性阻塞性肺疾病急性加重期呼吸衰竭15例[J].新中医,2005,37(1):41-42.
    [17]黄依兰,曾虹.健脾清肺化痰方治疗慢性阻塞性肺病合并肺感染临床观察[J].贵阳中医学院学报,2007,29(2):31-33.
    [18]付泽伟,王晓君.中西医结合治疗慢性阻塞性肺疾病继发真菌感染疗效观察[J].湖北中医杂志,2005,27(9):36-37.
    [19]王新元.慢性阻塞性肺气肿的中医辨治浅析[J].实用全科医学,2005,3(3):249.
    [20]陈云凤,启晓宇,刘洪,等.培本宁肺法对慢性阻塞性肺病稳定期患者临床疗效及肺功能的影响[J].成都中医药大学学报,2007,30(2):19-20.
    [21]王耀峰.补肾益肺胶囊治疗COPD临床研究[J].山东医药,2007,47(13):30-31.
    [22]洪敏俐,陈文喜,蔡少杭,等.愈肺汤对慢性阻塞性肺疾病患者肺功能干预作用的研究[J].中华中医药杂志,2005,20(2):92-95.
    [23]李艳,祝庆华.补肺益肾法对慢性阻塞性肺疾病稳定期肺功能的影响[J].长春中医药大学学报,2007,23(4):35.
    [24]张伯臾.中医内科学[M].上海:上海科学技术出版社出版,2003:73-74.
    [25]王胜,季红燕,张念志,等.益肺健脾中药改善慢性阻塞性肺疾病患者肺功能及营养状况[J].中国临床康复,2005,31(9):141-143.
    [26]朱渊红,王新华,朱奕豪,等.益气健脾方对慢性阻塞性肺疾病状态的影响[J].中国中西医结合杂志,2005,25(8):759-760.
    [27]刘小虹,单丽囡,宋阳,等.活血化痰法对慢性阻塞性肺疾病稳定 期患者肺功能和生存质量的影响[J].广州中医药大学学报,2006,23(4):275-277.
    [28]李海明,张华茹.银杏叶片治疗慢性阻塞性肺疾病稳定期疗效观察[J].现代中西医结合杂志,2004,13(2):146.
    [29]荆小莉,王东平,刘建博,等.加味千金苇茎汤治疗肺源性心脏病急性加重期及其对内皮细胞保护作用的研究[J].中国中西医结合急救杂志,2005,12(3):146-148.
    [30]傅曙华,文恒英,陈金苗,等.通肺静痰方治疗慢性阻塞性肺疾病56例总结[J].湖南中医杂志,2002,18(2):13-14.
    [31]范发才,赵凤达.苈黄导痰汤治疗慢性阻塞性肺疾病急性加重期临床观察[J].中医药学刊,2006(3):566-567.
    [32]林琳.培土生金综合治疗慢性阻塞性肺疾病稳定期胃肠功能紊乱[J].中草药,2000,31(8):611-612.
    [33]徐立然,闰婷,李丰年,等.咳喘康胶囊治疗慢性阻塞性肺疾病的临床报告[J].河南中医药学刊,2000,15(2):22-24.
    [34]李卫青,柯新桥,孙劲松,等.固本防喘胶囊对慢性阻塞性肺疾病急性加重期患者治疗作用的研究[J].中国中西医结合急救杂志,2006,13(2):76-79.
    [35]陈嘉馨,邱国海.川芎嗪并肝素雾化吸入治疗慢性阻塞性肺疾病30例中国临床实用医学[J].2007,1(1):65-67.
    [36]杨代勇,陈绍福,杨大男,等.红花合鱼腥草注射液雾化吸入治疗慢性阻塞性肺疾病临床观察[J].山东中医杂志,2003,22(7):400-401.
    [37]马琍,龚菊梅.炎喘平合剂雾化吸入对慢性阻塞性肺疾病急性加重期患者肺功能的影响[J].中国中医急症,2000,9(6):241-242.
    [38]马琍,龚菊梅,夏新,等.芩芎合剂雾化吸入治疗慢性阻塞性肺疾病急性加重期52例[J].浙江中医杂志,2004,39(2):92.
    [39]吴建芳.黄芪注射液雾化吸入治疗慢性阻塞性肺疾病稳定期疗效观 察[J].河北中医,2002,24(12):944-945.
    [40]何迎春,刘秀梅,郭建文,等.针刺配合拔罐疗法改善慢性阻塞性肺疾病患者血液流变性的影响[J].中国微循环,2003,16(7):387.
    [41]汤翠英,林琳,许银姬,等.培土生金法综合治疗对COPD稳定期患者营养状态及肺功能的影响[J].南京中医药大学学报,2005,21(1):16-19.
    [42]许银姬,何德平,林琳,等.中医综合疗法对慢性阻塞性肺疾病稳定期患者肺功能影响及其康复作用的临床研究[J].新中医,2004,36(10):18-19.
    [43]贾杰.针刺配合康复训练治疗慢性阻塞性肺疾病66例[J].陕西中医,2004,25(12):1125-1126.
    [44]陈钦,钟力炜,刘洪波,等.推拿治疗慢性阻塞性肺疾病的疗效[J].中国临床康复,2006,10(7):10-11.
    [45]章一平,李苏明.敷贴-脉冲疗法用于减少慢性阻塞性肺疾病急性加重的体会[J].现代中西医结合杂志,2006,15(13):24.
    [46]周樊华,刘婷,杨晓玲,等.慢性阻塞性肺疾病患者冬病夏治的护理[J].护理学杂志,2007,22(5):41.
    [47]李风森,王玲,杨卫江,等.中药穴位敷贴结合西药对COPD急性加重期患者血清TNF-α和IL-2的影响[J].上海中医药杂志,2006,40(8):38-39.
    [48]彭明松,龚新全,谢六安,等.中药穴位贴敷治疗慢性阻塞性肺疾病的临床观察[J].湖北中医杂志,2006,28(7):44-45.

© 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