基于“肺合大肠”理论的敷胸巴布贴干预Ⅳ诱导小鼠肺炎免疫机制研究
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摘要
目的:从“肺合大肠”的古今论述,提取肺与大肠的生理、病理的关系,探讨敷胸巴布贴组方应用的理论基础;通过克隆测序基因比对方法鉴定流感病毒(IV)诱导小鼠致肺炎的动物模型,为中医药防治IV实验研究提供可靠而稳定的动物模型;通过皮肤刺激实验对敷胸巴布贴进行安全性评价,为临床推广应用提供安全用药依据;将传统敷胸膏与巴布贴进行比较研究,通过不同剂量巴布贴对IV诱导小鼠肺炎的药效学及免疫机制研究,探讨其对IV肺炎小鼠的治疗作用,试阐明敷胸巴布贴治疗IV肺炎的作用机制,从而验证“肺合大肠”为其应用的理论基础,为中药新药研发提供实验基础和理论依据;采用高效液相色谱法(HPLC法)测定敷胸巴布贴中药物含量并进行透皮吸收实验,以期明确其治疗IV肺炎的物质基础。
     材料与方法:
     1.采用鼻腔接种流感病毒FM1株诱导昆明种小鼠致肺炎,观察小鼠在一般状态、肺组织的病理组织学等方面的差异,并应用RT-PCR技术检测病毒载量、克隆测序基因比对等多角度进行模型鉴定。
     2.通过皮肤刺激实验观察敷胸巴布贴对完整皮肤和破损皮肤的刺激作用。
     3.将传统敷胸膏与不同剂量的敷胸巴布贴以外敷在小鼠背部(相当于肺腧穴、膏肓穴等)为给药途径治疗小鼠IV肺炎,观察各组药物对小鼠一般状态、死亡保护作用、肺指数、肺悬液血凝滴度的影响。
     4.采用免疫组织化学方法和RT-PCR技术检测IV诱导小鼠肺炎的肺肠组织中促炎因子TNF-α、抗炎因子IL-10的蛋白及mRNA的表达水平,比较传统敷胸膏与不同剂量敷胸巴布贴对IV肺炎小鼠肺肠组织中TNF-α、IL-10改变的影响并对同一指标进行相关性分析。
     5.采用免疫组织化学方法和RT-PCR技术检测IV诱导小鼠肺炎的肺肠组织中转录因子NF-κB P65蛋白及mRNA的表达水平,比较传统敷胸膏与不同剂量敷胸巴布贴对IV肺炎小鼠肺肠组织中NF-κB P65改变的影响并进行相关性分析。
     6.应用HPLC法测定敷胸巴布贴中大黄的五种活性成分含量。
     7.以离体大鼠皮肤为透皮屏障,采用改良的Franz扩散装置,应用HPLC法测定大黄素、大黄酚的经皮渗透量,考察敷胸巴布贴透皮吸收情况。
     结果:
     1.采用鼻腔接种流感病毒FM1株诱导昆明种小鼠致肺炎,模型组病理改变有肺泡间隔增厚、水肿,内含有大量炎细胞浸润,肺泡壁毛细血管扩张,间见大量红细胞。小鼠感染IV第3~10天肺组织中病毒核酸阳性检出率达100%。将模型组小鼠肺组织的IV RT-PCR扩增产物,采用克隆测序方法测序,与美国国立生物信息中心已知的IV cDNA全序列比较,吻合率达到99.06%。
     2.敷胸巴布贴在完整皮肤用药部位未出现红斑、水肿等皮肤刺激反应;而对破损皮肤,用药部位出现轻度刺激反应。
     3.死亡保护作用结果:低、高剂量巴布贴组对IV感染小鼠的死亡保护率分别是25%、40%;延长生命率是33.33%、58.52%。与模型组比较,死亡率明显降低,平均存活天数明显延长(P<0.01)。可见高剂量巴布贴的死亡保护率最高、平均存活时间最长。
     4.体重结果:正常组体重逐日增长;模型组体重逐日下降,第3天开始直至第7天较正常组明显下降(P<0.05);敷胸巴布贴组和敷胸膏组较模型组体重下降变慢,从第6天起体重有所增长,敷胸巴布贴组第6天和第7天体重较模型组明显升高(P<0.01)。
     5.肺指数、肺组织血凝滴度结果:模型组较正常组肺指数明显升高,低、高剂量巴布贴组和敷胸膏组较模型组肺指数明显降低(P<0.05)。低、高剂量巴布贴组分别与敷胸膏组比较,均有显著性差异(P<0.05)。低、高剂量巴布贴组和敷胸膏组的血凝滴度较模型组明显降低(P<0.05),且高剂量巴布贴组疗效最佳。
     6.IV诱导小鼠肺炎的肺肠组织中TNF-α蛋白表达和mRNA表达水平及相关性分析:
     肺组织:正常组可见少许表达于支气管上皮细胞,可以检测到少量的TNF-α蛋白表达和mRNA表达水平。模型组TNF-α蛋白表达和mRNA含量最高,与正常组比较,有显著性差异(P<0.01);与赋形剂组相当,无显著性差异(P>0.05)。低、高剂量巴布贴组、敷胸膏组TNF-α蛋白表达和mRNA表达水平均高于正常组,但明显低于模型组(P<0.05);且两两比较,均有显著性差异(P<0.05)。高剂量巴布贴组与正常组比较,无显著性差异(P>0.05)。高剂量巴布贴组TNF-α蛋白表达和mRNA表达水平最低。
     肠组织:正常组可见少许表达于肠上皮细胞,可以检测到少量的TNF-α蛋白和mRNA表达水平。模型组TNF-α蛋白表达和mRNA含量最高,明显高于正常组,有显著性差异(P<0.05);与赋形剂组比较,无显著性差异(P>0.05)。低、高剂量巴布贴组、敷胸膏组TNF-α蛋白表达和mRNA表达水平均高于正常组,且明显低于模型组(P<0.05);且两两比较,均有显著性差异(P<0.05)。高剂量巴布贴组与正常组比较,无显著性差异(P>0.05)。高剂量巴布贴组TNF-α蛋白表达和mRNA表达水平最低。
     相关性分析:正常组肺肠组织TNF-α蛋白表达和mRNA表达水平未出现相关性(P>0.05);模型组、赋形剂组、敷胸膏组、高剂量巴布贴组出现正相关(P<0.05);低剂量巴布贴组未出现相关性(P>0.05)。高剂量巴布贴组肺肠组织相关性均高于敷胸膏组。7.IV诱导小鼠肺炎的肺肠组织中IL-10蛋白和mRNA表达水平及相关性分析:
     肺组织:正常组可以检测到少量的IL-10蛋白表达和mRNA表达水平。模型组IL-10蛋白表达和mRNA含量均高于正常组,具有显著性差异(P<0.05);与赋形剂组比较,无显著性差异(P>0.05)。低、高剂量巴布贴组、敷胸膏组IL-10蛋白表达和mRNA表达水平均明显高于正常组,但高于模型组(P<0.05);且两两比较,均有显著性差异(P<0.05)。高剂量巴布贴组IL-10蛋白和mRNA表达水平最高。
     肠组织:正常组可以检测到少量的IL-10蛋白表达和mRNA表达水平。模型组IL-10蛋白表达和mRNA含量均高于正常组,具有显著性差异(P<0.05~0.01);与赋形剂组比较,无显著性差异(P>0.05)。低、高剂量巴布贴组、敷胸膏组IL-10蛋白表达和mRNA表达水平均明显高于正常组,且高于模型组(P<0.05~0.01);且两两比较,均有显著性差异(P<0.05)。高剂量巴布贴组IL-10蛋白表达和mRNA表达水平最高。
     相关性分析:正常组肺肠组织IL-10蛋白和mRNA表达水平未出现相关性(P>0.05);模型组、赋形剂组、敷胸膏组、高剂量巴布贴组出现正相关(P<0.05);低剂量巴布贴组未出现相关性(P>0.05)。相关性排序:高剂量巴布贴组>模型组>赋形剂组>敷胸膏组。
     8.IV诱导小鼠肺炎的肺肠组织中NF-κB蛋白表达和mRNA表达水平及相关性分析:
     肺组织:正常组可以检测到少量的NF-κB P65蛋白表达和mRNA表达水平。模型组NF-κB P65蛋白表达和mRNA表达水平最高,与正常组比较,具有显著性差异(P<0.05);赋形剂组表达相当,无显著性差异(P>0.05)。低、高剂量巴布贴组、敷胸膏组的NF-κB P65蛋白表达和mRNA表达水平均高于正常组,且明显低于模型组(P<0.05~0.01);两两比较,均有显著性差异(P<0.05)。高剂量巴布贴组NF-κB P65蛋白表达和mRNA表达水平最低。
     肠组织:正常组可以检测到少量的NF-κB P65蛋白表达和mRNA表达水平。模型组NF-κB P65蛋白表达和mRNA表达水平最高,与正常组比较,具有显著性差异(P<0.05);与赋形剂组表达相当,无显著性差异(P>0.05)。低、高剂量巴布贴组、敷胸膏组的NF-κB P65蛋白表达和mRNA表达水平均高于正常组(P<0.01),且敷胸膏组、高剂量巴布贴组明显低于模型组(P<0.01),而低剂量巴布贴组的NF-κB P65蛋白表达和mRNA表达水平与模型组比较,无显著性差异(P>0.05)。三组药物组两两比较,均有显著性差异(P<0.05),高剂量巴布贴组NF-κB P65蛋白表达mRNA表达水平最低。
     相关性分析:正常组肺肠组织中NF-κB P65蛋白表达和mRNA表达水平未出现相关性(P>0.05),模型组、赋形剂组、敷胸膏组、高剂量巴布贴组均出现正相关(P<0.05),低剂量巴布贴组未出现相关性(P>0.05)。相关性排序:高剂量巴布贴组>模型组>赋形剂组>敷胸膏组。
     9.每片敷胸巴布贴中游离总蒽醌的含量是11.9023mg,每克敷胸膏中游离总蒽醌的含量是5.8702mg,赋形剂中未检出游离蒽醌。
     10.敷胸巴布贴和敷胸膏中主要的有效成分是有差异的,敷胸膏中除大黄酸含量低于巴布贴外,大黄素、大黄酸、芦荟大黄素、大黄酚、大黄素甲醚含量均不同程度的高于敷胸巴布贴。
     11.敷胸巴布贴的主要成分大黄素、大黄酚从给药4 h起,在各个时点的单位面积累积渗透量均高于敷胸膏,并随着时间的延长,单位面积累积渗透量的差值越来越大。
     结论:
     1.敷胸巴布贴对IV诱导小鼠肺炎具有一定的死亡保护作用;可明显缓解体重的降低,并减轻其肺部炎性病变,有一定的抑制鼠肺IV增殖作用。
     2.IV肺炎的发病机制可能与促炎因子TNF-α、抗炎因子IL-10异常升高及转录因子NF-κB P65的过度活化有关;敷胸巴布贴治疗IV肺炎可能与降低TNF-α、提高IL-10及抑制NF-κB P65表达水平有关。
     3.推测当敷胸巴布贴药量达到一定剂量,使肺肠组织中同一指标具有相关性时,即可能达到肺肠同治的治疗效果,验证了“肺合大肠”理论。
     4.HPLC法可作为敷胸巴布贴质量控制及含量测定可靠的方法。
     5.敷胸巴布贴是一种安全可靠的中药外用制剂,且有较好的经皮渗透性,剂型改良可行。
Purpose:From the " lung associating with large intestine " the ancient and modern discourse, extract the physiology and pathology relationship between lung and colon, to explore the application rationale of fuxiong- cataplasms. Through the method of cloning and sequencing to identify the influenza A virus induced animal model to provide a reliable and stable animal model for the influenza A virus prevention of traditional Chinese medicine.Through cutaneous stimulation experiment to evaluate the safety of fuxiong- cataplasms to provide the medication evidence for clinical implication.Comparing with the fuxiong-masticp and fuxiong- cataplasms, through the study of pharmacodynamics and immunologic mechanism of differnet doses of fuxiong- cataplasms on IV induced mice pneumonia,to explore the treatment of fuxiong- cataplasms and validate the rationale of " lung associating with large intestine ",to provie the experiment and theory foundation for the traditional chinese medicine research;Through high efficiency liquid chromatography (HPLC) to determine the active component contents of fuxiong- cataplasms and percutaneous permeability experiment to identify its material foundation of IV infected pneumonia treatment.
     Material and method:
     1.Using influenza A virus FM1 to infect mice to mice pneumonia, observed the general status、the differences of lung tissue, applied RT-PCR method to detect IV-RNA viral load、clone sequencing gene correlation to accredit the animal model.
     2.Through cutaneous stimulation experiment to observe the stimulatory function of fuxiong- cataplasms on intact and breakage skin.
     3.Put the fuxiong-masticp and different doses of fuxiong- cataplasms on the back of the mice(equal to Lung acupoints and Gaohuangshu points) to treat the mice pneumonia and observe the general state、mortality、lung index、hemagglutination titer of lung suspension.
     4.By immunohistochemistry and RT-PCR detection of lung pro-inflammatory factors in intestinal tissue TNF-α, anti-inflammatory factor IL-10 protein and mRNA expression levels, compare with the variance of TNF-α, IL-10 in IV induced mice pneumonia lung and intestine issues of fuxiong-masticp and different doses of fuxiong- cataplasms,and the dependablity analysis was available for the same index.
     5.By immunohistochemistry and RT-PCR method to detect lung and intestine transcription factor NF-κB P65 protein and mRNA expression levels, compare with the variance of NF IV -κB P65 in IV induced mice pneumonia lung and intestine issues of fuxiong-masticp and different doses of fuxiong- cataplasms and the dependablity analysis was available.
     6.Application of HPLC method to determin the five active components in the fuxiong- cataplasms.
     7. The skin excised rat was used as transdermal barrier, using the modified Franz diffusion devices,HPLC was used to determin the percutaneous permeation centent of emodin and rhein to investigate the percutaneous permeation conditon of fuxiong- cataplasms.
     Results:
     1.Intranasal inoculation with influenza virus FM1 strain caused pneumonia in mice were induced, pathological changes in the model group had alveolar septal thickening, edema, containing a large number of inflammatory cell infiltration, alveolar wall telangiectasia, a large number of red blood cells between the see. Mice were infected IV 3 to 10 days of virus DNA in lung tissue positive detection rate of 100%. The model mice lung tissue IV RT-PCR amplification, cloning and sequencing methods using DNA sequencing, and the United States National Center for Biotechnology Information known IV cDNA sequences comparison with the rate of 99.06%。
     2.External using the fuxiong- cataplasms and the excipient, there is no skin stimulus response on the intact skin, on the contrary, external using on the damaged skin,has mild irritation response.
     3.Protective effect of death results: low dose and high dose group barb post death in mice infected with influenza virus protection rate was 25%, 40%; prolong life rate is 33.33%, 58.52%. Compared with model group, mortality was reduced, the average survival time was significantly longer (P<0.01).the barb post can be seen affixed to the death of high doses of the highest protection rate, the average survival time is the longest。
     4.Weight results: growth of normal body weight daily; model group decreased body weight daily, 3 day until day 7 was significantly lower than normal (P<0.05); dressing fuxiong- cream paste group and apply weight loss group than in model group Slow, from 6 days increased body weight, dressing fuxiong- cataplasms Group 6 and 7 days was significantly higher body weight compared with model group (P <0.01)。
     5.Lung index, the virus titer Results: the model group was significantly higher than normal increase in lung index, deposited fuxiong-cream group and low and high dose group than in model group, fuxiong- cataplasms the lung index was significantly lower (P<0.05). Low and high dose groups were posted and deposited fuxiong-cream group, there were significant differences (P<0.05). Apply ointment group and the low thoracic and high dose groups hemagglutination barb posted significantly lower than the model (P<0.05), and the efficacy of high dose group posted the best.
     6.TNF-αprotein expression and mRNA expression levels in the lung and intestinal tissue and correlation analysis:
     Lung tissue:The normal group showed little expression in bronchial epithelial cells, and could detect small amounts of TNF-αprotein expression and mRNA expression levels.The expression of TNF-αprotein and mRNA were the highest concentrations in model group, with the normal group, there was significant difference (P<0.01) ; with the excipient group rather,there was no significant difference (P>0.05).Apply the low and high doses fuxiong- cataplasms group and fuxiong-cream group, the expression of TNF-αprotein and mRNA were higher than the normal group,but significantly lower than the model group (P<0.05); and the three pairwise comparisons were significantly different (P<0.05). High dose cataplasms group and normal group, no significant difference (P>0.05). High dose cataplasms group the lowest TNF-αprotein expression and mRNA expression levels.
     Intestinal tissue: The normal group showed little expression in intestinal epithelial cells, and could detect small amounts of TNF-αprotein expression and mRNA expression levels. The expression of TNF-αprotein and mRNA were the highest concentrations in model group,with the excipient group,no significant difference (P>0.05). Apply the low and high doses fuxiong- cataplasms group and fuxiong-cream group, the expression of TNF-αprotein and mRNA were higher than the normal group,but significantly lower than the model group (P<0.05); and the three pairwise comparisons were significantly different (P<0.05). High dose cataplasms group and normal group,no significant difference (P>0.05). High dose cataplasms group the lowest TNF-αprotein expression and mRNA expression levels.
     Correlation analysis: The lung and intestinal tissue in the normal groups, TNF-αprotein expression and mRNA expression levels did not appear correlated (P>0.05); the model group, the excipient groups, fuxiong-cream group, the high dose cataplasms group, TNF-αexpression in the lung and intestinal tissue showed positive correlation (P<0.05) and did not appear correlated in the low dose cataplasms group(P>0.05).The correlation of the lung and intestinal tissue in the high dose cataplasms group were higher than fuxiong-cream group. 7.IL-10 protein expression and mRNA expression levels in the lung and intestinal tissue and correlation analysis:
     Lung tissue:The normal group could detect small amounts of IL-10 protein expression and mRNA expression levels.IL-10 protein expression and mRNA levels in the model group were higher than the normal group,with significant differences(P<0.05);with the excipient group,no significant difference(P>0.05). Apply the low and high doses fuxiong- cataplasms group and fuxiong-cream group, the expression of IL-10 protein and mRNA were significantly higher than the normal group,and higher than the model group(P<0.05); and the three pairwise comparisons were significantly different(P<0.05).High dose cataplasms group the highest IL-10 protein expression and mRNA expression levels.
     Intestinal tissue: The normal group could detect small amounts of IL-10 protein expression and mRNA expression levels. IL-10 protein expression and mRNA levels in the model group were higher than the normal group ,with significant differences(P<0.05~0.01); with the excipient group, no significant difference (P>0.05). Apply the low and high doses fuxiong- cataplasms group and fuxiong-cream group, the expression of IL-10 protein and mRNA were significantly higher than the normal group,and higher than the model group(P<0.05); and the three pairwise comparisons were significantly different(P<0.05).High dose cataplasms group the highest IL-10 protein expression and mRNA expression levels.
     Correlation analysis: The lung and intestinal tissue in the normal groups, IL-10 protein expression and mRNA expression levels did not appear correlated (P>0.05); In the model group, the excipient group, fuxiong-cream group,the high dose cataplasms group, IL-10 protein expression and mRNA expression levels in the lung and intestinal tissue showed positive correlation (P<0.05) and did not appear correlatedin the low dose cataplasms group (P>0.05). Sort by Relevance:the high dose cataplasms group > the model group > the excipient group >fuxiong-cream group.
     8.NF-κB P65 protein expression and mRNA expression levels in the lung and intestinal tissue and correlation analysis:
     Lung tissue:In the normal group could detect small amounts of NF-κB P65 protein expression and mRNA expression levels.The expression of NF-κB P65 protein and mRNA were the highest concentrations in model group, with the normal group, there was significant difference (P<0.01);with the excipient group rather,there was no significant difference (P>0.05). Apply the low and high doses fuxiong- cataplasms group and fuxiong-cream group, the expression of NF-κB P65 protein and mRNA were higher than the normal group,but significantly lower than the model group (P<0.05); and the three pairwise comparisons were significantly different (P<0.05). High dose cataplasms group the lowest NF-κB P65 protein expression and mRNA expression levels.
     Intestinal tissue:In the normal group could detect small amounts of NF-κB P65 protein expression and mRNA expression levels. The expression of NF-κB P65 protein and mRNA were the highest concentrations in model group, with the normal group, there was significant difference (P<0.01) ;with the excipient group,no significant difference (P>0.05). Apply the low and high doses fuxiong- cataplasms group and fuxiong-cream group, the expression of NF-κB P65 protein and mRNA were higher than the normal group,but significantly lower than the model group (P<0.05); and the three pairwise comparisons were significantly different (P<0.05). High dose cataplasms group the lowest NF-κB P65 protein expression and mRNA expression levels.
     Correlation analysis: The lung and intestinal tissue in the normal groups, NF-κB P65 protein expression and mRNA expression levels did not appear correlated (P>0.05); the model group, the excipient groups, fuxiong-cream group, the high dose cataplasms group, NF-κB P65 expression in the lung and intestinal tissue showed positive correlation (P<0.05) and did not appear correlated in the low dose cataplasms group(P>0.05).Sort by Relevance:the high dose cataplasms group>the model group>the excipient group>fuxiong-cream group.
     9.The content of The total free anthraquinones in the fuxiong- cataplasms was 11.9023mg esch,that in fuxiong- cream is 5.8702mg each, there was no the total free anthraquinones in excipient.
     10.It is different Active ingredient from the fuxiong- cataplasms and the fuxiong- cream, the content of rhein in cream is lower than that in cataplasms, but the contents of emodin、rhein、aoe-emodin、chrysophanol and physcion in cream are higher.
     11.Starting from the forth hour, the Major components- emodin、chrysophanol in fuxiong-cataplasms,that permeation in unit area are higher than fuxiong- cream, as time been longer, as the difference value of permeation in unit area is bigger.
     Conclusion:
     1.The fuxiong- cataplasms reduced mortality of influenza virus to infect mice pneumonia;and reduced losses in transit visibly, its eased Lung inflammation, and been Inhibition of influenza viral to infect Rat lung replication。
     2.Pathogenesis of influenza viral Pneumonia maybe relate to excessive increasing inflammatory and activation of transcription factor NF-κB P65;The treatment of fuxiong- cataplasms maybe related to degrade TNF-α、raise IL-10 and interruption of NF-κB P65 expreesion.
     3.When the dose of fuxiong- cataplasms was up to a certain dose, the same indicator in the pulmonary and intestinal organizations were relevant to the treatment effect,which was correspond to the theory of“lung associating with large intestine”.
     4.HPLC become a mature technology to determin contents and quality control.
     5.The fuxiong- cataplasms is a safe and reliable Chinese herb preparations, and there is good percutaneous penetration, improved formulations possible.
引文
[1]汪受传.小儿病毒性肺炎的临床和实验研究[J].中医儿科进展,2003,11:7-14.
    [2]白晓红,董娜,王雪峰.中药敷胸散治疗支气管肺炎疗效观察[J].辽宁中医杂志,2004,31(1):49.
    [3]严文初,田立东,马立英,等.敷胸散促进小儿肺炎湿罗音吸收疗效机理探讨[J].中国函授通讯.1995,6:32-33.
    [4]董丹,吴振起.敷胸散对流感病毒肺炎小鼠防治作用的实验研究[J].辽宁中医杂志,2004,31(6):524.
    [5]刘淑芝.中药巴布剂研究现状分析及展望[J].中医外治杂志,2005,14(5):3-5.
    [6]徐敏,马伟斌.巴布剂的研究及新方向[J].中华中医药学刊.2007,25(6):1272-1274.
    [7]徐红日,王成祥,王惠芳,等.中医药对流感病毒感染所致炎性损伤的干预机制研究概况[J].实用心脑肺血管病杂志.2010,18(11):1731-1733.
    [8]曹建,廖品虎.转录调节因子核因子κB参与调控的急性肺损伤相关的细胞因子基因[J].医学综述,2007,13(20):1526-1528.
    [9]WEI L,SANDBULTE MR,THOMAS PG,et al.NF-κB negative regulates interferon induced gene expression and anti-influenza activity[J].J Biol Chem,2006,281(17):11678-11684.
    [10]DANIELA BERNASCONI,CARLA AMICI,SIMONE LAFRAZIA.The IκB Kinase Is a Key Factor in Triggering Influenza A Virus-induced Inflammatory Cytokine Production in Airway Epithelial Cells[J].The Journal of Biological Chemistry,2005,280(25):24127-24134.
    [11]刘旭海.大黄药理作用及临床应用研究进展[J].山东医学高等专科学校学报.2007,29(3):229-231.
    [12]吴力群,王晓英.特制狗皮膏穴位贴敷促进支气管肺炎罗音吸收临床分析[J].中医药研究,1998,14(6):18.
    [13]李群.社区获得性肺炎病原体的研究进展[J].西部医学,2006,18(3):354-356.
    [14]Lamb R,Krug RM.Orthomyxoviridae:the viruses and thei replication.In:Fields BN,Knipe RM,Chanock MS,et al.editors.Fields Virology.Philadelphia:Lippincott-Raven Publishers,1996:1353-96.
    [15]Portela A,Zurcher T,Nieto A,et al.Replication of orthomyxoviruses[J].Adv Virus Res,1999,54:319-48.
    [16]Wright PF,Webster RG.Orthomyxoviruses[A].In: Knipe DM,Howley PM,editors.Fields virology,vol.1[M].4th ed. Philadelphia:Lippincott Williams and Wilkins,2001.1533-79.
    [17]Alexander DJ.A review of avian influenza in different bird species[J].Vet Microbiol,2000,74(1-2):3-13.
    [18]Portela A,Digard P.The influenza virus nueleoprotein:a ultifunetional RNA-binding protein pivotal to virus replieation[J].JGenVirol.2002,83(4):723-734.
    [19]Okada A,Miura T,Takeuchi H.Protonation of histidine and histidine-tryptophaninteraction in the activation of the M2 ion channel from influenza a virus[J].Biochemistry,2001,40(20):6053-6060.
    [20]Lin YP,et al.Recent changes among human influenza viruses[J].Virus Res.2004;103(l-2):47-52.
    [21]Potter CW.Attenuated influenza virus vaccies[J].Rev Med Viral.1994;4(4):279-292.
    [22]刘广杰.流行性感冒病毒的临床诊治[J].中国临床医生杂志,2007;35(2):13-14.
    [23]Retails P.Strange C.Harley R.The speetrum of adult adenovirus pneumonla[J].Chest,1996,109:1656-1657.
    [24]Opsjln SL,Wathen NC,Fingulstad S,et al.Tumor necrosis factor,interleukin-1 and‘interleukin-6 in normal human pregnancy[J].Am J Gyneeol,1993,169:397-406.
    [25]巴德年主编.当代免疫学技术与应用[M].北京医科大学、北京协和医科大学联合出版社,1998,第一版,49-71.
    [26]Van Reeth K.Cytokines in the Pathogenesis of influenza[J].Vet Microbiol,2000;74(l-2):109-116.
    [27]Song M,Kellum JA.Inierleukin-6.Crit Care Med,2005;33(12):463-465.
    [28]李红霞.白介素-10对急性肺损伤的保护作用[J].国外医学呼吸系统分册,2000,20(2):94-96.
    [29]Pajkrt D,Camoglio L,Tiel-van Buul MC,et al.Attenuation of proinflammatory response by recombinnant human IL-10 in human endotoxemia:effect of timing of recombinant human IL-10 administration[J].J Immunol,1997,158:3971.
    [30]洪新,郭振辉,毛宝龄.白细胞介素-10和地塞米松对人外周血单个核细胞核因子-κB活化及肿瘤坏死因子产生的影响[J].解放军医学杂志,1999,24(5):317-320.
    [31]De Waal Malefyt R,Abrams J,Bennett B,et al.Interleukin 10(IL-10)inhibits cytokine synthesis by human macrophage:an autoregulatory role of IL-10 produced by monocytes[J].J Exp Med,1991,174:1209-1220.
    [32]Wiley AJ,Cerwenka A,Harkema RJ,et al.Production of interferon-γby influenza hemagglutinin-specific CD8 effector T cells influences the development of pulmonary immunopathology[J].American Journal of Pathology.2001,158:119-130.
    [33]Wang KS,Frank DA,Ritz J.Interleukin-2 enhances the response of natural killer cells to interleukin-12 through up-regulation of the interleukin-12 receptor and STAT4[J].Blood,2000,9(10):3183-3190.
    [34]LeVine AM,Koeningsknecht V,Stark JM.Decreased pulmonary clearance of S.pneumoniae following influenza A infection in mice[J].J Virol Methods,2001,94(1-2):173-86.
    [35]史利卿,邱全瑛,吕燕宁等.宣肺解毒颗粒剂对流感病毒肺炎小鼠血浆中细胞因子水平的影响[J].北京中医药大学学报,1998,4:23-25.
    [36]任现志,汪受传,李江全.清肺口服液在小鼠体内诱生干扰素的实验研究[J].南京中医药大学学报(自然科学版),2000,16(2):100-101.
    [37]Kostense S,Sun WH,Cottey R,et al.Interleukin2 administration enhances Thl activity but delays reeovery from influenza A virus infection in mice[J].Antiviral Res,1998:38:117.
    [38]金伯泉主编.细胞和分子生物学[M].北京世界图书出版公司,1995,135.
    [39]杨贵贞主编.医学免疫学[M].长春吉林科学技术出版社,1995,45,83.
    [40]Matikainen S,Pirhonen J,Govenius-Vintola C,et al.Influenza A and sendai viruses induce differential chemokine gene expression and transcription factoractivation in human macrophages[J].Virology,2000,276:138-47.
    [41]Flory E,Kunz M,Scheller C,et al.Influenza virus-induced NF-kappaB-dependent gene expression is mediated by overexpression of viral proteins and involves oxidative radicals and activation of IkappaB kinase[J].J Biol Chem,2000,275:8307-14
    [42]Ponnappan S,Cullen SJ,Ponnappan U.Constitutive degradation of IkappaBalpha in human T lymphocytes ismediated by calpain[J].Immun Ageing,2005,2:15.
    [43]Kumar A,Haque J,Lacoste J,et al.Doublestranded RNA-dependent protein kinase activates transcription factor NF-kappa B by phosphorylating I kappaB[J].Proc Natl Acad Sci USA,1994,91:6288-92.
    [44]Kujime K,Hashimoto S,Gon Y,et al.p38 mitogen-activated protein kinase and c-jun-NH2-terminal kinase regulate RANTES production by influenza virus-infected human bronchial epithelial cells[J].J Immunol,2000,164:3222-8
    [45]Hofmann P,Sprenger H,Kaufmann A,et al.Susceptibility of mononuclear phagocytes to influenza A virus infection and possible role in the antiviral response[J].J Leukoc Biol,1997,61:408-14.
    [46]Coccia EM,Passini N,Battistini A,et al.Interleukin-12 induces expression of interferon regulatory factor-1 via signal transducer and activator of transcription-4 in human T helper type 1 cells[J].J Biol Chem,1999,274:6698-703.
    [47]Lehtonen A,Matikainen S,Julkunen I.Interferons up-regulate STAT1,STAT2,and IRF family transcription factor gene expression in human peripheral blood mononuclear cells and macrophages[J].J Immunol,1997,159:794-803.
    [48]Mamane Y,Heylbroeck C,Genin P,et al.Interferon regulatory factors:the next generation.Gene,1999,237:1-14.
    [49]Matikainen S,Pirhonen J,Govenius-Vintola C,et al.Influenza A and sendai viruses induce differential chemokine gene expression and transcription factor activation in human macrophages[J].Virology,2000,276:138-47.
    [50]Sato M,Hata N,Asagiri M,et al.Positive feedback regulation of type I IFN genes by the IFN-inducible transcription factor IRF-7[J].FEBSLett,1998,441:106-10.
    [51]Marie I,Durbin JE,Levy DE.Differential viral induction of distinct interferon-alpha genes by positive feedback through interferon regulatory factor-7[J].EMBO J,1998,17:6660-9.
    [52]Levy DE,Lew DJ,Decker T,et al.Synergistic interaction between interferon-alpha and interferongamma through induced synthesis of one subunit of the transcription factor ISGF3[J].EMBO J,1990,9:1105-11.
    [53]Wong LH,Hatzinisiriou I,Devenish RJ,et al.IFN-gamma priming up-regulates IFN-stimulated gene factor 3(ISGF3)components,augmenting responsiveness of IFN-resistant melanoma cells to type I IFNs.J Immunol,1998,160:5475-584.
    [54]Choi AM,Knobil K,Otterbein SL,Eastman DA,et al.Oxidant stress responses in influenza virus pneumonia:gene expression and transcription factor activation[J].Am J Physiol,1996,271:383-91
    [55]高慧.肺炎贴膏治疗小儿肺炎100例[J].中医外治杂志,1999,8(2):11
    [56]张艳平.穴位贴敷治疗小儿肺炎30例临床观察[J].吉林中医药,2006,2(611):57-58
    [57]许晓莉.自拟中药制剂肺炎宁帖穴位贴敷佐治小儿肺炎63例疗效观察[J].中国中西医结合儿科.2010,2(5):437-438
    [58]黄玲丽,杨湘华.茴芥散外敷治疗病毒性肺炎[J].湖北中医杂志,2004,26(9):23.
    [59]端木惠贤.综合法治疗小儿病毒性肺炎26例[J].双足与保健,2003,(3):4.
    [60]吴文,姜永红,李文,等.内服外治法治疗小儿急性肺炎85例[J].上海中医药杂志,2008,42(9):31-33
    [61]王雪峰,刘芳,董丹,等.内外合治法治疗小儿肺炎临床疗效评价[J].中国中西医结合杂志,2005,25(6):536-539
    [62]李杰,广凌,王雪峰.中药内外合治小儿病毒性肺炎的临床研究[J].辽宁中医杂志,1999,26(6):261.
    [63]许伦霞.宣肺膏敷脐治疗小儿病毒性肺炎[J].黑龙江中医药,1997,(2):43.
    [64]杜克宽.中药内外合治小儿肺炎80例[J].河北中医,2000,22(1): 37.
    [65]王理群.自拟三白敷贴散治疗小儿肺炎临床观察[J].中医药临床杂志,2004,16(5): 413.
    [66]张玉芬,李严滔.双黄连治疗小儿病毒性肺炎疗效观察[J].实用心脑肺血管病杂志,2003,11(4):229.
    [67]田雅萍,侯明惠,李祥.痰热清注射液治疗病毒性肺炎52例临床观察[J].临床肺科杂志,2004,9(5):505.
    [68]吴倩倩,师晶丽,金皎,等.银花合剂雾化吸入治疗婴幼儿病毒性肺炎的临床与试验研究[J].中国中西医结合杂志,1999,19(12):728-730.
    [69]禹丽,刘丽波,刘汉利.鱼金注射液雾化吸入治疗婴幼儿病毒性肺炎[J].现代医药卫生,2005,21(3):288.
    [70]秦凤伟,王娟.双黄连雾化吸入治疗小儿病毒性肺炎30例[J].辽宁中医杂志,2003,30(12):1004-1005.
    [71]龚先明,刘冬平,李玉华.双黄连雾化吸入治疗喘憋性肺炎疗效观察[J].郧阳医学院学报,2000,19(2):81-82.
    [72]李凤连.经皮给药治疗仪佐治小儿喘憋性肺炎疗效观察[J].山西医药杂志,2004,33(3):237-238.
    [73]秦立鹏.中西药结合直肠注入治疗小儿肺炎208例[J].中国社区医师综合版,2004,6(15):36.
    [74]王冰注.黄帝内经[M].中医古籍出版社,2003.
    [75](明)徐师曾等.经络全书[M].中医古籍出版社,1992.5.
    [76](隋)巢元方.诸病源候论[M].辽宁科学技术出版社,1997.8.
    [77]田(清)唐宗海.中西汇通医经精义[M].上海古籍出版社,1996.
    [78]唐容川.中西医汇通医经精义(上卷)[M].王眯眯,李林主编.医学全书.北京:中国中医药出版社,1999.21
    [79]孙文胤.丹台玉案[M].上海科学技术出版社,1984.
    [80]孙星衍校.华氏中藏经[M].商务印书馆,1956.
    [81]宋乃光主编.刘完素医学全书[M].中国中医药出版社,2006-01-01.
    [82](元)朱震亨.丹溪手镜[M].人民出版社,1982.2
    [83](明)戴元礼.证治要诀[M].商务印书馆,1939.
    [84](明)皇甫中.明医指掌[M].人民卫生出版社,1982.
    [85]费伯雄.医醇剩义[M].人民卫生出版社,2006.
    [86]喻昌.寓意草[M].中国中医药出版社,2008.
    [87]孔祥文,严志林.宣白承气汤治疗肺脓肿高热55例[J].中国中医急症,2003,(12):3
    [88]杨献民,杨军.大承气汤加味治疗儿童休克型大叶性肺20例[J].国医论坛,2000,(15):2
    [89]曾兆麟,李玉梅.从中医肺与大肠相表里理论探索难治性非典型性肺炎(SARS)治疗的新思路[J].上海中医药杂志,2003,(37):5
    [90]李志军,李银平,王今达.肺与大肠相表里学说与多器官功能障碍综合征[J].中国中西医结合急救杂志,2004,(11):3
    [91](唐)王冰撰.素问六气玄珠密语[M].上海古籍出版社,1996.
    [92](清)叶天士.临证指南医案[M].华夏出版社.1995
    [93]赵富宝.香砂承气汤治疗肺心病失代偿期胃肠功能衰竭82例[J].中医杂志,1999,(40):6
    [94]肖阳娥,黄晓川,卿敬军,等.增液承气汤加减在慢性呼吸衰竭救治中的应用[J].广后医学,1995(9):2
    [95]秦昌遇.证因脉治[M].中医古籍出版社,2000:6.
    [96](宋)陈言著.三因极—病证方论[M].人民卫生出版社,1957.
    [97](元)朱震亨.丹溪治法心要[M].人民出版社,1983.7.
    [98](元)朱震亨.金匾钩玄[M].人民出版社.1980.12.
    [99]余霖.疫疹一得[M].人民卫生出版社,1959.
    [100]陈自明.妇人大全良方[M].中国中医药出版社,2007.
    [101]吴鞠通.吴鞠通医案[M].人民卫生出版社,1985.
    [102]杨上善撰注黄.帝内经太素[M].人民卫生出版社1965.
    [103]周学海.读医随笔[M].中国中医药出版社,1997.
    [104]陈士铎.石室秘录[M].人民军医出版社,2009.
    [105]张隐庵.黄帝内经灵枢集注.上海科学技术出版社,1959.
    [106](金)张子和.儒门事亲[M].人民卫生出版社,2005.
    [107](东汉)张仲景.仲景全书[M].中医古籍出版社,2000
    [108](清)俞震辑.古今医案按[M].中国中医药出版社,1999-08-01.
    [109](明)王肯堂.伤寒证治准绳[M].人民卫生出版社,2005-9.
    [110](金)成无已.注解伤寒论[M].人民卫生出版社,1963.
    [111]盖晓丽.王雪峰教授运用通腑法治疗小儿肺炎喘嗽摭拾[J].实用中医内科杂志.2008,22(5):10.
    [112]朱胜.通腑泻痰法在小儿肺炎喘嗽急性发作中的应用[J].辽宁中医学院学报.2004,6(1):39.
    [113]朱晓蕾.肺与大肠同治法治疗喘证机理初探[J].陕西中医函授.1997,4:7-9
    [114]杜丽娟,李风森,刘慧芳.哮喘大鼠气道、大肠黏膜中CD4+、CD8+淋巴细胞变化研究[J].中华实用中西医杂志.2008,21(13):1117-1118.
    [115]张立山,戴雁彦,武维屏.毒损肺络与SARS[J].中国中医基础医学杂志.2003,9(12):18-19.
    [116]陈美男,李富玉.从痰毒辨治疾病初探[J].中医药临床杂志,2006,18(6):625-627.
    [117]邓文龙.中医解毒法实质研究及内毒素性疾病的中医药防治[J].中药药理与临床,1993,8(4):40.
    [118]余林中.中药解毒新机制—对细胞信号转导调控作用研究[J].哈尔滨商业大学学报,2002,18(3):8-9.
    [119]张进陶,王飞,陈勇.中医对呼吸道病毒感染的病因病机探析[J].四川中医.2008,26(1):15-16.
    [120]王文革.痰热闭肺证本质是肿瘤坏死因子等细胞因子失衡假说初探.2010,16(9):10-13.
    [121]原金隆.杂谈病毒感染的辨治特点[J].辽宁中医杂志,1986,(1):6
    [122]蔡定芬.抗庚散治疗病毒性高热的临床研究[J].中国医药学报,1990,(5):19.
    [123]饶宏孝.通腑泻热法治小儿急症四则[J].新中医.1992.11:37-38
    [124]史利卿,邱全瑛,吕燕宁,等.宣肺解毒颗粒剂对流感病毒肺炎小鼠血浆中细胞因子水平的影响[J].北京中医药大学学报,1998,21(4):23-25.
    [125]王雪峰.中西医结合儿科学[M].北京:中国中医药北京出版社.2005,8:75.
    [126]郭元吉.流行性感冒病毒及其实验技术[M].北京:中国三峡出版社,1997.91,94-96,100-106,110-112.
    [127]藤田次郎.流感病毒性肺炎[J].日本医学介绍.2004,25(9):402.
    [128]刘崇海.流感病毒感染动物模型的研究进展[J].国际病毒学杂志.2006,13(1):9-12.
    [129]Sauerbrei A,Ulbricht A,Wutzler P.Antiviral Res.2003 Mar;58(1):81-7.
    [130]黄祯祥.医学病毒学基础及实验技术[M].北京:科学出版社,1990:656.
    [131]萨姆布鲁克J,弗里奇EF,丁曼尼柯蒂斯T.分子克隆实验指南[M].第2版.北京:科学出版社,1992.602.
    [132]徐敏,马伟斌.巴布剂的研究及新方向[J].中华中医药学刊.2007,25(6):1272-1274.
    [133]孙六合,曹健美.浅谈穴位贴敷疗法[J].河南中医药学刊,2001,16(2):45.
    [134]傅继华.病毒学实用实验技术[M].济南:山东科学技术出版社,2001:6.
    [135]余小萍,傅慧婷.中医药防治流感的免疫调节机制的研究概况[J].辽宁中医杂志,2006,33(8):1044-1046.
    [136]石榴,黄文杰.核因子KB与肺炎治疗的最新进展[J].国际呼吸杂志.2009,29(4):231-233.
    [137]曹杰.IFN_PDS合剂对甲型流感病毒噬鼠肺强毒株所致病毒性肺炎的保护作用及机制研究[D].吉林大学博士学位论文.2006.
    [138]中华医学会中华儿科杂志编辑委员会.常见病毒性急性呼吸道感染的防治[J].中华儿科杂志,2000,38(10):641~645
    [139]曹建,廖品琥.转录调节因子核因子κB参与调控的急性肺损伤的相关的细胞因子基因[J].医学综述,2007,13(20):1526-1528.
    [140]WEI L,SANDBULTE MR,THOMAS PG,et al. NF-κB negatively regulates Interferon induced gene expression and anti-influenza activity[J].J Biol Chem,2006,281(17):11678-11684.
    [141]DANIELA BERNASCONI,CARLA AMICI,SIMONE LAFRAZIA. The IκB Kinase Is a Key Factor in Triggering Influenza A Virus-induced Inflammatory Cytokine Production in Airway Epithelial Cells[J].The Journal of Biological Chemistry,2005,280(25):24127-24134.
    [142]Basak S,Hoffmann A.Crosstalk via the NF-kappa B signaling ystem[J].Cytokine Growth Factor Rev,2008,19:187-197.
    [143]王丽英,张丽珍,鲁刚英.大黄药理作用研究进展[J].时珍国医国药,2000,4(11):381-382.
    [144]侯炜,杨占秋,陈科力,等.大黄有效成分抗单纯疱疹病毒作用的实验研究[J].药物分析杂志,2003,23(4):259-262.
    [145]宋艳艳,王桂亭,王小凡.大黄乙醇提取物体内抗单纯疱疹病毒作用的研究[J].中华实验和临床病毒学杂志,2003,17(2):169-173.
    [146]申元英,杨占秋,刘建军,等.大黄在体内抗柯萨奇B3病毒的实验研究[J].中国病毒学杂志,2001,16(1):86.
    [147]梁荣感,罗伟生,李利亚,等.大黄蒽醌类化合物体外抗流感病毒作用的研究[J].2006,19(3):396-398.
    [148]肖崇厚,杨松松,洪筱坤,等.中药化学[M].上海:上海科学技术出版社,2002:218-219.
    [149]国家药典委员会.中国药典(2005版一部)[S].北京:化学工业出版社,2005.附录9.
    [150]张剑飞,边际.巴布剂贴膏基质的工艺研究[J].山东医药工业,200l,20(5):3.
    [151]贾伟,高文远.中药巴布剂的研究现状[J].中国中药杂志,2003,28(1):7-11.
    [152]付毅华,杜华碧.活血止痛贴蛇床子素的体外透皮实验研究[J].医学信息.2010年,23(4):896-898.
    [153]梁学政,奉建芳,陈惠红,等.双柏凝胶剂中大黄素体外透皮吸收的实验研究[J].时珍国医国药.2010,21(1):160-161.
    [154]于敏,韩德强,苏瑾,等.乳腺康巴布剂的体外释放实验研究[J].中国现代应用药学.2010,27(2):135-137.
    [155]国家药典委员会.中国药典(2005版一部)[S].北京:化学工业出版社,2005.附录9.
    [156]崔乃杰,袁桂玉,张伯礼.中西医结合实用临床病毒学[M].天津:天津科技翻译出版公司,1999.398
    [157]汪受传,任现志,朱先康.小儿病毒性肺炎病原病机证候探讨[J].辽宁中医杂志,1999,26(1):5-6
    [158]张进陶,王飞,陈勇.中医对呼吸道病毒感染的病因病机探析[J].四川中医. 2008,26(1):15-16.
    [159]成建山.中医外治的现状和展望[J].中医杂志,1992,33(12):40.
    [160]吴震西.近十年来中医发展概况[J].2003,12(1):32-33.
    [161]李忠.中医内病外治的研究进展及思路——全身性疾病药物外治的文献回顾发展趋势及技术要点[J].中医外治杂志,2003,12(6):3-5.
    [162]高桂新,沈华浩.感冒双解合剂对流感病毒FM1感染小鼠肺部炎性损伤的影响[J].中国病理生理杂志,2007,23(6):1137-1140.

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