当归饮子对慢性荨麻疹迟发相过敏反应的影响研究

现出一定的 剂量依赖性。综上所述，当归饮子可以抑制慢性荨麻疹的迟发相过敏反应，当归饮子 对LTB4的抑制作用是其临床疗效的基础之一。 关键词：慢性荨麻疹 迟发相 白三烯 当归饮子 lll EffectofChineseAngeIicaDecoctionon Late—phasereactionofchronicurticaria ABSTRACT SpeciaIity：SurgeryofTradjtionalOh}Des8Medlcine Author：XiaoHongIi Tutor：CuiXuejiao 1 Objective Sincetheresearchaboutchronicurticaria(cu)mainlyconcentratedonthe early-phasereaction(EPR)ofitandthestudyabouttheeffectofChineseherb onthelate—phasereaction(LPR)ofCUwasalmostblankinthepast，thistopic researchthefunctionalmechanismofChineseherbonCUinrespectto inhibitingthelate—phasereaction(LPR)forthefirsttime．Thistopic researchtheinhibitoryeffectofChineseAngelicaDecoction(CAD)onLPRof CUandleukotrieneB4whichisaveryimportantinflammatorymediatorinthe LPRofCU．Thistopicwili expandnewtreatmentandresearchmethodforCU attheangleofanti—inflammation． 2 Method 2．1Literatureinvestigation Theliteratureonchronicurticaria(CU)wassummarizedinorderto systematicallyfathomthecurrentsituationofCU．The1iterature investigationindicatesthatthefoundationalresearchofChineseherbonCU isscarce，andespeciallytheresearchaboutChineseherbonlate～phase reactionofCUisalmostblank． 2．2C1inicalstudy Adoptingtheruleofsingleblind，randomandcontrast，120caseswere dividedintofourgroups，groupAtakingChineseangelicadecoction，groupB takingMizolastine，groupCtakingMontelukast，andgroupDtakingloratadine- Comparetheearlycurativeeffect，prostecdtiveefficacy，relapserateand theserflm]evelof1eukotrieneB4inthefourgroups． 2．3Experimentalstudy 2．3．1Micepassivecutaneousanaphylaxistest(PCA) Adoptingtheruleofrandomandcontrast，sensitizedNIHmiceweredivided intosevengroups。thesensitizedcontrolgroup(groupA)，high—dosegroupof CAD(groupB)，low—dosegroupofCAD(groupC)，mizolastinegroup(group D)，montelukastgroup(groupE)，loratadinegroup(groupF)，dexamethasone group(groupG)．PCAwasinducedbyintraperitonealantiseruminjection．And themiceweretreatedwithgastricinfusionsimultaneously．30minutesLater afterthelastfeeding，antigenattackwasconducted．Thenthesemicewere executed，theirbloodwascolleeted，andthesensitizedsectionofskinWaS cutted．InhibitoryrateofPCAinsevengroupsweremeasuredbycolorimetric determination．TheserumlevelofLTB4wasdetectedbyELISAmethod． CorrelationbetweeninhibitoryrateofPCAandserumlevelofleukotriene B4wasmeasured． 2．3．2InhibitiontestonreleaseofleukotrieneB4fromspleenlymphocytes ofsensitizedmice Adoptingtheruleofrandomandcontrast，BALB／cmiceweredividedinto normalcontrolgroupandsensitizedcontrolgroup．Thesensitizedgroupwas dividedintoeightgroups，thesensitizedcontrolgroup(groupA)，DMSO group(groupB)，high—dosegroupofCAD(groupC)，low—dosegroupofCAD(group D)，mizolastinegroup(groupE)，montelukastgroup(groupF)，loratadine group(groupG)，dexamethasonegroup(groupH)．Miceweresensitizedby intraperitonealinjectionsofOVA．Thespleenlymphocyteswereisolatedand lymphocytesconcentrationwasregulatedwithcellculturesolution．Thenthe spleenlymphocyteswereincubatedwithdrugsolutionabove—mentionedprior toantigenre—attackwithOVA．ELISAwasappliedtodetectthelevelofLTB4 incellculturesupernateineverygroup． 3ResuIts 3．1CIinicalstudy Statisticanalysisindicatedthatnodifferenceofearlycurativeeffect wasfoundamongChineseangelicadecoction(A)，mizolastine(B)and V loratadine(D)(P>0．05)．Theearlycurativeeffectofmontelukast(C)waslower thanotherthreegroups(PO．10)．TheprostecdtiveefficacyofgroupDwaslowerandthe relapserateofgroupDwashigherthangroupA，B，C(P<0．05)．Therelapse intervalofgroupA，BandCwasobviouslylongerthangroupD(PO．25)andwassignificantly lowerthanprior—treatment(PO．50)． 3．2Experimentalstudy 3．2．1MicepassiveCUtaneousanaphylaxiStest(PCA) GroupB，C，D，E，FandG couldsignificantlyinhibitPCAin mice(P<0．001)．Theinhibitoryrateofdexamethasone(groupG)wasstrongest amonga11groups(P0．50)．TheinhibitoryeffectofgroupC，Ewas statisticallysimilar(P>O．50)andinferiortogroupB，D，F(P<0．001)． TheserumlevelofLTB4ingroupB，C，D，E，GwassignificantlYlowerthan thatofgroupA(sensitizedcontrolgroup)andgroupF(PO．50)．GroupC，D，E，HcouldsignificantlyinhibitthereleaseofLTB4from spleenlymphocytes．ThereleaselevelofLTB4ingroupC，D，E，Hdiffered statisticallYfromgroupA，B(P<0．01)．TheinhibitoryeffectofgroupHwas strongerthangroupC，D，E(P0．50四组性别构成无显著性差异 lO 当归饮子对慢性荨麻疹迟发相过敏反应的影响研究 表2荨麻疹患者年龄构成比较(岁) P>O．50四组年龄构成无显著性差异 2．1．7处理措施：A组予当归饮子，每日一剂，水煎二次合汁，分二次口服；B组予 眯唑斯汀，每日lOmg口服；C组予孟鲁司特，每日lOmg口RE；D组予氯雷他定，每 日lOmg口服。均阻4周为一疗程，第4周结束时停药，进行近期疗效评定。并分别 于治疗结束后4周及8周时随访，进行远期疗效及复发率的评定。 2．1．8症状和体征评分标准：采用4级评分法，评分内容包括皮肤瘙痒、风团数量和 风团大小 皮肤瘙痒 风团数量 风团大小 0分为无瘁感，1分为轻度瘙痒，2分为中度瘙痒，3分为严重瘙痒。 0分为无风团，1分为l～6个，2分为7～12个，3分为>12个。 O分为无风团，1分为直径20mm。 2．1．9疗效判断标准治疗前后症状和体征评分的总和为总评分。 下降指数=(治疗前总评分一治疗后总评分)／治疗前总评分×100％。 疗效标准：①痊愈，下降指数=100％；②显效，60％4下降指数<100％；③有效，20％4 下降指数<60％；④无效，下降指数<20％。以痊愈与显效之和计算有效率。 2．1．10复发标准：对各组中痊愈的病例追踪观察8周，每4周随访1次，统计复发 率。 2．1．11辅助观察指标：设正常对照组30例，均为健康志愿者，无慢性疾病及过敏性 疾病史。检测