中医联合治疗发作期激素抵抗型哮喘的临床观察和对血浆NF-κB、AP-1表达水平的影响.pdfVIP

提 要 目的：观察中医联合疗法对急性发作期激素抵抗型哮喘（steroid-resistant asthma,SRA ）患者的临床疗效及对血浆 NF-κB 、AP-1 表达水平的影响，探讨中医联 合疗法治疗 SRA 的作用机制，为该病提供新的治疗思路与方法。方法：将符合纳入 标准的 60 例发作期 SRA 患者按就诊的先后顺序随机分为中医联合（中药+穴位敷贴+ 拔罐+针灸）治疗组 20 例，博利康尼治疗组 20 例，氨茶碱治疗组 20 例，分别给药 18 日，观测各组患者治疗前后血浆NF-κB 、AP-1 表达水平的变化，同时检测患者肺 功能变化、观察主要症状和体征，判断临床疗效。所有实验数据用 SPSS16.0 软件进 行统计。结果：结果显示，中医联合组、氨茶碱组、博利康尼组患者治疗后主要症状 和体征均有明显改善，中医联合组疗效优于两西药组，两西药组疗效相当；三组肺通 气功能明显提高（P ＜0.05 ），中医联合组优于两组西药组（P ＜0.05 ），两西药组组间 无显著差异（P ＞0.05 ）；三组均降低患者血浆NF-κB 、AP-1 表达水平（P0.05 ），中 医联合组优于两西药组（P ＜0.05 ），两西药组组间无显著差异（P ＞0.05 ）。结论：中 医联合疗法可有效缓解哮喘患者气道高反应性，改善肺通气功能；可通过降低 NF-κB 、 AP-1 的表达，抑制转录因子的过度活化，缓解气道炎症，能在较高的水平上调控产 生炎性因子的总体环节，有效改善患者病情，是急性发作期 SRA 的一种行之有效的 治疗方法。 关键词 中医联合疗法；SRA；NF-κB 、；AP-1 ；临床研究 Clinical Research of Chinese Traditional Medicine to the Period of Onset of Steroid-resistant Asthma and its Influence on Plasma NF-κB and AP-1 Speciality: Combination clinic of TCM with Western medicine Author: Niu Rui Tutor: Professor Zheng Xin Abstract Objective: To observe the clinical effect of united Chinese traditional medicine to the period of onset of steroid-resistant asthma (SRA) and its influence on plasma NF-κB and AP-1. To explore the mechanism of united Chinese traditional medicine to SRA and provide new ideas and methods to that. Methods: Sixty patients with SRA were randomly divided into three groups of 20 people each according to treatment order, including Chinese traditional medicine group (traditional Chinese medicine, point application, ventouse and acupuncture), terbutaline group and aminofilina group. They were administered for 18 days respectively. Plasma levels of nuclear factor-κB (NF-κB), activator protein -1 (AP- 1) were observed before and after trea