清热利湿饮联合咪唑斯汀治疗湿疹湿热证的探究.pdfVIP

提 要 目的：观察清热利湿饮联合咪唑斯汀治疗湿疹湿热证的疗效；通过动物实验观察 清热利湿饮对Ⅳ型变态反应、炎症反应及 5-脂氧合酶的影响，探讨清热利湿饮治疗湿 疹可能的作用机理。方法：临床部分将 60 例湿疹患者随机分成治疗组（清热利湿饮+ 咪唑斯汀组）、对照组（清热利湿饮组），疗程4 周。观察两组患者瘙痒程度、红斑、 丘疹等积分的变化及不良反应。实验部分建立小鼠Ⅳ型变态反应模型，将小鼠随机分 组，灌胃生理盐水、醋酸泼尼松、清热利湿饮、清热利湿饮+咪唑斯汀,观察对Ⅳ型变 态反应的影响；建立小鼠耳廓肿胀炎症模型，随机分组，分别外涂生理盐水、哈西奈 德、清热利湿饮，观察对炎症反应的影响；建立大鼠花生四烯酸大鼠足跖肿胀模型， 随机分组，灌胃生理盐水、咪唑斯汀、清热利湿饮，观察对 5-脂氧合酶的影响。结果： 治疗组愈显率 96.70%，总有效率 100％，对照组愈显率73.33%，总有效率 90.00 ％， 两组比较差异有显著性（P0.05 ）。治愈后 3 月复诊，两组比较无显著性差异（P ＞0.05 ）； 实验显示，清热利湿饮明显抑制Ⅳ型变态反应、炎症反应及 5-脂氧合酶。结论：清热 利湿饮+咪唑斯汀治疗湿热型湿疹可提高疗效。清热利湿饮的作用机理与其抗Ⅳ型变 态反应、抑制 5-脂氧合酶减少白三烯的产生、抗炎、抗病原微生物、利尿等有关。 关键词 湿疹；中西医结合；临床研究；实验研究 The Clinical and Experimental Study for Treating Eczema with Qing Re Li Shi Yin Speciality: Dermatology,Surgery of TCM Author: Wang Guo Ying Tutor: Professor Du Xixian Abstract Objective:To observe clinical efficacy for eczema of MH of Qing Re Li Shi Yin (QRLSY) combine Mizolastine.To observe impact on Ⅳ allergic reaction, Inflammatory reaction and 5-LO of QRLSY by the animal experiment.To approach the mechanism of action of QRLSY for eczema.Method:60 patients were separated at random into the therapy group (group with QRLSY and mizolastine)and the compare group (group with QRLSY).During 4 weeks’ treatments, degree of prurit,erythema and papula were abserved.To etect the model of Ⅳ allergic reaction in the animal experiment. After devided into group at random,saline, prednisone acetate, QRLSY and QRLSY combine mizolastine were given respectively,and to observe the effect of inhibition.To erect the model of infl by swelling of pinna in small mice after devided into group at random, saline, halcino