【作者】 王素霞；

【导师】 王秀霞；

【作者基本信息】 黑龙江中医药大学 ， 中医妇科学， 2003， 博士

【摘要】 本文对人巨细胞病毒感染的临床流行病学特点、机体免疫学变化、宫内感染机制、临床表现、诊断以及防治等的国内外研究现状予以较全面的综述。课题借助体外细胞培养技术，观察不同浓度的山桔颗粒药物在2BS细胞培养内对HCMV的抑制作用。实验采用细胞病变效应(CPE)法，设立丙氧鸟苷(GCV)对照组及病毒阳性对照组，采用定量逆转录-聚合酶链反应(RT-PCR)方法，检测感染后2BS细胞HCMV晚期mRNA的表达，从基因水平上对中药山桔颗粒抗人巨细胞病毒感染的体外作用机制进行了研究。在此基础上，将山桔颗粒应用于临床治疗育龄妇女HCMV活动性感染，分别采用RT-PCR、PCR、ELISA等方法测定治疗前后患者血清HCMV晚期mRNA、HCMV DNA、肿瘤坏死因子-α(TNF-α)以及白细胞介素-6(IL-6)的水平。 结果显示 1．山桔颗粒在体内外均能够抑制HCMV晚期mRNA的表达；2．山桔颗粒对HCMV所致细胞病变有明显的抑制作用；3．临床研究发现，山桔颗粒临床有效率达80％以上。HCMV-IgM阳性孕妇及育龄妇女TNF-α、IL-6较对照组显著增高(p＜0.05)；山桔颗粒治疗后TNF-α、IL-6基本恢复至正常水平。HCMV-IgM转阴率为80％，显著高于未治疗组的自然转阴率17.17％(p＜0.005)，HCMV DNA转阴率为70％。本研究结果表明HCMV感染对机体有免疫损伤效应；HCMV mRNA表达与活动性感染密切相关；血清TNF-α、IL-6水平与体内HCMV活动状态有关；山桔颗粒能够提高机体的免疫功能，在体内外对HCMV均有显著的抑制作用，在一定范围内，随药物浓度增高作用增强，是治疗HCMV活动性感染，尤其是孕期感染的安全、有效的中药制剂。更多还原

【Abstract】 Objective Our paper was to study the inhibition of traditional Chinese medicie Shanjie granules (SJ) against human cytomegalovirus (HCMV) infection in clinical and its antiviral activity in vitro.Methods Cytopathic effect (CPE) method was used to observe the inhibition activity of SJ against HCMV AD]69 in vitro. The expression of the HCMV late-mRNA was measured by quantitative reverse transcription polymerase chain reaction (RT-PCR) before and after the treament of Chinese medicine SJ. Ganciclovir (GCV) was used for positive control. In the clinical test ,enzyme-linked immunosorbant assay (ELISA) technique was employed to screen HCMV antibodies in 358 pregnant women and child-bearing women. There were 87 pregnant women and child-bearing women who had positive HCMV-IgM , of which the blood HCMV DNA and HCMV-mRNA was examined by PCR and RT-PCR respectively. At the same time,the serum level of tumor necrosis factor-alpha(TNF- a )and interleukin-6 (IL-6) were examined before and after the treatment of SJ by ELISA method. Results:1. SJ had inhibition effect both on HCMV-mRNA and CPE. The clinical effective rate of SJ was 80%.2. After SJ treatment , 80% of the HCMV-IgM positive cases turned negative which was higher than that (17.17% ) in control group. 70% HCMV DNA positive cases turned negative.3. The serum level of the TNF- a and IL-6 increased significantly in HCMV-IgM positive cases when compared with normal women. After being treated with SJ , The serum level of the TNF- a and IL-6 in patients returned to normal level.Conclusion It was suggested that serum level of the TNF- a and IL-6 is related to the activity of HCMV which has harmful effect on immune system . SJ can improve immunity of the body and has an obvious inhibition on HCMV in vitro and vivo, and can thus serve as safe and effective medicine for treatment of active HCMV infection ,especially for the pregnant women.更多还原