当归饮子治疗慢性荨麻疹的临床与实验研究

【作者】 肖红丽；

【导师】 陈汉章；

【作者基本信息】 广州中医药大学 ， 中医外科学， 2000， 硕士

【摘要】 荨麻疹是皮肤粘膜小血管扩张及渗透性增加而出现的一种限局性水肿反应，多由变态反应引起，病程超过3个月称为慢性荨麻疹。本研究旨在观察采用当归饮子治疗本病的疗效，并通过实验初步探讨其作用机理。一、文献研究 复习了中医古代文献及近年中、西医文献对本病的论述。中医理论认为，慢性荨麻疹的根本原因在于禀赋不耐，对某些物质敏感，风邪致病贯穿了整个病理过程。临床上治疗本病有复方、单味药及针灸等。西医认为慢性荨麻疹的发病多数为变态反应，治疗主要为对症治疗，应用最多的是抗组胺药物。二、临床研究 采用单盲随机对照法，将合格的60个病例随机分为A、B两组，A组予当归饮子，B组予开瑞坦。经统计学分析结果显示，两组病例性别、年龄分布均衡，具可比性。四周后统计两组近期疗效无显著性差异（P＞0.10）；对痊愈病例进行三个月的随访，A组的复发率明显低于B组（P＜0.01）；痊愈至复发相隔时间比较，A组明显长于B组（P＜0.001）。 通过观察发现，免疫球蛋白异常的病例均表现为异常增高，无降低病例。A组治疗后IgG、IgE的异常增高例数减少（P＜0.05）；对IgA、IgM的影响治疗前后无显著性差异（P＞0.25）。B组对四种免疫球蛋白的作 当归伙子治疗馒性年麻疹的临床与实险研究用治疗前后均无差异叩川．50入两组治疗后比较，A组IgE增高例数显著减少（P＜0．05），两组对IgG、IgA、IgM的作用无明显差异（P）0．05）。 观察病例中，T淋巴细胞转化率的异常均表现为低于正常值，无异常增高病例。经统计学分析，A组与B组相比，可显著提高患者的T淋巴细胞转化率（P＜0．025）。三、实验研究1．小白鼠被动皮肤过敏反应实验仟CA）结果表明，当归饮于高、低剂量组和开瑞坦组对小白鼠PCA均有明显的抑制作用；当归饮子高剂量组和开瑞坦的抑制作用要强于当归饮子低剂量组；当归饮子高剂量组与开瑞坦组的作用无显著差异。2．小白鼠被动腹腔肥大细胞脱颗粒实验结果表明，当归饮于高、低剂量组对小白鼠腹腔肥大细胞脱颗粒均有明显的抑制作用；开瑞坦组无明显的抑制作用；当归饮子高、低剂量组的抑制作用显著强于开瑞坦组；当归饮子高、低剂量组的作用无显著性差别。四、结论 当归饮子是治疗慢性尊麻疹的有效方剂，其近用疗效基本符同于开瑞坦，并有较好的防止和控制复发的效果。对细胞免疫、体液免疫有一定的调节作用，同时可抑制被动皮肤过戳反应和肥大纲胞脱瞩粒。更多还原

【Abstract】 (Jrticaria , itchy wheal of skin or mucous membrane , is caused mainly by allergic reaction . it is called chronic urticaria when lasting over 3 months. The purpose of the study is to observe the curative effect of Chinese angelica decoction applying to chronic urticaria ,and to search the functional mechanism of it by experiments. The ancient and contemporary bibliography was reviewed first. According to Traditional Chinese Medicine theory , the fundamental cause leading to chronic urticaria is allergic predisposition . And the wind梕vil is throughout the whole pathologic course . In clinic , complex or simple prescription or acupuncture can be used. In the opinion of western medicine , chronic urticaria is one kind of allergic diseases. Expectant treatment is adopted commonly And antihistamine is used mostly. In the clinical observation ,according to the rule of single blind ,random and contrast ,60 cases were divided into two groups ,group A taking Chinese angelica decoction and group B taking Clarityne. Significance test indicated that no difference of curative effect between group A and B was found. In the follow梪p survey , we found the recurrence rate of group A was significantly lower than group B , and the recurrent interval of group A was longer 3 than group B. Laboratory examination indicated that Chinese angelica decoction could decrease the immunoglobulin value of those abnormally high, and increase T條ymphocyte transformation rate. Mouse passive cutaneous anaphylaxis test(PCA) indicated that both Chinese angelica decoction and Clarityne could inhibit PCA .Mouse passive abdominal mastocyte degranulation test indicated that Chinese angelica decoction could significantly inhibit mastocyte degranulation in comparison with Clarityne. A conclusion can be drawn that Chinese angelica decoction is a effective complex prescription for chronic urticaria and can decrease recurrence rate .Chinese angelica decoction can also adjust cellular immunity and humoral immunity to some extent , and can inhibit PCA and mastocyte degranulation.更多还原