成都中医药大学
博士学位论文
复方苦蛇乳膏治疗慢性湿疹的临床和实验研究
姓名：***
消防工程师难考
申请学位级别：博士
二年级口算练习题>6级作文模板专业：中医外科学
指导教师：***
每日一句英语2009-05
中文摘要
目的：本课题主要通过临床观察慢性湿疹患者在运用复方苦蛇乳膏治疗前后的瘙痒程度、皮损表现及皮损面积等变化，初步肯定其对慢性湿疹的疗效，并对该药进行安全性评价；通过动物实验研究了解复方苦蛇乳膏对湿疹的作用，初步探索其作用于慢性湿疹的机理。
方法：临床观察：将60例慢性湿疹患者随机分为复方苦蛇乳膏组30例和冰黄肤乐软膏组30例，分别给以复方苦蛇乳膏和冰黄肤乐软膏，每日两次，一周为一个疗程，观察两个疗程，并在每个疗程后判定疗效，同时在治疗过程中对试验药物进行安全性评价。
实验研究：主要从三个大的方面观察复方苦蛇乳膏对湿疹的作用：对小鼠慢性湿疹模型的影响、抗过敏作用研究、抗炎作用研究。用2,4－二硝基氟苯复制小鼠慢性湿疹模型，运用超微结构制片、免疫组化，ELISA等先进技术和研究手段，从细胞的超微结构、细胞因子、组织蛋白等方面对复方苦蛇乳膏作用慢性湿疹的机理进行了探讨。
结果：临床观察结果显示：复方苦蛇乳膏治疗30例慢性湿疹，两周后临床痊愈10 例，显效16例，有效4例，无效0例。总显效率为87％，总有效率为100％。其治疗效果优于冰黄肤乐软膏组（P<0.01）。本试验复方苦蛇乳膏在临床观察中未发现有任何不良反应。
capitalism实验研究结果表明：复方苦蛇乳膏对小鼠慢性湿疹模型有良好的对抗作用，在病理改变中观察到炎性细胞浸润数明显减少，表皮角质层厚度明显变薄；对DNFB致小鼠DTH有明显抑制作用、 能提高胸腺指数，有减小脾脏指数的趋势、能明显抑制组织胺诱发的大鼠皮肤通透性的增加、对磷酸组织胺致豚鼠瘙痒有较好的对抗作用；对冰醋酸致小鼠腹腔通透性增加有显著抑制作用，能明显减轻二甲苯致小鼠耳肿胀，但对角叉菜胶引起的小鼠足肿胀改善不明显。
在电镜下观察到经复方苦蛇乳膏治疗后慢性湿疹皮肤角质层脂质超微结构修复较好，能明显降低水通道蛋白3在湿疹皮肤组织中半定量总评分，组织中水通道蛋白3的染色强度弱到中度，主要在基底层表达，很少部分表达在棘层。复方苦蛇乳膏能
降低小鼠慢性湿疹模型血清中IFN-г、IL-18、IL-31含量，提高IL-4的含量。
结论：临床试验提示：外用复方苦蛇乳膏治疗慢性湿疹有较好的疗效和安全性。动物实验研究提示：复方苦蛇乳膏具有较好的抗炎、抗过敏作用，并对慢性湿疹具有较好的对抗作用，为该药用于治疗慢性湿疹提供了较好的实验基础。此外我们推测复方苦蛇乳膏作用慢性湿疹的机理可能与修复皮肤屏障功能，调节T辅助细胞(Th1/Th2)的动态平衡有关。
关键词：复方苦蛇乳膏慢性湿疹临床研究实验研究
Study on clinical and experimental action of KuShe
图片英文
compound cream in chronical eczema
Abstract
Obiective: Through clinical obrvation to the patient with chronic eczema after using KuShe compo
und cream,we record the change of the itching grade,the symptom and the area of sick skin before treament and after one, and preliminary firm the effectiveness on chronic eczema.And we find out the role of prevention and cure on chronic eczema through experimentation on animals,preliminary explore its mechanism of preventing and controling. Methods: Clinical study: 60patients with chronic eczema were divided randomly into the test group (30 cas) treated with KuShe compound cream and the control group (30 cas) treated with BingHuangFuLe paste .Both groups had been given two one-weeks cours and judged the efficacy, simultaneously carried on curly evaluating.
Experiment study: three main aspects: he effect of the model of chronic eczema ,anti-delayed allergy reation and reliving inflammation .Repeated challenges of the back of previously nsitized mice with DNFB induced typical chronic eczema,and utilized vanguard technology and rearch approach to explore the its mechanism on chronic eczema.
peeping holesResults:Clinical study shows that KuShe compound cream treating 30 cas of chronic eczema for two weeks ,10 cure In cas,16 marked effectiveness in cas,4effectiveness in cas and 0 flaiure in cas.Its total excellence is 87 %,the total effective rate is 100 %.The sffect in treament group is much better than in BingHuangFuLe paste（P<0.01）.And we did not find out any untoward effect in the process of the clinical study.
The study result shows in the experiment: KuShe compound cream has favorable action on the model of chronic eczema, can obviously reduce the imflammatory cellular infiltration and in histopathological changes , can notely suppress DTH of the mice and rai the thymus index,exist tendency of reducing spleen index.The drug had very marked inhibition eddect on
exudation of capillary vesl of skin on rate and itch in guinea pigs induced by histamine, inhibit the increa of capillary permeability caud by glacial acetic acid in mice ,significantly reduce the degree of tumefaction in mice with auricle by dimethylbenzene,but no obvious effect on tumefaction in feet by carrageenan.
motion是什么意思
In the electronic microscope ,ultrastructure of skin of chronic eczema were obrved and showed less damage after the treatment of KuShe compound cream. And it can reduce rum levels of IFN - г, IL - 18, IL – 31of chronic eczema model of mice , rai rum levels of IL – 4; and significantly reduced mi-quantitative total score of AQP3 in chronic eczema skin tissues , intensity of dyeing is weak to moderate, mainly expresd in the stratum basal , rarely expresd in the stratum spinosum .
电话接线员>the bell curveConclusion: clinical trials point out: KuShe compound creams have good efficacy and safety in the tr
eatment of chronic eczema, the rearch of animal experiments suggests that KuShe compound creams have excellent effects of anti-inflammatory and antiallergic, has the fine role of prevention and cure on chronic eczema,which provides a good experimental basis.In addition, we speculate that the mechanism of KuShe compound creams on chronic eczema is probably adjusted dynamic balance of T helper cells (Th1/Th2), restrain expression of AQP3 in the stratum spinosum, granular and corneum.
Key words:KuShe compound cream chronic eczema clinical study experiment study
