【关键词】 ,疏肝理肺法
［摘要］目的：探讨心理因素对哮喘发病的影响和调肝法调节应激、防治哮喘的作用机制。方法：用卵蛋白加束缚应激刺激建立应激条件下哮喘大鼠模型，采用放射免疫分析法、酶联免疫吸附法、原位杂交、免疫组化、光镜及电镜等方法，检测各组大鼠血浆皮质酮、白细胞介素4、干扰素γ、海马糖皮质激素受体mRNA和下丘脑促肾上腺皮质激素释放激素（adrenocorticotropic hormone corticoliberin, CRH）阳性神经元，并观察肺和海马组织形态学的变化。结果：疏肝理肺方可明显降低血浆皮质酮水平，升高血浆干扰素γ，降低血浆白细胞介素4，减少下丘脑室旁核CRH阳性神经元，上调海马CA3区糖皮质激素受体mRNA的表达，减轻海马神经元的损伤，并可明显减轻应激条件下哮喘大鼠肺组织的病理改变。结论：疏肝理肺方通过抑制应激条件下哮喘大鼠下丘脑垂体肾上腺皮质轴功能的亢进及调节免疫系统的功能，从而起到防治哮喘的作用。
［关键词］应激; 哮喘; 疏肝理肺法
Protective and therapeutic effects of Shugan Lifei Recipe on rats with asthma under stress and the mechanisms
ABSTRACT Objective: To explore the influence of psychological factor on asthma, the protective and therapeutic effects of Shugan Lifei Recipe on rats with asthma under stress and the mechanisms. Methods: Allergy and stressinduced asthma models were established in rats by giving ovalbumin and restraining stress. Radioimmunoassay, enzyme linked immunosorbent assay, in situ hybridization and immunohistrochemical method were used to detect plasma corticosterone, IL4, IFNγ, expression of glucocorticoid receptor (GR) mRNA in hippocampus and adrenocorticotropic hormone corticoliberin (CRH) positve neuron in hypothalamus. Optical and electron microscopes were used to observe the morphological changes of pulmonary hilar and hippocampal tissues.Results: Shugan Lifei Recipe (SGLFR) could reduce plasma corticosterone, decrease CRH positive neurons in paraventricular nucleus of hypothalamus, upregulate the expression of GR mRNA in hippocampus and reduce the injury of hippocampal neuron. SGLFR had certain inhibitive effect on hyperfunction of hypothalamopituitaryadrenal cortex (HPA) axis in rats with asthma under stress and could also relieve the pathological changes of the pulmonary hilar tissue. The level of plasma IFNγ was increased while the level of plasma IL4 was decreased in SGLFRtreated group. Conclusion: The mechanism of SGLFR in treating the rats with asthma under stress is probably to regulate the hyperfunction of HPA axis and the disorder of immuosystem.
KEY WORDS stress; asthma; dispersing stagnated liver qi and regulating lung qi
支气管哮喘是一种多病因疾病，发病机制十分复杂，严重危害人类的健康。其发病受生物、心理和社会三方面因素的影响，其中精神心理因素在哮喘的发生、发展和转归中起着重要的作用。现代社会工作和生活节奏日益加快，竞争日趋激烈，机体长期处于紧张状态下，通过影响神经内分泌系统继而干扰机体的免疫功能，从而诱发或加重哮喘。
中医学很早就认识到不良的环境或精神刺激与躯体疾病的发生、发展有密切的关系。肝主疏泄，调畅气机，在心理应激调节中起着决定性的作用。现代医学认为：任何形式的应激都可导致神经内分泌功能紊乱，造成免疫功能障碍，使机体对各种感染性疾病呈易感状态。大量研究表明：肝主疏泄功能与现代医学的神经内分泌免疫网络密切相关，调肝法有调整神经内分泌免疫功能失调的作用。本实验运用疏肝理肺方治疗应激条件下的哮喘大鼠，探讨心理因素对哮喘发病的影响以及调肝法调节应激、防治哮喘的作用机制。
1材料与方法
1.1实验动物分组及模型建立 SD雄性大鼠56只，体质量（190±20）g，随机分为7组：正常组、哮喘组、应激组、哮喘应激组、地塞米松组、理肺组和疏肝理肺组，每组8只。哮喘组、哮喘应激组、地塞米松组、理肺组和疏肝理肺组大鼠分别予以腹腔注射抗原液（含卵蛋白、氢氧化铝干粉和灭活百日咳杆菌）1 ml致敏；正常组和应激组大鼠则分别予以腹腔注射等量生理盐水。致敏后第8天起，应激组、哮喘应激组、地塞米松组、理肺组和疏肝理肺组大鼠予以双后肢立式固定，行束缚应激刺激，4 h/d，共3周；致敏后第8天起，哮喘组、哮喘应激组、地塞米松组、理肺组和疏肝理肺组大鼠另分别予以2%卵蛋白雾化吸入，3 min/d，共2周。
1.2药物及给药方法 理肺方（Lifei Recipe, LFR）即小青龙汤，由麻黄9 g、桂枝9 g、炙甘草9 g、细辛9 g、干姜9 g、半夏9 g、五味子9 1 2 3 4 5 下一页
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