中药注射剂不良反应发生原因分析

1 与患者体质有关 中药注射剂不良反应中过敏反应比例较高,其发生机理可能是：具有抗原性的药物进入人体后,刺激机体合成特异性IgE,并与肥大细胞和嗜碱粒细胞等细胞表面的特异性受体结合.当药物再次进入人体时,即可与肥大细胞、嗜碱性粒细胞表面的IgE结合,损伤肥大细胞、嗜碱性粒细胞,使之脱颗粒,释放出过敏性介质,如组胺、5-羟色胺、激肽等,进而作用于靶细胞,导致过敏反应的发生.统计显示,过敏体质的患者发生过敏反应的几率较无过敏史的患者高出4～10倍,属于不良反应高危人群,用药时当特别注意.     

丝瓜藤提取物治疗鼻炎的机理研究

[目的]探讨丝瓜藤提取物治疗鼻炎的作用机理。[方法]采用卵清白蛋白和Al(OH)3建立小鼠过敏性鼻炎模型,按剂量灌服相应药物10 d,观察小鼠的症状和鼻黏膜组织形态学的病理变化,并检测血清中的组胺含量及鼻黏膜嗜酸性粒细胞计数。[结果]丝瓜藤氯仿部位提取物能有效改变鼻炎小鼠鼻黏膜病理改变,减少血清中组胺含量及鼻黏膜嗜酸性粒细胞计数,从而达到治疗鼻炎的作用。[结论]丝瓜藤治疗鼻炎的作用机制可能是通过降低组胺水平和嗜酸性粒细胞数量来实现的。     

咳喘宁对支气管哮喘患者外周血嗜酸粒细胞及血清IgE的影响

目的：探讨咳喘宁胶囊对支气管哮喘患者外周血嗜酸粒细胞、血清IgE及病情控制水平的影响。方法：72例支气管哮喘患者分为咳喘宁治疗组（n=42）和对照组（n=30）,治疗前及治疗后8w,测定外周血嗜酸粒细胞与IgE。结果：治疗8w后,两组患者的外周血嗜酸粒细胞、血清IgE水平较治疗前减少（P〈0．01）;咳喘宁治疗组患者的外周血嗜酸粒细胞数量、血清IgE水平明显低于对照组（P〈0．05）。结论：咳喘宁胶囊能降低支气管哮喘患者外周血嗜酸粒细胞数量、血清IgE水平。     

藜子70%醇提物对变态反应的抑制作用

目的：观察藜子醇提物对速发型及迟发型变态反应的作用,探讨其止痛作用机制及其作为地肤子代用品使用的合理性。方法：大鼠或小鼠皮内注射大鼠 抗卵白蛋白抗血清诱导被动皮肤过敏反应,以SRBC或PC诱导小鼠迟发型变态反应。体外试验以^3H-TdR掺入法观察小鼠淋巴细胞增殖反应。结果： 藜子70％醇提物400mg/kg ig可明显抑制大鼠同种被动皮肤过敏反应及颅骨膜肥大细胞脱颗粒;200、400mg/kgig可减轻异处耳被动皮肤过敏反应及组胺所致足肿胀。藜子醇提物400mg/kg于抗原攻击后给药可抑制SRBC或PC诱导的小鼠迟发型变态反应,而在抗原攻击前给药则无明显影响。体外试验藜子醇提物125、250μg/ml对小鼠脾淋巴细胞增殖无明显影响,当浓度升至500μg/ml时则呈明显的抑制作用。结论：藜子的止痛功效可能与其对速发型变态反应的抑制作用有关;藜子抑制Ⅰ、Ⅳ型变态反应的作用特征与地肤子十分相似,提示其可作为后的代用品用于治疗变态反应性疾病。     

复方甲氧那明胶囊联合布地奈德对 嗜酸粒细胞性支气管炎疗效观察

〔摘 要〕 目的：研究复方甲氧那明胶囊联合布地奈德治疗嗜酸粒细胞性支气管炎的效果。方法：选取新郑市中医院 2016 年 5 月至 2017 年 11 月收治被确诊为嗜酸粒细胞性支气管炎患者 180 例,依据治疗方法分组：对照组患者应用布地奈 德雾化吸入治疗,观察组在此基础上加用复方甲氧那明胶囊口服。结果：观察组患者的治疗总有效率为 96.67 % 高于对照 组的 86.67 %,差异具有统计学意义（P ＜ 0.05）;治疗后,观察组患者的外周血嗜酸粒细胞计数、诱导痰嗜酸粒细胞分类 均低于对照组患者,差异具有统计学意义（P ＜ 0.05）;两组患者的不良反应发生率比较,差异无统计学意义（P ＞ 0.05）。 随访 1 年,观察组患者复发率为 2.22 % 低于对照组的 11.11 %,差异具有统计学意义（P ＜ 0.05）。结论：复方甲氧那明胶 囊联合布地奈德用于嗜酸粒细胞性支气管炎治疗中疗效较好,控制嗜酸粒细胞计数和分类,控制炎症反应,且用药安全性高, 预防病情反复发作。     

麻黄汤拆方对过敏性炎症的抑制作用

目的通过对麻黄汤各拆方配伍组合对嗜酸性粒细胞和肥大细胞的抑制作用探讨其配伍规律。方法采用在体试验观察致敏小鼠抗原攻击后肺灌洗液(BALF)和外周血中的嗜酸性粒细胞聚集反应,采用离体试验观察致敏大鼠抗原攻击后腹腔肥大细胞脱颗粒反应。结果麻黄汤及拆方减少BALF和外周血中嗜酸性粒细胞的浸润不完全相同;麻黄汤及拆方也不同程度抑制致敏大鼠腹腔肥大细胞脱颗粒反应。结论麻黄汤对嗜酸性粒细胞和肥大细胞具有抑制作用,拆方分析显示麻黄汤全方效果最佳,并初步验证了麻黄汤组方的科学性和合理性。     

特应性皮炎患者血清总IgE与嗜酸性粒细胞检测的临床意义

目的探讨特应性皮炎（AD）与血清总IgE含量和外周血嗜酸性粒细胞计数（EOS）关系。方法选择AD患者43例及正常体检者（对照组）30例,定量测定血清总IgE含量,并作外周血嗜酸性粒细胞计数。结果AD患者血清总IgE浓度、嗜酸性粒细胞计数均高于或显著高于对照组,其中血清总IgE含量与AD病情严重程度呈正相关。结论外周血嗜酸细胞计数有助于辨别特应性皮炎而血清总IgE测定有助于判定特应性皮炎病情严重程度和活动度。     

针刺血清对高嗜酸粒细胞血症大鼠外周血嗜酸粒细胞数目的影响

目的 :明确肾上腺切除大鼠哮喘模型注射针刺治疗后的血清对高嗜酸粒细胞血症大鼠外周血嗜酸粒细胞数目的影响 ,为证明该种针刺血清中存在影响嗜酸粒细胞数目的非皮质激素类活性因子提供实验依据。方法 :将稀释后的针刺血清以 2 .5mL/kg经尾静脉注入模型大鼠 ,连续3天 ,同时连续 1 0天测定该种针刺血清对高嗜酸粒细胞血症大鼠外周血嗜酸粒细胞计数的影响。结果 :与空白血清和普通哮喘针刺血清相比较 ,该种针刺血清在尾静脉注射后第 3～ 1 0天能明显降低高嗜酸粒细胞血症大鼠的外周血嗜酸粒细胞计数 (P =0 .0 1 2 ,0 .0 0 0 ,0 .0 0 0 ,0 .0 0 0 ,0 .0 0 0 ,0 .0 0 0 ,0 .0 0 0 ,0 .0 0 0 )。结论 :肾上腺切除大鼠哮喘模型注射针刺治疗后的血清能明显降低高嗜酸粒细胞血症大鼠外周血嗜酸粒细胞数目 ,提示该针刺血清中存在影响嗜酸粒细胞数目的非皮质激素类活性因子     

平喘合剂对寒性哮喘患者白介素2及其受体影响的临床研究

目的：观察平喘合剂及普米克、氨茶碱对哮喘患者外周血细胞计数、SIL-2R、IL-2的影响。方法：运用ELISA法测IL-2、SIL-2R。结果：治疗组与对照组的临床疗效、外周血细胞计数无明显差异，两组嗜酸粒细胞治疗后比治疗前显著降低，中性粒细胞与淋巴细胞则无显著差异；治疗组治疗后IL-2、SIL-2R水平较治疗前显著下降。结论：平喘合剂可降低外周血嗜酸细胞计数及SIL-2R、IL-2水平，而治疗哮喘。     

大黄素对小鼠缺血再灌注肠黏膜肥大细胞活性的影响

目的:研究大黄素对小鼠肠缺血再灌注肠黏膜肥大细胞活性的影响。方法:28只昆明种小鼠随机均分为4组,假手术组(A组)、模型组(B组)、模型+大黄素60 mg.kg-1组(D1组)及模型+大黄素120 mg.kg-1组(D2组)。采用肠系膜上动脉夹闭法建立小肠缺血再灌注模型,观察肠黏膜病理结构变化、肠黏膜肥大细胞超微结构变化及类胰蛋白酶表达、比较计算肥大细胞数量,测定小肠组织组胺、肿瘤坏死因子-α(TNF-α)浓度。结果:与假手术组比较,模型组Chiu’s评分、肥大细胞数量、组胺及TNF-α浓度显著增加(P<0.05或P<0.01)。与模型组比较,大黄素60,120 mg.kg-1组的肥大细胞数量明显减少(P<0.05),大黄素120 mg.kg-1组的小肠组织TNF-α浓度明显降低(P<0.05)。假手术组肥大细胞超微结构正常,模型组肥大细胞颗粒包膜相互融合形成细胞内空泡等脱颗粒现象,大黄素60,120 mg.kg-1组肥大细胞形成空泡较少。结论:大黄素能减少小鼠小肠黏膜结构破坏,抑制小肠肥大细胞活化及脱颗粒,从而起到防治肠缺血再灌注损伤的作用。     

广西甜茶的抗过敏作用研究

目的：研究广西甜茶（Rubus suavissimus S.Lee）提取物的抗过敏作用并观察其对大鼠腹腔肥大细胞释放组胺的影响,探讨可能的作用机制。方法：采用2,4-二硝基氟苯（DNFB）及绵羊红细胞（SRBC）诱发的小鼠迟发型过敏反应,小鼠异种被动皮肤过敏反应（PCA）,观察连续口服给予广西甜茶提取物的抗过敏作用。利用高效液相-库仑阵列电化学检测系统（HPLC-ECD）测定Compound 48/80刺激大鼠腹腔肥大细胞释放组胺,评价广西甜茶提取物对肥大细胞释放组胺的影响。结果：与模型组相比,连续口服广西甜茶提取物125、250及500 mg/kg均能显著抑制由DNFB诱发小鼠耳肿胀及血管通透性的增高。此外,广西甜茶提取物可以减轻小鼠异种被动皮肤过敏反应及对SRBC诱发小鼠迟发型过敏反应足跖肿胀也显示有一定程度的抑制作用。体外实验证明广西甜茶提取物对Compound 48/80刺激大鼠腹腔肥大细胞释放组胺呈剂量依赖性抑制作用。结论：广西甜茶具有显著的抗过敏作用,其作用机制可能与抑制肥大细胞释放组胺有关。     

Proanthocyanidin‐rich Pinus radiata bark extract inhibits mast cell‐mediated anaphylaxis‐like reactions

Mast cells play a critical role in the effector phase of immediate hypersensitivity and allergic reactions. Pinus radiata bark extract exerts multiple biological effects and exhibits immunomodulatory and antioxidant properties. However, its role in mast cell‐mediated anaphylactic reactions has not been thoroughly investigated. In this study, we examined the effects of proanthocyanidin‐rich water extract (PAWE) isolated from P. radiata bark on compound 48/80‐induced or antidinitrophenyl (DNP) immunoglobulin E (IgE)‐mediated anaphylaxis‐like reactions in vivo. In addition, we evaluated the mechanism underlying the inhibitory effect of PAWE on mast cell activation, with a specific focus on histamine release, using rat peritoneal mast cells. PAWE attenuated compound 48/80‐induced or anti‐DNP IgE‐mediated passive cutaneous anaphylaxis‐like reactions in mice, and it inhibited histamine release triggered by compound 48/80, ionophore A23187, or anti‐DNP IgE in rat peritoneal mast cells in vitro. Moreover, PAWE suppressed compound 48/80‐elicited calcium uptake in a concentration‐dependent manner and promoted a transient increase in intracellular cyclic adenosine‐3′,5′‐monophosphate levels. Together, these results suggest that proanthocyanidin‐rich P. radiata bark extract effectively inhibits anaphylaxis‐like reactions.     

火棘果实提取物的美白作用

目的:研究火棘Pyracantha fortuneana(Maxim.)Li果实提取物的美白作用并观察其对大鼠腹腔肥大细胞释放组胺的影响,探讨可能的作用机制。方法:采用熊果苷为抑制酪氨酸酶活性的标准对照,以酪氨酸酶法探讨火棘果实提取物对酪氨酸酶活性及B16细胞黑色素合成的影响,评价火棘果实提取物的美白作用。利用高效液相库仑阵列电化学检测系统(HPLC-ECD)测定Compound 48/80刺激大鼠腹腔肥大细胞释放组胺,评价火棘果实提取物对肥大细胞释放组胺的影响。结果:火棘果实提取物对酪氨酸酶活性具有明显抑制作用,能显著减少小鼠B16细胞内黑色素的含量。此外,火棘果实提取物对Compound 48/80刺激大鼠腹腔肥大细胞释放组胺呈剂量依赖性抑制作用。结论:火棘果实提取物显著抑制酪氨酸酶活性和肥大细胞释放组胺,为火棘果实作为美白添加剂提供了实验依据。     

痛泻要方抑制致敏大鼠腹腔肥大细胞脱颗粒的研究

目的观察痛泻要方对化合物48/80(C48/80)诱导的大鼠腹腔肥大细胞脱颗粒的影响,探讨痛泻要方对肠易激综合征的作用机制。方法应用钙离子荧光指示剂Fluo-3,通过光学显微镜和激光共聚焦荧光显微镜,观察痛泻要方对致敏大鼠腹腔肥大细胞脱颗粒百分数及肥大细胞内游离钙浓度和组胺释放的影响。结果实验组(痛泻要方组)致敏大鼠腹腔肥大细胞脱颗粒百分数为13%,对照组为41%,2组有显著性差异(P<0.05);对照组和实验组致敏大鼠腹腔肥大细胞内游离钙浓度分别为(436.16±12.30)nmol/L和(78.31±3.28)nmol/L,2组相比有显著性差异(P<0.05);对照组和实验组大鼠腹腔肥大细胞上清液组胺浓度分别为(98.41±7.23)nmol/L和(33.23±21.50)nmol/L,2组相比有显著性差异(P<0.05)。结论痛泻要方对C48/80诱导的大鼠腹腔肥大细胞的脱颗粒过程有明显的抑制作用,表明痛泻要方是通过抑制肠道肥大细胞活化,从而减少其释放组胺等递质实现治疗作用的。     

Effect of saikosaponin-A,a triterpenoid glycoside,isolated from Bupleurum falcatum on experimental allergic asthma

The separation and isolation of an extract of Bupleurum falcatum were performed based on antiallergic activities in preliminary studies with higher plants. The final active compound was identified as saikosaponin-A (SSA), a triterpenoid glycoside. SSA at more than 1 mg/kg (i.v.) significantly inhibited the passive cutaneous anaphylaxis reaction in rats in a dose-dependent manner, attaining a maximum inhibition of approximately 60% with 10 mg/kg. SSA at 3 and 10 mg/kg also suppressed asthmatic bronchoconstriction in sensitized guinea-pigs. SSA possesses a weak inhibitory activity on histamine-induced tracheal contraction in guinea-pigs and on histamine release induced by A-23187 in rat mast cells. These results indicate that SSA has an inhibitory activity against allergic asthma. This activity seems to derive from both antagonism of the histamine action and inhibition of allergic mediators. Additional mechanisms may also be involved.     

辛夷二氯甲烷提取物抗炎、抗过敏作用研究

目的：研究中药辛夷二氯甲烷提取物的药理作用。方法：采用体外,体内多种动物模型对辛夷二氯甲烷提取物进行了抗炎,抗过敏方面的研究。结果：辛夷二氯甲烷提取物对组胺（HA）、乙酰胆碱（Ach)引起的豚鼠离体回肠收缩具有显著的抑制作用,并能抑制卵白蛋白（OA）所致的豚鼠离体回肠过敏性收缩,对HAc引起的小鼠腹腔毛细血管通透性增高具有抑制作用,能显著抑制角叉菜胶引起的小鼠足肿胀,并减少前列腺素E2（PGE2）在炎症组织中产生。结论：辛夷二氯甲烷提取物具有明显的抗炎,抗过敏作用。     

Inhibitory effects of Selaginella tamariscina on immediate allergic reactions

The anti-allergic effects of a 70% ethanol extract from Selaginella tamariscina herb (EST) were evaluated in this study. EST given at the doses of 500 and 1000 mg/kg can inhibit mouse systemic anaphylactic shock induced by compound 48/80 in a dose-dependent manner. It can also dose-dependently block rat homologous passive cutaneous anaphylaxis and skin reactions caused by exogenous histamine and serotonin with a significant difference observed at the dose of 1000 mg/kg. In addition, EST can reduce histamine release from rat peritoneal mast cells triggered by compound 48/80 and an antigen in vitro. When incubated with rat mast cells, the extract (200 microg/ml) can significantly elevate the intracellular cAMP levels. The finding suggests that EST inhibits mast cell-dependent, immediate allergic reactions. Its effects appear to be mediated by reducing the release of vasoactive amines such as histamine from mast cells via stabilizing the cell membrane and weakening the inflammatory action of these amines. Based on these results, Selaginella tamariscina and one of its active components flavonoids may be useful as potential remedies for allergic rhinitis and other allergy-related diseases.     

Mast cell protecting effects of shilajit and its constituents

The effects of shilajit and the combined effects of its main constituents, fulvic acids (FAs), 4′-methoxy-6-carbomethoxybiphenyl (MCB) and 3,8-dihydroxy-dibenzo-α-pyrone (DDP), were studied in relation to the degranulation and disruption of mast cells against noxious stimuli. Shilajit and different combinations of FAs, MCB and DDP provided statistically significant protection to antigen-induced degranulation of sensitized mast cells, markedly inhibited the antigen-induced spasm of sensitized guinea-pig ileum, and prevented mast cell disruption induced by compound 48/80. The findings are appraised in view of the clinical use of shilajit in the treatment of allergic disorders in Ayurvedic medicine.     

Shini-san inhibits mast cell-dependent immediate-type allergic reactions

Shini-San has been used for treatment of allergic disease in Korea. However, its effect in experimental models remains unknown. The mast cell plays a pivotal role in initiating allergic response by secreting intracytoplasmic granular mediators such as histamine. The present report describes an inhibitory effect of Shini-San on mast cell-mediated immediate-type allergic reactions. Topical application of compound 48/80 can induce an ear swelling response in normal (WBB6F1(-)+/+) mice but not in congenic mast cell-deficient WBB6F1-W/WV mice. Shini-San inhibited concentration-dependent mast cell-dependent ear swelling response induced by compound 48/80 in normal mice. Shini-San inhibited concentration-dependent passive cutaneous anaphylaxis induced by anti-dinitrophenyl (DNP) immunoglobulin E (IgE) in rats by topical application. Shini-San also inhibited in concentration-dependent fashion the histamine release from the rat peritoneal mast cells by compound 48/80 or anti-DNP IgE. Moreover, Shini-San had a significant inhibitory effect on compound 48/80-induced systemic anaphylactic reaction. These results indicate that Shini-San inhibits immediate type allergic reactions by inhibition of mast cell degranulation in vivo and in vitro.     

Forsythia suspensa extract alleviates hypersensitivity induced by soybean β-conglycinin in weaned piglets

Aim of the study

Soybeans are known to stimulate food allergies; however, current therapies are lacking in alleviating hypersensitivity. The present study investigated whether Forsythia suspensa extract could attenuate purified soybean β-conglycinin-induced anaphylactic reactions in weaned piglets.

Materials and methods

Eighteen 14-day-old piglets were sensitized and boosted by oral administration of purified β-conglycinin. Forsythia suspensa extract was supplemented in the diet after the initial sensitization and continued for the remainder of the experiment. Piglets were challenged on day 28, and anaphylactic symptoms, passive cutaneous anaphylaxis, plasma histamine and intestinal microbial flora were analyzed. T-cell proliferative responses and cytokine production were also determined.

Results

Forsythia suspensa extract alleviated β-conglycinin-induced anaphylactic symptoms by markedly reducing anaphylactic antibodies, mast cell degranulation, and histamine release while improving intestinal microbial flora. Furthermore, Forsythia suspensa extract significantly suppressed β-conglycinin-induced T lymphocyte proliferation and IL-4 synthesis.

Conclusion

Forsythia suspensa extract protected β-conglycinin-sensitized piglets from anaphylactic reactions. Forsythia suspensa extract may provide a novel effective therapy for soybean allergy.