“调肺”治疗儿童多发性抽动症医案数据挖掘研究及中药复方对小鼠免疫功能影响的研究
|
摘要
研究目的
利用数据挖掘技术,对“调肺”治疗多发性抽动症的医案进行挖掘分析探索多发性抽动症的基本病因病机和本次研究“调肺”治疗本病的临证辨治思路,并尝试探求本病“调肺”治疗的部分理论意义。同时,应用实验的研究方法,观察“调肺”治疗多发性抽动症的中药复方对免疫低下小鼠免疫功能的影响,探索“调肺”复方可能对多发性抽动症免疫影响的作用机制。
研究方法
1.“调肺”治疗儿童多发性抽动症医案数据挖掘研究
(1)按照纳入标准,确定纳入病例,共收集多发性抽动症病例98例,110例次医案。
(2)按医案临床信息采集要点,收集记录临床信息资料。
(3)应用“医案采集系统”及“中医处方智能分析系统信息采集界面”,对医案信息进行录入。利用《中医主题词表》对医案信息进行标引。
(4)医案由专人录入,录入人员要经过专门培训。对录入后的病例进行多次核查。随机抽取病例进行检查,以确保录入质量。
(5)应用中医医案数据库系统和中医处方智能分析系统,对医案进行挖掘分析。
2.“调肺”治疗多发性抽动症中药复方对小鼠免疫功能影响的研究
环磷酰胺50 mg·kg-1腹腔注射建立免疫功能低下小鼠模型,“调肺”治疗多发性抽动症中药复方(3,6,12 g·kg-1)灌胃给药连续7天,用碳粒廓清法观察小鼠单核巨噬细胞吞噬功能,耳肿增重法观察小鼠迟发型超敏反应,溶血素抗体测定法观察小鼠溶血素抗体生成。
研究结果
1.“调肺”治疗儿童多发性抽动症医案数据挖掘研究
(1)利用“中医医案数据库系统”对多发性抽动症医案的研究
①一般资料：多发性抽动症男性患儿比女性患儿多,男女之比为5.1：1；就诊年龄以6～15岁患儿居多,15岁后人数骤减。
②多发性抽动症常见的症状体征有：红舌、脉弦滑、腻苔、眼肌抽动、喉中怪声、咽红、黄苔、眠差、鼻腔红、性急易怒、白苔、皱鼻、耸肩、手肌抽动、点头等。
③医案所涉及的病因包括：内风、热痰、六淫、情志伤、风痰、外伤、食伤等,但主要以内生邪气为主。
④医案涉及病位肝者为99.09%,心为13.64%,脾为4.55%,肺为3.64%。
⑤医案所涉及的病机：肝风内动最显著81.82%,痰火扰心13.64%,痰火上扰13.64%,脾虚肝旺4.55%,风痰阻络0.91%。
⑥医案所涉及的证候类型：肝风内动证81.82%,痰火上扰证13.64%,脾虚肝旺证4.55%。
⑦医案所涉及的治疗方法以平熄内风,疏风化痰(81.82%)为主,同时应用清心安神、清热化痰、熄风涤痰、调和肝脾的方法。治法经完全分类统计后,多发性抽动症治疗以“治风”、“祛痰”为主,占所有治法的89.51%。
⑧用药规律：“调肺”治疗多发性抽动症用药比较集中,苍耳子、伸筋草酸枣仁、木瓜、清半夏、辛夷、玄参、板蓝根、钩藤,是“调肺”治疗多发性抽动症最常用的中药。
(2)利用“中医处方智能分析系统”对多发性抽动症医案的研究
①处方药物使用权重较高的中药有：酸枣仁、木瓜、伸筋草、清半夏辛夷、乌梢蛇、钩藤、白芍、蕤仁、蝉蜕、炙甘草、天麻等。
②处方药物药性以平性、温性、微寒较高；110例次处方,几乎整体偏凉(95.45%)。
③处方药物药味以甘、苦、辛为主
④处方药物归经以归肝为主,其次肺、胃、脾、心,再一级别为肾、其他。
⑤对处方功效权重计算,功效祛风、安神、清热、活络、平肝、解疮毒、熄风、明目、散结、舒筋居前10位；经筛选后的前10位功效由高到低依次为：清热、祛风、平肝、活络、散结、祛痰、熄风、舒筋、祛湿、泻火
⑥对处方涉及证素进行计算,证素风邪、神不安、热、络脉阻、肝亢疮毒、热毒、筋急、目、动风居前10位；经筛选后热、风邪、肝亢、络脉阻、结、痰、动风、筋急、湿、实火居前10位。
⑦处方主要适应证居前10位的由高到低依次为：肝风内动证、风湿化热证、痰热动风证、表寒里热证、热盛动风证、湿热蕴结证、风中经络证、痰热内扰证、胃肠湿热证、风热化火证。
⑧对处方症状体征关注度进行计算,其中前10位症状体征中,除去主症(眼肌抽动、皱鼻、耸肩、手肌抽动)、舌(红舌、黄苔)、脉(脉弦滑),伴随症状(性急易怒、眠差),咽红的关注度较高。
2.“调肺”治疗多发性抽动症中药复方对小鼠免疫功能影响的研究
(1)对环磷酰胺免疫抑制小鼠单核巨噬细胞吞噬功能的影响
“调肺”复方高剂量组、中剂量组能明显提高免疫低下小鼠的碳粒廓清指数K和吞噬指数α(P<0.01,P<0.05),提示“调肺”复方能提高环磷酰胺免疫抑制小鼠的单核巨噬细胞吞噬功能。
(2)对环磷酰胺免疫抑制小鼠迟发型过敏反应(DTH)的影响
“调肺”复方高剂量组、中剂量组可拮抗环磷酰胺诱导的免疫低下小鼠耳肿胀度减轻(P<0.01,P<0.05),增强低下的迟发型超敏反应(DTH)反应水平。
(3)对环磷酰胺免疫抑制小鼠血清溶血素含量的影响
‘调肺”复方高剂量组能提高免疫低下小鼠血清溶血素含量(P<0.05)。
研究结论
1.通过对医案中症状体征、病因、病位、病机、证候、治法及处方用药进行挖掘分析,客观、详细地分析总结了本病的基本病因病机,病因包括感受外邪、情志内伤、饮食因素、外伤因素、胎遗胎传及先天不足；病位主要在肝,但与肺、脾、心、肾相关；风、火、痰既是本病的致病因素,又是病理产物,是影响疾病转归的重要因素,病程中风、火、痰相互作用导致了本病的发生或加重。
2.本次研究“调肺”治疗多发性抽动症临证辨治过程中,注重肝肺并调,内外并治。“祛风、调肝、清热”是本次研究“调肺”治疗本病把握的核心,在处方用药性味归经及功效等的侧重应用上都有体现,同时又注意把握全方“祛风清热,平肝祛痰、安神”的综合作用。临证过程中也非常注意观察患儿鼻咽部的变化对本病的影响。
3.肺与肝在生理病理上存在密切的联系,多发性抽动症病变核心在肝,调肺对本病同样也起到治疗作用；肺邪传肝是本病发病极为重要的潜在因素,调肺截断外邪内传的通路,对于多发性抽动症治疗具有积极意义；痰是威胁多发性抽动症的重要病邪,“调肺”可改善机体水液的代谢的异常,减少内生痰邪的产生,有利于多发性抽动症的治疗
4.“调肺”治疗多发性抽动症中药复方通过增强非特异性免疫、细胞免疫、体液免疫功能,可以减少机体对链球菌、病毒等致病微生物感染的机会,有利于神经-内分泌-免疫网络的稳定,从而减轻或消除抽动症状。
5.“正气”可以类推为现代医学的“免疫力”,正气是决定疾病发生发展的决定性因素,其生成、输布运行均与肺具有密切的联系,“调肺”治疗本病同免疫调节治疗方法内涵具有部分近似性。
6.本研究从医案中医临证要素出发,引入数据挖掘技术,初步探索了本病病因病机和“调肺”治疗的临证辨治思路,验证了数据挖掘的方法在中医医案研究分析中的可行性。
4“调肺”治疗儿童多发性抽动症医案数据挖掘研究及中药复方对小鼠免疫功能影响的研究ABSTRACT
Objective By analyzing the Tourette's syndrome cases based on data mining,
explore the basic cause and mechanism of Tourette's syndrome with
treatment by regulating lung. And try to discuss the theoretical
significance of TS treatment by regulating lung. Meanwhile, study the
effect and explore the possible mechanism of "Regulating lungs'
composite prescription on immunity effects in immunodepressed mice with
TS.
Methods 1. The study of Tourette's syndrome cases with treatment of regulating
the lung based on date mining (1)Collected 110 cases of patients according to diagnosis and
classification standards Tourette's syndrome. (2)Collected and recorded clinical information according to medical
record. (3)Input information and established a database of Tourette's
syndrome. Data preprocessing, including data standardization and
quantification for data indexing. (4)Multiple post-entry verifications.10% of randomly selected cases
were checked to ensure the quality of entry. (5)Analyzed the Tourette's case with "CPDBS" and "CPIAS" 2. Research of the effect of "Tiaofei" composite prescription on
immunity effects in immunodepressed mice The immunodepressed mice models were induced by intraperitoneal
injection of cyclophosphamide with 50mg·kg-1. Mice were administrated
with "Tiaofei" composite prescription 3,6,12 g·kg-1 for 7 consecutive
days. The phagocytic activity of monocytes, the delayed
hypersensitivity reaction and the haemolysin antibody formation in mice
were observed by means of carbon particle clearance, ear swelling and
haemolysin antibodies.
Results 1. The study of Tourette's syndrome cases with treatment of
regulating the lung based on data mining (1)The study of Tourette's syndrome cases with "CPDBS"①General information:Tourette's syndrome Incidence rate of boy
is higher than girl, the ratio is 5.1:1. Majority in age of 6-15 years old, the incidence rate significantly decreased after age of 15.
②Common clinical symptoms of Tourette's syndrome include:redness of tongue, wiry and slippery pulse, greasy tongue, movement tics, vocal tic, redness of pharynx, insomnia, etc.
③The causes of Tourette's syndrome included in this research: endogenous wind, heat-phlegm, internal injury caused by excess of emotions, surgical trauma, dyspepsia. But the main cause is endogenous factor which affecting health.
④Tourette's syndrome mainly damages liver, counted for 99.09%; heart, counted for 13.64%; spleen, counted for 4.55%; lung, counted for 13.64%.
⑤The mechanisms of Tourette's syndrome include:endogenous liver wind, counted for 81.82%; pyrophlegmatic mania,13.64%; splenic asthenia and hepatic accentuation,4.55%; obstruction of collateral caused by wind-phlegm,0.91%.
⑥The cases of Tourette's syndrome involved three complex symptoms:endogenous liver wind,81.82%; pyrophlegmatic mania,13.64%; splenic asthenia and hepatic accentuation,4.55%.
⑦The treatment of Tourette's syndrome in this research includes calming the liver to stop the wind, expelling wind and dissipating phlegm mainly(counted for 81.82%), easing mental anxiety, eliminating phlegm by cooling, stopping endogenous wind and washing away the phlegm, eliminating phlegm by cooling coordinating. After the complete classification of Statistics, the treatment mainly include calming wind and eliminating phlegm, counted for 89.51%.
⑧The most common herbs of Tourette's syndrome prescription include in this reach:siberian cocklebur fruit, lycopodii herba, jujube seed, Chinese quince, prepared RHIZOMA PINELLIZE, biond magnolia flower, figwort root, isatis root, gambir plant.
(2)The study of Tourette's syndrome cases with "CPIAS"
①Herbs used in the Tourette's syndrome prescriptions include: jujube seed, Chinese quince, lycopodii herba, prepared RHIZOMA PINELLIZE, biond magnolia flower, black snake, gambir plant, paeoniae alba, nux prinsepiae, cicada slough, prepared RADIX GLYCYRRHIZAE, tall gastrodia tuber, etc.
②The property of the herbs of Tourette's syndrome prescriptions mainly is mild, warm and cool.
③The flavor of the herbs of Tourette's syndrome prescriptions mainly is sweet, bitter and pungent.
④Meridian distribution of herbs show up that the maximum distribution percentage is the liver system, followed by the lung system, spleen system, heart system, kidney system, and else.
⑤The effectiveness of Tourette's syndrome prescription in this research mainly include:eliminating wind, calming the nerves, heat-clearing, activating collaterals, calming the liver, eliminating sore poison, stopping endogenous wind, improving acuity of vision, eliminating stagnation, relaxing the tendons, which are among the top 10. After screening, the effectiveness of the top 10 in order were heat-clearing, eliminating wind, calming the liver, activating the tendons, eliminating stagnation, eliminating phlegm, stopping endogenous wind, relaxxing the tendons, dehygrosis, purging pathogenic fire.
⑥Syndrome elements of Tourette's syndrome prescriptions involved in this research mainly include:pathogenic wind, anxiousness, pathogenic heat, collaterals and subcollateral s blockage, hepatic accentuation, sore poison, pyretic toxicity, muscular contracture, eye, wind symptom, which are among the top 10. After screening effectiveness of the top 10 in order were pathogenic heat, pathogenic wind, hepatic accentuation, collaterals and subcollateral s blockage, stagnation, phlegm, wind symptom, muscular contracture, dampness, distinguish fire.
⑦These are ten kinds of complex symptom of Tourette's syndrome prescriptions in this research by order:endogenous liver wind, wind and dampness heated, convulsion caused by heat-phlegm, external cold and internal heat, endogenous wind-evil caused by excessive heat, blockage caused by humid heat, veins and arteries invasion by wind, disturbance caused by phlegm-heat attacking, humid heat caused by stomach intestine blockage, fire-syndrome resulting from wind-heat.
⑧Signs and symptoms in this research are focused on movement tic, creasing nose, shrugging shoulders, vocal tic, redness of tongue, yellow fur, wiry and slippery pulse, restless and angry, sleep week, redness of pharynx, which were the the top 10. Redness of pharynx is more significant in the treatment of Tourette's syndrome.
2. Research of the effect of "Tiaofei" composite prescription on immunity effects in immunodepressed mice.
6 and 12 g·kg-1 dose of "Tiaofei" composite prescription could improve clearance index and phagocytic index in immune function of carbon of mice, decrease ear swelling induced by cyclophosphamide.12 g·kg-1 dose of "Tiaofei" composite prescription could increase content of haemolysin antibody induced by cyclophosphamide.
Conclusion
1. Through s i gns and symptoms, etiology, disease bits, pa thogenes i s, therapy and prescription medication of medical records, objectively and detailedly analyze the summary of the basic etiology and pathogenesis of the disease. Causes included:affected by evil qi,emotions injuries, dietary factors, trauma factors, genetic, and congenital deficiency. Main problem is located in the Liver, but related with lung, spleen, heart and kidney. Wind, fire, phlegm were the main cause in this disease, and also are pathological products. They also are important factors course of this disease, which worsening of the disease.
2. Regulating both inside and outside of the liver and lung are important in this treatment process. In this study, "expelling wind" "harmonizing liver", "removing heat " are the core treatment of the regulating lung therapy. In addition to reflect application of prescription,medication, taste, tropism and effect, also concentrate to the combined effects with all parties of expelling wind, remove heat, harmonizing liver, removing sputum and calm the nerves. In the clinical process, concentrate on the changes in children with nasopharyngeal impact of this disease.
3. According TCM, lung and liver have a close link on the physiological and pathological part. Main problem of Tourette's syndrome is in liver, regulating lung also play a therapeutic role. Evil qi turn from Lung to liver is very important factor of this disease. Therefore, regulating lung, has positive effect for Tourette's syndrome. Sputum is also an important pathogenic factor of threatening Tourette Syndrome. Through the "regulating lung" can improve the body's abnormal fluid metabolism, while reducing endogenous sputum evil, which are conducive to the treatment of Tourette's syndrome.
4. In treating Tourette's syndrome, the regulating lung composite prescription can enhance non-specific immunity, cellular immunity, humoral immunity, largely reduce streptococcus, viruses and other pathogenic microorganisms infection. Meanwhile, it can play a role in correcting functional status of the disorder with Tourette Syndrome cytokines. It also can induce different cytokine to achieve the homeostasis of physiological. Thus it can stabilize neuro- endocrine -immune network and or reduce the tic symptoms.
5. "Zhengqi" can be regarded as immunity in modern medicine. It is decisive factor in the development of disease. The generation, transmission and distribution, whole operation of "zhengqi' are closely linked with lung. Therefore, the "regulating lung" treatment of Tourette's syndrome has some similar meaning with immunomodulatory therapy.
6.This study used clinical factors of medical records as starting point, by means of data mining techniques, preliminarily explore of etiology and pathogenesis with regulating lung as clinical treatment point. And verify the feasibility of data mining methods in the study about medical records of Traditional Chinese Medicine.
利用数据挖掘技术,对“调肺”治疗多发性抽动症的医案进行挖掘分析探索多发性抽动症的基本病因病机和本次研究“调肺”治疗本病的临证辨治思路,并尝试探求本病“调肺”治疗的部分理论意义。同时,应用实验的研究方法,观察“调肺”治疗多发性抽动症的中药复方对免疫低下小鼠免疫功能的影响,探索“调肺”复方可能对多发性抽动症免疫影响的作用机制。
研究方法
1.“调肺”治疗儿童多发性抽动症医案数据挖掘研究
(1)按照纳入标准,确定纳入病例,共收集多发性抽动症病例98例,110例次医案。
(2)按医案临床信息采集要点,收集记录临床信息资料。
(3)应用“医案采集系统”及“中医处方智能分析系统信息采集界面”,对医案信息进行录入。利用《中医主题词表》对医案信息进行标引。
(4)医案由专人录入,录入人员要经过专门培训。对录入后的病例进行多次核查。随机抽取病例进行检查,以确保录入质量。
(5)应用中医医案数据库系统和中医处方智能分析系统,对医案进行挖掘分析。
2.“调肺”治疗多发性抽动症中药复方对小鼠免疫功能影响的研究
环磷酰胺50 mg·kg-1腹腔注射建立免疫功能低下小鼠模型,“调肺”治疗多发性抽动症中药复方(3,6,12 g·kg-1)灌胃给药连续7天,用碳粒廓清法观察小鼠单核巨噬细胞吞噬功能,耳肿增重法观察小鼠迟发型超敏反应,溶血素抗体测定法观察小鼠溶血素抗体生成。
研究结果
1.“调肺”治疗儿童多发性抽动症医案数据挖掘研究
(1)利用“中医医案数据库系统”对多发性抽动症医案的研究
①一般资料：多发性抽动症男性患儿比女性患儿多,男女之比为5.1：1；就诊年龄以6～15岁患儿居多,15岁后人数骤减。
②多发性抽动症常见的症状体征有：红舌、脉弦滑、腻苔、眼肌抽动、喉中怪声、咽红、黄苔、眠差、鼻腔红、性急易怒、白苔、皱鼻、耸肩、手肌抽动、点头等。
③医案所涉及的病因包括：内风、热痰、六淫、情志伤、风痰、外伤、食伤等,但主要以内生邪气为主。
④医案涉及病位肝者为99.09%,心为13.64%,脾为4.55%,肺为3.64%。
⑤医案所涉及的病机：肝风内动最显著81.82%,痰火扰心13.64%,痰火上扰13.64%,脾虚肝旺4.55%,风痰阻络0.91%。
⑥医案所涉及的证候类型：肝风内动证81.82%,痰火上扰证13.64%,脾虚肝旺证4.55%。
⑦医案所涉及的治疗方法以平熄内风,疏风化痰(81.82%)为主,同时应用清心安神、清热化痰、熄风涤痰、调和肝脾的方法。治法经完全分类统计后,多发性抽动症治疗以“治风”、“祛痰”为主,占所有治法的89.51%。
⑧用药规律：“调肺”治疗多发性抽动症用药比较集中,苍耳子、伸筋草酸枣仁、木瓜、清半夏、辛夷、玄参、板蓝根、钩藤,是“调肺”治疗多发性抽动症最常用的中药。
(2)利用“中医处方智能分析系统”对多发性抽动症医案的研究
①处方药物使用权重较高的中药有：酸枣仁、木瓜、伸筋草、清半夏辛夷、乌梢蛇、钩藤、白芍、蕤仁、蝉蜕、炙甘草、天麻等。
②处方药物药性以平性、温性、微寒较高；110例次处方,几乎整体偏凉(95.45%)。
③处方药物药味以甘、苦、辛为主
④处方药物归经以归肝为主,其次肺、胃、脾、心,再一级别为肾、其他。
⑤对处方功效权重计算,功效祛风、安神、清热、活络、平肝、解疮毒、熄风、明目、散结、舒筋居前10位；经筛选后的前10位功效由高到低依次为：清热、祛风、平肝、活络、散结、祛痰、熄风、舒筋、祛湿、泻火
⑥对处方涉及证素进行计算,证素风邪、神不安、热、络脉阻、肝亢疮毒、热毒、筋急、目、动风居前10位；经筛选后热、风邪、肝亢、络脉阻、结、痰、动风、筋急、湿、实火居前10位。
⑦处方主要适应证居前10位的由高到低依次为：肝风内动证、风湿化热证、痰热动风证、表寒里热证、热盛动风证、湿热蕴结证、风中经络证、痰热内扰证、胃肠湿热证、风热化火证。
⑧对处方症状体征关注度进行计算,其中前10位症状体征中,除去主症(眼肌抽动、皱鼻、耸肩、手肌抽动)、舌(红舌、黄苔)、脉(脉弦滑),伴随症状(性急易怒、眠差),咽红的关注度较高。
2.“调肺”治疗多发性抽动症中药复方对小鼠免疫功能影响的研究
(1)对环磷酰胺免疫抑制小鼠单核巨噬细胞吞噬功能的影响
“调肺”复方高剂量组、中剂量组能明显提高免疫低下小鼠的碳粒廓清指数K和吞噬指数α(P<0.01,P<0.05),提示“调肺”复方能提高环磷酰胺免疫抑制小鼠的单核巨噬细胞吞噬功能。
(2)对环磷酰胺免疫抑制小鼠迟发型过敏反应(DTH)的影响
“调肺”复方高剂量组、中剂量组可拮抗环磷酰胺诱导的免疫低下小鼠耳肿胀度减轻(P<0.01,P<0.05),增强低下的迟发型超敏反应(DTH)反应水平。
(3)对环磷酰胺免疫抑制小鼠血清溶血素含量的影响
‘调肺”复方高剂量组能提高免疫低下小鼠血清溶血素含量(P<0.05)。
研究结论
1.通过对医案中症状体征、病因、病位、病机、证候、治法及处方用药进行挖掘分析,客观、详细地分析总结了本病的基本病因病机,病因包括感受外邪、情志内伤、饮食因素、外伤因素、胎遗胎传及先天不足；病位主要在肝,但与肺、脾、心、肾相关；风、火、痰既是本病的致病因素,又是病理产物,是影响疾病转归的重要因素,病程中风、火、痰相互作用导致了本病的发生或加重。
2.本次研究“调肺”治疗多发性抽动症临证辨治过程中,注重肝肺并调,内外并治。“祛风、调肝、清热”是本次研究“调肺”治疗本病把握的核心,在处方用药性味归经及功效等的侧重应用上都有体现,同时又注意把握全方“祛风清热,平肝祛痰、安神”的综合作用。临证过程中也非常注意观察患儿鼻咽部的变化对本病的影响。
3.肺与肝在生理病理上存在密切的联系,多发性抽动症病变核心在肝,调肺对本病同样也起到治疗作用；肺邪传肝是本病发病极为重要的潜在因素,调肺截断外邪内传的通路,对于多发性抽动症治疗具有积极意义；痰是威胁多发性抽动症的重要病邪,“调肺”可改善机体水液的代谢的异常,减少内生痰邪的产生,有利于多发性抽动症的治疗
4.“调肺”治疗多发性抽动症中药复方通过增强非特异性免疫、细胞免疫、体液免疫功能,可以减少机体对链球菌、病毒等致病微生物感染的机会,有利于神经-内分泌-免疫网络的稳定,从而减轻或消除抽动症状。
5.“正气”可以类推为现代医学的“免疫力”,正气是决定疾病发生发展的决定性因素,其生成、输布运行均与肺具有密切的联系,“调肺”治疗本病同免疫调节治疗方法内涵具有部分近似性。
6.本研究从医案中医临证要素出发,引入数据挖掘技术,初步探索了本病病因病机和“调肺”治疗的临证辨治思路,验证了数据挖掘的方法在中医医案研究分析中的可行性。
4“调肺”治疗儿童多发性抽动症医案数据挖掘研究及中药复方对小鼠免疫功能影响的研究ABSTRACT
Objective By analyzing the Tourette's syndrome cases based on data mining,
explore the basic cause and mechanism of Tourette's syndrome with
treatment by regulating lung. And try to discuss the theoretical
significance of TS treatment by regulating lung. Meanwhile, study the
effect and explore the possible mechanism of "Regulating lungs'
composite prescription on immunity effects in immunodepressed mice with
TS.
Methods 1. The study of Tourette's syndrome cases with treatment of regulating
the lung based on date mining (1)Collected 110 cases of patients according to diagnosis and
classification standards Tourette's syndrome. (2)Collected and recorded clinical information according to medical
record. (3)Input information and established a database of Tourette's
syndrome. Data preprocessing, including data standardization and
quantification for data indexing. (4)Multiple post-entry verifications.10% of randomly selected cases
were checked to ensure the quality of entry. (5)Analyzed the Tourette's case with "CPDBS" and "CPIAS" 2. Research of the effect of "Tiaofei" composite prescription on
immunity effects in immunodepressed mice The immunodepressed mice models were induced by intraperitoneal
injection of cyclophosphamide with 50mg·kg-1. Mice were administrated
with "Tiaofei" composite prescription 3,6,12 g·kg-1 for 7 consecutive
days. The phagocytic activity of monocytes, the delayed
hypersensitivity reaction and the haemolysin antibody formation in mice
were observed by means of carbon particle clearance, ear swelling and
haemolysin antibodies.
Results 1. The study of Tourette's syndrome cases with treatment of
regulating the lung based on data mining (1)The study of Tourette's syndrome cases with "CPDBS"①General information:Tourette's syndrome Incidence rate of boy
is higher than girl, the ratio is 5.1:1. Majority in age of 6-15 years old, the incidence rate significantly decreased after age of 15.
②Common clinical symptoms of Tourette's syndrome include:redness of tongue, wiry and slippery pulse, greasy tongue, movement tics, vocal tic, redness of pharynx, insomnia, etc.
③The causes of Tourette's syndrome included in this research: endogenous wind, heat-phlegm, internal injury caused by excess of emotions, surgical trauma, dyspepsia. But the main cause is endogenous factor which affecting health.
④Tourette's syndrome mainly damages liver, counted for 99.09%; heart, counted for 13.64%; spleen, counted for 4.55%; lung, counted for 13.64%.
⑤The mechanisms of Tourette's syndrome include:endogenous liver wind, counted for 81.82%; pyrophlegmatic mania,13.64%; splenic asthenia and hepatic accentuation,4.55%; obstruction of collateral caused by wind-phlegm,0.91%.
⑥The cases of Tourette's syndrome involved three complex symptoms:endogenous liver wind,81.82%; pyrophlegmatic mania,13.64%; splenic asthenia and hepatic accentuation,4.55%.
⑦The treatment of Tourette's syndrome in this research includes calming the liver to stop the wind, expelling wind and dissipating phlegm mainly(counted for 81.82%), easing mental anxiety, eliminating phlegm by cooling, stopping endogenous wind and washing away the phlegm, eliminating phlegm by cooling coordinating. After the complete classification of Statistics, the treatment mainly include calming wind and eliminating phlegm, counted for 89.51%.
⑧The most common herbs of Tourette's syndrome prescription include in this reach:siberian cocklebur fruit, lycopodii herba, jujube seed, Chinese quince, prepared RHIZOMA PINELLIZE, biond magnolia flower, figwort root, isatis root, gambir plant.
(2)The study of Tourette's syndrome cases with "CPIAS"
①Herbs used in the Tourette's syndrome prescriptions include: jujube seed, Chinese quince, lycopodii herba, prepared RHIZOMA PINELLIZE, biond magnolia flower, black snake, gambir plant, paeoniae alba, nux prinsepiae, cicada slough, prepared RADIX GLYCYRRHIZAE, tall gastrodia tuber, etc.
②The property of the herbs of Tourette's syndrome prescriptions mainly is mild, warm and cool.
③The flavor of the herbs of Tourette's syndrome prescriptions mainly is sweet, bitter and pungent.
④Meridian distribution of herbs show up that the maximum distribution percentage is the liver system, followed by the lung system, spleen system, heart system, kidney system, and else.
⑤The effectiveness of Tourette's syndrome prescription in this research mainly include:eliminating wind, calming the nerves, heat-clearing, activating collaterals, calming the liver, eliminating sore poison, stopping endogenous wind, improving acuity of vision, eliminating stagnation, relaxing the tendons, which are among the top 10. After screening, the effectiveness of the top 10 in order were heat-clearing, eliminating wind, calming the liver, activating the tendons, eliminating stagnation, eliminating phlegm, stopping endogenous wind, relaxxing the tendons, dehygrosis, purging pathogenic fire.
⑥Syndrome elements of Tourette's syndrome prescriptions involved in this research mainly include:pathogenic wind, anxiousness, pathogenic heat, collaterals and subcollateral s blockage, hepatic accentuation, sore poison, pyretic toxicity, muscular contracture, eye, wind symptom, which are among the top 10. After screening effectiveness of the top 10 in order were pathogenic heat, pathogenic wind, hepatic accentuation, collaterals and subcollateral s blockage, stagnation, phlegm, wind symptom, muscular contracture, dampness, distinguish fire.
⑦These are ten kinds of complex symptom of Tourette's syndrome prescriptions in this research by order:endogenous liver wind, wind and dampness heated, convulsion caused by heat-phlegm, external cold and internal heat, endogenous wind-evil caused by excessive heat, blockage caused by humid heat, veins and arteries invasion by wind, disturbance caused by phlegm-heat attacking, humid heat caused by stomach intestine blockage, fire-syndrome resulting from wind-heat.
⑧Signs and symptoms in this research are focused on movement tic, creasing nose, shrugging shoulders, vocal tic, redness of tongue, yellow fur, wiry and slippery pulse, restless and angry, sleep week, redness of pharynx, which were the the top 10. Redness of pharynx is more significant in the treatment of Tourette's syndrome.
2. Research of the effect of "Tiaofei" composite prescription on immunity effects in immunodepressed mice.
6 and 12 g·kg-1 dose of "Tiaofei" composite prescription could improve clearance index and phagocytic index in immune function of carbon of mice, decrease ear swelling induced by cyclophosphamide.12 g·kg-1 dose of "Tiaofei" composite prescription could increase content of haemolysin antibody induced by cyclophosphamide.
Conclusion
1. Through s i gns and symptoms, etiology, disease bits, pa thogenes i s, therapy and prescription medication of medical records, objectively and detailedly analyze the summary of the basic etiology and pathogenesis of the disease. Causes included:affected by evil qi,emotions injuries, dietary factors, trauma factors, genetic, and congenital deficiency. Main problem is located in the Liver, but related with lung, spleen, heart and kidney. Wind, fire, phlegm were the main cause in this disease, and also are pathological products. They also are important factors course of this disease, which worsening of the disease.
2. Regulating both inside and outside of the liver and lung are important in this treatment process. In this study, "expelling wind" "harmonizing liver", "removing heat " are the core treatment of the regulating lung therapy. In addition to reflect application of prescription,medication, taste, tropism and effect, also concentrate to the combined effects with all parties of expelling wind, remove heat, harmonizing liver, removing sputum and calm the nerves. In the clinical process, concentrate on the changes in children with nasopharyngeal impact of this disease.
3. According TCM, lung and liver have a close link on the physiological and pathological part. Main problem of Tourette's syndrome is in liver, regulating lung also play a therapeutic role. Evil qi turn from Lung to liver is very important factor of this disease. Therefore, regulating lung, has positive effect for Tourette's syndrome. Sputum is also an important pathogenic factor of threatening Tourette Syndrome. Through the "regulating lung" can improve the body's abnormal fluid metabolism, while reducing endogenous sputum evil, which are conducive to the treatment of Tourette's syndrome.
4. In treating Tourette's syndrome, the regulating lung composite prescription can enhance non-specific immunity, cellular immunity, humoral immunity, largely reduce streptococcus, viruses and other pathogenic microorganisms infection. Meanwhile, it can play a role in correcting functional status of the disorder with Tourette Syndrome cytokines. It also can induce different cytokine to achieve the homeostasis of physiological. Thus it can stabilize neuro- endocrine -immune network and or reduce the tic symptoms.
5. "Zhengqi" can be regarded as immunity in modern medicine. It is decisive factor in the development of disease. The generation, transmission and distribution, whole operation of "zhengqi' are closely linked with lung. Therefore, the "regulating lung" treatment of Tourette's syndrome has some similar meaning with immunomodulatory therapy.
6.This study used clinical factors of medical records as starting point, by means of data mining techniques, preliminarily explore of etiology and pathogenesis with regulating lung as clinical treatment point. And verify the feasibility of data mining methods in the study about medical records of Traditional Chinese Medicine.
引文
[1]陈文伟,黄金才.数据仓库与数据挖掘[M].北京：人民邮电出版社,2004：4.
[2]Richard J. Roiger,Michael W. Geatz, Data mining a tutorial-based primer[M].清华大学出版社,2003,11.
[3]强永乾,郭佑民,王秋萍.数据挖掘技术在临床医学中的应用[J]. 中国高等医学教育,2007,4：92-94.
[4]张华.缺血性中风急性期中医证候演变和神经功能缺损程度的相关性研究[D].北京中医药大学硕士研究生学位论文,2006.
[5]周毅萍.属肝系病证月经病论治规律研究[J].河南中医,2010,30(3)：251-252.
[6]洪霞,毛丽君,吴小明,等.周绍华教授抑郁症医案数据挖掘分析[J].陕西中医,2010,31(12)：1571-1573.
[7]刘惠玲,童光东.《名医类案》方药的计算机分析[J]. 中国中医基础医学杂志,1996,2(2)：59-60.
[8]刘丹雯.基于传统文献与数据挖掘的民国前岭南医案相关研究[D].广州中医药大学硕士研究生学位论文,2003.
[9]汤尔群,任廷革,陈明,等.基于数据挖掘方法的《伤寒论》非衡量器药物剂量研究[J]. 中国中医信息杂志,2009,16(10)：90-93.
[10]曾大方.《临证指南医案》方药统计分析[J].山东中医学院学报.1985,5(1)： 13-17.
[11]姜良铎.温病诊断指标及证治方药规律的研究—古今温病医案10009例次统计分析[J].中医杂志.1987,30(11)：30.
[12]童光东,吴华强,李洪涛,等.新安“温补培元”医家医案温补培元治法计算机分析研究[J]. 中国医药学报,1999,14(4)：56-57.
[13]朱立成,林色奇,薛汉荣,等.名中医哮喘医案445例关联规则分析[J].江西中医学院学报,2007,19(5)：83-87.
[14]李文林,赵国平,陆建峰,等.关联规则在名医临证经验分析挖掘中的应用[J]. 南京中医药大学学报,2008,24(1)：21-24.
[15]饶嫒,邱仕君.基于聚类分析的邓铁涛教授临床用药规律探讨[J].辽宁中医药大学学报,2009,11(7)：5-7.
[16]姜德友,林静,郭加利.基于古今医案数据分析的消渴病证治规律研究[J].中华中医药学刊,2010,28(5)：911-913.
[17]柴程芝,刘志刚,寇俊萍.当归芍药散医案药物剂量研究[J].中医杂志2009,50(11)：1042-1044.
[18]孙燕,臧传新,任廷革,等.支持向量机分类器在中医方剂模式识别中的应用研究[J]. 中医药管理杂志,2006,14(11)：25-28.
[19]叶进,邢传鼎.基于人工神经网络的病症诊断原型系统[J].东华大学学报(自然科学版).2003,29(4)：43-44.
[20]刘昆,刘业政.基于决策树的医疗数据分析[J].计算机工程.2002,28(2)： 41-43,78.
[21]孙继佳,苏式兵,陆奕宇.基于粗糙集与支持向量机的中医辨证数据挖掘方法研究[J].数理医药学杂志.2010,23(3)：261-265.
[22]Vapnik V N. Estimation of dependencies based on empireical data. Berlin:Springer-Verlag,1982.
[23]Vapnik V N. The nature of statistical learning theory, New York: Springer-Verlag,1995.
[24]王阶,吴荣,周雪忠.基于支持向量机的名老中医治疗冠心病证候要素研究[J].北京中医药大学学报.2008,31(8)：540-543,560.
[1]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1997,第1版：188.
[2]钱乙.小儿药证直决[M].南京：江苏科技出版社,1983,第1版：9.
[3]王肯堂.证治准绳[M].上海：上海卫生出版社,1958,第1版：12.
[4]张璐.张氏医通[M].上海：上海科学技术出版社,1990,第1版：294.
[5]吴鞠通.温病条辨[M].上海：辽宁科学技术出版社,1997,第1版：78.
[6]郝宏文.刘弼臣治疗抽动-秽语综合征经验[J].中医杂志,2005,46(6)：417-418.
[7]陈祺.宣桂琪名老中医治疗小儿抽动-秽语综合征[J].中医药学报,2009,37(3)： 43-45.
[8]王文革,孟宪军.汪受传治疗小儿多发性抽动症的经验[J].辽宁中医杂志2004,31(3)： 181-182.
[9]季之颖,陈芳.陈昭定教授治疗儿童抽动症经验[J].中国中医急症,2006,15 (3)： 278.
[10]万亚雄.张士卿教授治疗小儿多发性抽动症的经验[J].中医儿科杂志,2007,3(6)： 3-5.
[11]张骠.小儿多发性抽动症中医证治特点及其研究述略[J].江苏中医药2004,25(9)： 1-3.
[12]李丹, 肖应耀.李宜瑞从肝肾论治儿童抽动秽语综合征[J].辽宁中医杂志,2008,35(12)：1815-1816.
[13]赖东兰,李宜瑞.李宜瑞教授治疗儿童抽动-秽语综合征经验述要[J].中医药学刊,2004,22(7)：1176.
[14]陈要金.郑健治疗小儿抽动-秽语综合征经验[J].中医药临床杂志,2009,21(5)： 390-391.
[15]田建东.从肺论治小儿抽动-秽语综合征经验[J].北京中医药大学学报(中医临床版),2005,12(1)：26.
[16]吴敏,周亚兵.抽动障碍之“伏邪致动”学说初探[J].云南中医学院学报,2007,30(6)：11-13,17.
[17]薛小娜,吴琼,陈自佳,等.王素梅教授治疗多发性抽动症经验撷萃[J].四川中医,2008,26(10)：3-4.
[18]谢佑宁.平肝清胃法治疗小儿抽动秽语综合征[J].时珍国医国药,2000,11(1)：23.
[19]邹治文,文胜.从肝论治多发性抽动症[J].中华中医药杂志,2006,21(1)：38-39.
[20]李香玉.原晓风教授治疗小儿多发性抽动症经验拾萃[J].中国中西医结合儿科学,2010,2(6)：502-503.
[21]韩斐.抽动-秽语综合征辨治探讨[J].Chinese Journal of Information on TCM,2007,14 (9):88.
[22]李继君.李安源治疗小儿多发性抽动症经验[J].中医杂志,2009,50(1)：15-16.
[23]郝宏文.刘弼臣治疗抽动-秽语综合征经验[J].中医杂志,2005,46(6)：417-418.
[24]姚风莉,李海南.刘弼臣治疗抽动-秽语综合征的经验[J].辽宁中医杂志,2002,29(2)：648.
[25]原晓风,安笑然,冯晓纯,等.清心调神熄风除痰法治疗儿童抽动-秽语综合征26例[J].中国临床医生,2003,31(6)：36-37.
[26]张霞.史英杰辨治小儿多发性抽动症经验[J].北京中医药,2009,28(1)：20-21.
[27]刘奔.叶冬兰治疗儿童多发性抽动症经验[J].山东中医杂志,2010,29(5)：343-344.
[28]肖淑琴,郑军,王国玮.二陈汤加减治疗小儿抽动-秽语综合征120例[J].北京中医杂志,1991,(1)：44-45.
[29]郑宏.卞同琦老中医治疗抽动秽语综合征经验[J].中医研究,2001,14(4)：37.
[30]艾小文,马传红.抽动-秽语综合征从脾论治[J].山东中医杂志,1999,18 (5)：208.
[31]赵久龄,金红花.李宝珍治疗小儿多发性抽动症经验[J].世界中医药,2008,3(6)：348-349.
[32]刘成全.韩新民教授治疗小儿多发性抽动症验案2则[J].新中医,2007,39(8)：86.
[33]王守运,姜蕾.鲍远程治疗多发性抽动症经验[J].中医药临床杂志,2010,22(12)：1042-1043.
[34]徐佩莉.知柏地黄丸新用[J].新中医,2005,37(11)：76.
[35]郭映君.百合甘麦大枣汤治疗小儿抽动-秽语综合征30例[J].江西中医药,2005,36(270)：39.
[36]甄德江.玉真散加减治愈抽动秽语综合征[J].北京中医,1989,(5)：45.
[37]刘弼臣,陈丹.小儿抽动-秽语综合征中医分型辨治初探[J].北京中医1993,(2)：14-17.
[38]欧芳兰,柳静,李风美.裴学义治疗抽动秽语综合征的经验[J].北京中医2001,20(1)：5-6.
[39]张军,叶冬兰.胡成群主任医师辨治小儿多发性抽搐症经验[J].北京中医药[J],2008,27(1)：15-16.
[40]孙孝登,邱文菁.中医辨证分型治疗抽动-秽语综合征[J].中国中西医结合杂志,2001,21(5)：378.
[41]高鸿.从肝论治抽动-秽语综合症探析[J].实用中医内科杂志,2004,18 (3)：192-193.
[42]张莹莹,白晓玲,许波,等.抽动秽语综合征从肝论治疗效观察[J].中国中医急症,2008,17(12)：1960,1724.
[43]展玉萍.从肝辨治儿童抽动秽语综合征15例[J].新中医,2003,35(5)：56.
[44]李荣平.从肝辨治小儿抽动秽语综合征50例[J].河南中医,2008,28(5)：77.
[45]张艳琴,夏桂选.白术芍药散加味治疗抽动-秽语综合征[J].北京中医药,2008,27(11)： 875-876.
[46]徐桂萍.健脾平肝法治疗儿童多发性抽动症疗效分析[J].实用中医杂志2010,26(1)：5-7.
[47]于作洋.刘弼臣从肺论治小儿抽动-秽语综合征经验[J].中国中医药信息杂志,2006,13(4)：81.
[48]刘初生,王俊宏,刘弼臣.熄风静宁汤对抽动-秽语综合征患儿血浆多巴胺和兴奋性氨基酸的影响[J].中国中医药信息杂志,2002,9(5)：19.
[49]吴敏,倪红宝,周亚兵,等.肝肺并调法治疗儿童抽动秽语综合征临床研究[J].上海中医药杂志,2005,39(12)：35-36.
[50]李安源,牟林茂,温兆春,等.宁动颗粒治疗抽动-秽语综合征临床观察.第三界世界中西医结合大号论文摘要集.
[51]王春辉.韩斐治疗小儿抽动-秽语综合征经验[J].中国中医药信息杂志,2010,17 (3)： 91-92.
[52]王悟云.中医治疗抽动-秽语综合征102例[J].江苏中医,2000,21(10)：28-29.
[53]吴心芳,余嘉宁.补肾祛风止动汤治疗抽动-秽语综合征30例[J].河南中医,2006,26(11)：43-44.
[54]石海莎,王晓利.张建新教授治疗小儿多发性抽动症经验[J].世界中西医结合杂志,2010,5(12)：1024,1093.
[55]张合红.滋补肝肾法治疗抽动症10例[J].河南中医,2000,20(6)：37.
[56]徐菁.分期辨治小儿多发性抽动症32例[J].浙江中医杂志,2008,43(4)：229
[57]彭征屏,冀晓华.安效先治疗小儿抽动秽语综合征经验[J].中国民间疗法,2006,14(10)：8-9
[58]葛青叶,杨军.头皮针治疗小儿抽动-秽语综合征[J].四川中医,2008,16(9),114-115.
[59]祝晓忠.腹针治疗小儿抽动秽语综合征16例[J].国际医药卫生导报,2006年,12(11)：84-85.
[60]杨白燕.针刺治疗抽动-秽语综合征疗效观察[J].中医药学刊,2005,23(7)：133.
[61]龚霞.耳穴贴压治疗儿童抽动症75例[J].中国针灸,1994,(3)：40.
[62]尹传清,刘守兰,周峰然.中西医结合综合治疗抽动-秽语综合征65例[J].辽宁中医杂志,2000,27(7)：313-314.
[63]邵愚.抽动症的中西医结合治疗[J].浙江中西医结合杂志,2000,10(2)：111.
[64]黄坚明,焦鹏涛,刘培兰,等.中西医结合综合治疗儿童多发性抽动症的临床观察[J].《中外健康文摘》临床医药版,2008,5(5)：102-103.
[1]Singer HS, Loiselle C. PANDAS A commentary [J]. Psycbosom Res,2003.55 (1):31.
[2]Leonard HL, Kiessling LS. Speculations on antineuronal Antibody mediated neuropsychiatric disorders of chi ldhood[J]. Pediatrics, 1994,93 (2):323-326.
[3]Swedo SE, Leonard HL, Garvey MA, et al.Pediatric autoimmune neuro psychiatric disorders associated with streptococcal infections; clinical description of the first 50 cases[J]. Am J Psychiatry, 1998,155 (2):264-271.
[4]金嵘,徐惠琴.抽动障碍患儿A族溶血性链球菌抗体的测定[J].中华精神科杂志,2003,36(4)：231-233.
[5]Muller N, Kroll B, SchwarzMJ, et al. Increased titers of antibodies against streptococcal M12 and M19 proteins in patients with Tourette's syndrome [J]. Psychiat Res,2001,101 (2):187-193.
[6]Morshed SA, Parveen S, Leckman JF, et al. Antibodies against neural, nuclear, cytoskeletal, and streptococcal epitopes in children and adults with Tourette's syndrome, Sydenham' s chorea, and auto immune disorders[J]. Biol Psychiatry,2001,50 (8):566-577.
[7]Dale RC. Autoimmunity and the basal ganglia:New insights into old disease[J]. QJM,2003,96 (3):183,
[8]Hal let t JJ, Harling-Berg CJ, Knopf PM,et al. Anti-dtriatal antibodies in Tourette syndrome cause neuronal dysfunction [J]. J Neuroimmunol,2000,111:195-202.
[9]Church AJ, Dale RC, Lees AJ, et al. Tourette's syndrome:A across sectional study to examine the PANDAS hypothesis [J]. J Neurol Neurosurg Psychiatry,2003,74 (5):602-607.
[10]Singer HS, Giuliano JD, Hansen BH, et al.Antibodies against a neuron-like (HT B-10 neuroblastoma)cell in children with Tourette syndrome[J]. Biolpsychiatry,1999,46 (6):775-780.
[11]Swedo SE, Leonard HL, Mi tt leman BB,et al. Identifieation of children with pediatric autoimmune neuroPsychiatric disorders associated with streptococcal infections by a marker associated with rheumatic fever[J]. Am J Psychiatry,1997,154 (1):110-112.
[12]谢小玲,叶海翠,戴智勇,等.TS临床与补体C3关系的探讨[J].中国现代医学杂志,2001,11(8)：42-43.
[13]李海波,张赛,张波.抽动秽语综合征患儿免疫功能研究[J].中国实用 儿科杂志,2008,23(11)：857-858.
[14]李尔珍,赵文耀,王立文,等.抽动秽语综合征儿童的免疫功能研究[J].北京医学,1999,21(1)：13.
[15]郭淑玉,王海链,周力音,等.抽动秽语综合症与免疫学的探讨[J].中国免疫学杂志,1996,12(6)：365.
[16]陈燕惠,林秋君.抽动障碍患儿免疫功能检测与其临床意义[J].中国神经免疫学和神经病学杂志,2003,10(3)：201.
[17]Muller N, Aekenheil M. Psychoneuroimmunology and the cytokine action in the CNS:implications for psychiatric disorders[J]. Prog Neuropsychopharmacol Bio Psychiatry,1998,22 (1):1-33.
[18]Singer HS.Tourette's syndrome:from behaviour to biology[J]. The Lancet Neurology,2005,4 (3):149-159.
[19]Leckman JF, KatsovichL, Kawikoval, et al. Increased serum levels of interleukin-12 and tomor necrosis factor-alpha in Tourette' s syndrome [J]. Biol Psychiatry,2005,57 (6):667-673.
[20]阮毅燕,李尔珍,许克铭,等.细胞因子L-6、 L-8及TNF-α在Tourette综合征儿童中的表达[J]. 中国妇幼保健,2009,24(6)：808-810.
[21]常桂芬,张波,李海波,等.抽动秽语综合征患儿血清白细胞介素-12和肿瘤坏死因子-a水平变化研究[J]. 中国妇幼保健,2009,24(24)：3425.
[22]李荣,王杰军,沈毅珺,等.IL-6体外对PC12细胞株DA和NE代谢抑制的机制[J].世界华人消化杂志,2008,16(1)：45-49.
[23]成祥林,张晓琴.肿瘤坏死因子-α与癫痫[J].国外医学神经病学神经外科学分册,2003,30(3)：278-279.
[24]Muller, Michael Riedel, Stefanie F, et al. Tourette's syndrome and mycoplasma pneumoniae infect ion [J]. Am J Psychiatry,2000, 157 (3):481-482.
[25]常健,李海波,梁东,等.肺炎支原体感染与儿童多发性抽动症相关性研究[J]. 中国神经精神疾病杂志,2006,32(4)： 349-350.
[26]卢银平,董继华,刘朝,等.抽动-秽语综合征儿童巨细胞病毒感染的意义初探[J]. 中国神经医学杂志,2006,5(11)：1175-1176.
[27]陈燕惠,林桂秀.儿童抽动障碍与微小病毒B19感染和免疫功能[J].中国心理卫生杂志,2006,20(4)：218-220.
[28]金嵘,郑荣远,李健仁,等.Tourette综合征发病危险因素的条件Log istic回归分析[J].中华精神科杂志,2000,33(4)：255-256.
[29]Muller N, Riedel M, Erfurth A, et al. Immunoglobulin therapy in Gilles dela Tourette syndrome [J]. Nervenarzt,1997,68(11):914
[30]Leonard HL, Swedo SE. Pediaric autoimmune neuropsychiatric disorders associated with streptococcal infection(PANDAS)[J]. Int J Neuropsychopharmacol,2001,4(2):191-198.
[31]Singer HS, Loiselle CR, Lee 0,et al.Anti-basal ganglia antibodies in PANDAS[J].Mov Disord,2004,19 (4):406-415.
[32]Taylor JR, Morshed SA, Parveen S. et al. An animal model of Tourette's syndrome [J]. Am J Psychiatry,2002,159 (4):657-660.
[33]陈燕惠,陈珊,王勇,等.干扰素对儿童抽动障碍免疫调节作用的探讨[J]. 中国实用儿科杂志,2002,17(4)：219-221.
[34]Gadow KD, Nolan EE, Sverd J, et al. Anxiety and depression symptoms and response to me thylphenidate in children with at tent ion-deficit hyperactivity disorder and tic disorder[J]. J Clin Psychopharmacol,2002,22(3):267.
[35]Martin JB. The integration of neurology, psychiatry, and neuroscience in the 21 st century[J]. Am J Psychiatry,2002,159(5):
[1]Freeman RD, Fast DK, Burd L, et al.An international perspective on Tourette syndrome:selected findings from 3500 individuals in 22 countries [J]. Dev Med Child Neurol,2000,42:436-447.
[2]Church AJ,Dale RC, Lees AJ, et al. Tourette's syndrome:across sectional study to examine the PANDAS hypothesis [J]. J Neurol Neurosurg Psychiatry,2003,74 (5):602-607.
[3]Scahill L, Sukhodolsky D, Williams S, Leckman J. The public health importance of tics and tic di sorder s [J]. Adv Neurol,2005,96:240-248.
[4]刘智胜主编.小儿多发性抽动症[M].北京：人民卫生出版社,2004,第1版：166.
[5]徐荣谦主编.中医儿科学[M].北京：中国中医药出版社,2010,第1版：12-13.
[6]Singer HS,Walk Kup JT.Tourette Syndrome and other tie disorders diagnosis,pathophysiology and treatment[J]. Medieine,1991:71:15.
[7]Binyon S.Eye-movement tics in children.Cev Med Child [J].Neurol, 1991,33:352.
[8]刘智胜.第3届国际多发性抽动症研讨会侧记[J].实用儿科临床杂志2000,15(6)：344-345.
[9]华于静,钱连华.性激素和兴奋性神经递质与Tourette综合征[J].国外医学精神病学分册,1994,21(2)：103-104.
[10]钱乙.小儿药证直决[M].南京：江苏科技出版社,1983,第1版：9.
[11]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1977,第1版：13.
[12]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1997,第1版：65.
[13]张莹莹,白晓玲,许波,等.抽动障碍的中医病因学探讨[J].中国中医药科技,2009,16(4)：251-252.
[14]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1997,第1版：65.
[15]郑毅.抽动秽语综合征病因与发病机制的研究进展[J].中国实用儿科杂志,2002,17(4)：193-194.
[16]李忠权,龚树辉,段月鹏.儿童抽动秽语综合征与颈椎损伤[J].现代康复,1999,3(1)：24-25.
[17]陈复正.幼幼集成[M].上海：上海科技出版社,1962,第1版：50-51.
[18]金嵘,郑荣远,李健仁,等.Tourette综合征发病危险因素的条件Logistic回归分析[J].中华精神科杂志,2000,33(4)：255-256.
[19]郑毅.抽动秽语综合征病因与发病机制的研究进展[J].中国实用儿科杂志,2002,17(4)：193-194.
[20]Kano Y, Ohta M, Nagai Y.et al.A Family study of Tourette syndrome in Japan[J]. Am J Med Gent,2001,105 (5):414.
[21]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1997,第1版：188.
[22]钱乙.小儿药证直诀[M].北京：人民卫生出版社,2006,第1版：7.
[23]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：368.
[24]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：368.
[25]万全.万氏家藏育婴秘诀[M].武汉：湖北科学技术出版社,1986,第1版：25.
[26]王肯堂.证治准绳[M].上海：上海卫生出版社,1958,第1版：12.
[27]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：164.
[28]万全.万氏家传幼科发挥[M].武汉：湖北科学技术出版社,1986,第1版：21.
[29]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：228.
[30]叶天士.临证指南医案[M].上海：上海科学技术出版社,1959,第1版：18.
[31]缪遵义.吴中珍本医籍四种[M].北京：中国中医药出版社,1994,第1版：18.
[32]钱乙.小儿药证直决[M].南京：江苏科技出版社,1983,第1版：10.
[33]汪认庵.医方集解[M].上海：上海卫生出版社,1957,第1版：247.
[34]段东印.略论“肝亦为痰之源”[J].河南中医学院学报,2004,19(1)：18-19.
[35]方永奇.痰证研究思路探讨[J].中国中医基础医学杂志,1996,2(6)：20-23.
[36]张仲景.金匮要略[M].北京：中医古籍出版社,1997,第1版：31.
[37]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：302.
[38]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：492.
[39]吴鞠通.温病条辨[M].沈阳：辽宁科学技术出版社,1997,第1版：65.
[40]祁坤.外科大成[M].上海：上海科学技术出版社,1957,第1版：16.
[41]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：432.
[42]叶天士.临证指南医案[M].上海：上海科学技术出版社,1959,第1版：98.
[43]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：245.
[44]张仲景.金匮要略[M].北京：中医古籍出版社,1997,第1版：2.
[45]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：403.
[46]孙一奎.赤水玄珠全集[M].北京：人民卫生出版社,1986,第1版：47.
[47]沈金鳌.杂病源流犀烛[M].上海：上海科学技术出版社,1962,第1版：307.
[48]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：38.
[49]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1997,第1版：40.
[50]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：87.
[51]喻嘉言.医门法律[M].上海：上海卫生出版社,1957,新1版：370.
[1]李燕.熄风静宁汤对小鼠免疫功能的影响[J].中国实验方剂学杂志2011,17(7)：198-201.
[2]郭淑玉,王海链,周力音,等.抽动秽语综合征与免疫学的探讨[J].中国免疫学杂志,1996,12(6)：365.
[3]谢小玲,叶海翠,戴智勇,等.TS临床与补体C3关系的探讨[J].中国现代医学杂志,2001；11(8)：42-43.
[4]李海波,张赛,张波.抽动秽语综合征患儿免疫功能研究[J].中国实用儿科杂志,2008,23(11)：857-858.
[5]李尔珍,赵文耀,王立文,等.抽动秽语综合征儿童的免疫功能研究[J].北京医学,1999,21(1)：13.
[6]杨龙飞.熄风静宁冲剂治疗Tourette征的药效及机理研究[D].北京中医药大学硕士研究生学位论文,2003：24.
[7]李仪奎.中药药理实验方法学[M].上海：上海科学技术出版社,1991,15.
[8]Kerbeshian J,Burd L,Pettid R. A possible post-streptococcal movement disorder with chorea and tics. Dev Med Child Neurol,1990,32(7):642-644.
[9]Swedo SE,Leonard HL,Garvey MA,et al.Pediatric autoimmune neuro psychiatric disorders associated with streptococcal infect ions; clinical description of the first 50 cases [J]. Am J Psychiatry,1998,155 (2):264-271.
[10]Muller N,Kroll B, Schwarz MJ,et al. Increased titers of antibodies against streptococcal M12 and M19 proteins in patients with Toutette's syndrome[J].Psychiatry Reserch,2001,101 (2):187-193.
[11]常健,李海波,梁东,等.肺炎支原体感染与儿童多发性抽动症相关性研究[J].中国神经精神疾病杂志,2006,32(4)：349-350.
[12]卢银平,董继华,刘朝,等.抽动-秽语综合征儿童巨细胞病毒感染的意义初探[J].中国神经医学杂志,2006,5(11)：1175-1176.
[13]陈燕惠,林桂秀.儿童抽动障碍与微小病毒B19感染和免疫功能[J].中国心理卫生杂志,2006,20(4)：218-220.
[14]Zang X X,Qian B C. Types of hemolysin and determination by spectrophotometric method [J]. Acta Pharmac Sin,1987,22 (4):301 304.
[15]Ho CS, Shen EY, Shyur SD,et al.Association of allergy with Tourette's syndrome [J]. J Formos Med Assoc,1999,98 (7):492-495.
[16]陈燕惠,林秋君.抽动障碍患儿免疫功能检测与其临床意义[J].中国神经免疫学和神经病学杂志,2003,10(3)：201.
[17]MullerN.Ackenheil M. Psychoneuroimmunology and the cutokine action in the CNS:implications for psychiatric disorders[J].Prog Neuropsychopharmacol Bio Psychiatry,1998,22 (1):1-33.
[18]Muller N,Rledel M,Aekenhell M,et al. The role of immune function in schizophrenia:an overview [J].Eur Arch Psychiatry Clin Neurosci,1999,249 (suppl 4):62-68.
[19]常桂芬,张波,李海波,等.抽动秽语综合征患儿血清白细胞介素-12和肿瘤坏死因子-α水平变化研究[J]. 中国妇幼保健,2009,24(24)：3425-3425.
[20]Leckman JF,Katsovich L,Kawikova I,et al. Increased serum levels of interleukin-12 and tomor necrosis factor-alpha in Tourette' s syndrome[J]. Biol Psychiatry,2005,57 (6):667-673.
[21]阮毅燕.Touret te综合征儿童链球菌感染与细胞免疫功能及细胞因子表达的相关研究[D].中国协和医科大学硕士研究生学位论文,2006：63.
[22]朱伟雄,杨晋凯,胡道伟.辛夷成分及药理应用研究综述[J].海峡药学2002,14(54)：5-7.
[23]吉晓滨,邓家德,臧林泉,等.辛夷对实验性变态性鼻炎红细胞免疫功能的影响[J].广东医学,2006,27(8)：1149-1151.
[24]左祖英.防风苍耳子水煎剂对小鼠免疫功能的影响[J].川北医学院学报,1997,12(3) ：9-10.
[25]王龙妹,傅惠娣,周志兰.细辛、苍耳子对小鼠干扰素诱生的影响[J].中国临床药学杂志,1999,8(增刊)：23-25.
[26]王龙妹,傅惠娣,周志兰.枸杞子、白术、细辛、苍耳子对白细胞介素-2受体表达的影响[J]. 中国临床药学杂志,2000,9(3)：171-173.
[27]李医明,蒋山好,朱大元.玄参属植物化学成分与药理活性研究进展[J].中草药,1999,30(4)：3074-3075.
[28]谢丽华,刘洪宇,钱瑞琴,等.哈巴苷与哈巴俄苷对阴虚小鼠免疫功能血浆环化核苷酸的影响[J].北京大学学报,2001,33(3)：283-284.
[29]胡兴昌,黄旭冬,许燕.板蓝根凝集素对小鼠胸腺发育的影响[J].解剖学杂志,2000,23(6)：559-562.
[30]郑咏秋,魏伟,汪倪萍.木瓜苷对环磷酰胺增强的小鼠接触性超敏反应的影响[J].中国药理学与毒理学杂志,2004,18(6)：415-420.
[31]Naito T.半夏厚补汤对人血浆和唾液中神经肽水平的影响[J].国外医学中医中药分册,2005,27(1)：36-37.
[32]Naito T.比较半夏泻心汤和六君子汤对人血浆CGRP和P物质水平的影响[J].上海中医药杂志,2006,40(6)：37.
[33]莫莉,皮明钧,武参荣,等.半夏泻心汤及其拆方对幽门螺杆菌感染小鼠胃粘膜CD4+、CD8+表达的影响[J].湖南中医学院学报,2006,26(1)：8-
[34]郑海兴,周忠光.伸筋草煎剂对小鼠免疫功能影响的实验研究[J].中医药学报,2005,33(4)：36-37.
[35]史之茂,韩玉生,李燕敏,等.伸筋草乙醇提取物对小鼠免疫功能影响的实验研究[J].黑龙江中医药,2010,1：55-56.
[36]熊明华,钟建国,刘永忠.钩藤颗粒剂对大鼠免疫功能的影响[J].江西中医学院学报,2000,12(4)：182.
[37]郎杏彩,李明湘,吴淑勋.酸枣仁增强小鼠免疫功能的实验研究[J].中药学报,1988,13(11)：683.
[38]鲍淑娟,李淑芳,韩国强,等.酸枣仁的抗炎作用[J].贵阳医学院学报,1994,19(4) ： 336-386.
[39]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：154.
[40]黄帝内经素问[M].北京：人民卫生出版社,1963,第1版：67.
[41]黄帝内经素问[M].北京：人民卫生出版社,1963,第1版：40.
[42]灵枢经[M].北京：人民卫生出版社,2005,第1版：53.
[43]灵枢经[M].北京：人民卫生出版社,2005,第1版：53.
[44]赵献可.医贯[M].北京：学苑出版社,1996,第1版：5.
[45]灵枢经[M].北京：人民卫生出版社,2005,第1版：150.
[46]吴谦等编.医宗金鉴·删补名医方论[M].北京：人民卫生出版社,1957,第1版：3.
[47]黄建庄.试论“肺主一身之气”[J].北京中医学院学,1989,12(4)：11-13.
[48]陈士铎.辨证奇闻[M].北京：中医古籍出版社,1993,第1版：51.
[49]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：202.
[50]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：90.
[51]高世拭.医学真传[M].南京：江苏科学技术出版社,1983,第1版：8.
[52]张介宾.类经·下册[M].北京：人民卫生出版社,1965,第1版：722.
[2]Richard J. Roiger,Michael W. Geatz, Data mining a tutorial-based primer[M].清华大学出版社,2003,11.
[3]强永乾,郭佑民,王秋萍.数据挖掘技术在临床医学中的应用[J]. 中国高等医学教育,2007,4：92-94.
[4]张华.缺血性中风急性期中医证候演变和神经功能缺损程度的相关性研究[D].北京中医药大学硕士研究生学位论文,2006.
[5]周毅萍.属肝系病证月经病论治规律研究[J].河南中医,2010,30(3)：251-252.
[6]洪霞,毛丽君,吴小明,等.周绍华教授抑郁症医案数据挖掘分析[J].陕西中医,2010,31(12)：1571-1573.
[7]刘惠玲,童光东.《名医类案》方药的计算机分析[J]. 中国中医基础医学杂志,1996,2(2)：59-60.
[8]刘丹雯.基于传统文献与数据挖掘的民国前岭南医案相关研究[D].广州中医药大学硕士研究生学位论文,2003.
[9]汤尔群,任廷革,陈明,等.基于数据挖掘方法的《伤寒论》非衡量器药物剂量研究[J]. 中国中医信息杂志,2009,16(10)：90-93.
[10]曾大方.《临证指南医案》方药统计分析[J].山东中医学院学报.1985,5(1)： 13-17.
[11]姜良铎.温病诊断指标及证治方药规律的研究—古今温病医案10009例次统计分析[J].中医杂志.1987,30(11)：30.
[12]童光东,吴华强,李洪涛,等.新安“温补培元”医家医案温补培元治法计算机分析研究[J]. 中国医药学报,1999,14(4)：56-57.
[13]朱立成,林色奇,薛汉荣,等.名中医哮喘医案445例关联规则分析[J].江西中医学院学报,2007,19(5)：83-87.
[14]李文林,赵国平,陆建峰,等.关联规则在名医临证经验分析挖掘中的应用[J]. 南京中医药大学学报,2008,24(1)：21-24.
[15]饶嫒,邱仕君.基于聚类分析的邓铁涛教授临床用药规律探讨[J].辽宁中医药大学学报,2009,11(7)：5-7.
[16]姜德友,林静,郭加利.基于古今医案数据分析的消渴病证治规律研究[J].中华中医药学刊,2010,28(5)：911-913.
[17]柴程芝,刘志刚,寇俊萍.当归芍药散医案药物剂量研究[J].中医杂志2009,50(11)：1042-1044.
[18]孙燕,臧传新,任廷革,等.支持向量机分类器在中医方剂模式识别中的应用研究[J]. 中医药管理杂志,2006,14(11)：25-28.
[19]叶进,邢传鼎.基于人工神经网络的病症诊断原型系统[J].东华大学学报(自然科学版).2003,29(4)：43-44.
[20]刘昆,刘业政.基于决策树的医疗数据分析[J].计算机工程.2002,28(2)： 41-43,78.
[21]孙继佳,苏式兵,陆奕宇.基于粗糙集与支持向量机的中医辨证数据挖掘方法研究[J].数理医药学杂志.2010,23(3)：261-265.
[22]Vapnik V N. Estimation of dependencies based on empireical data. Berlin:Springer-Verlag,1982.
[23]Vapnik V N. The nature of statistical learning theory, New York: Springer-Verlag,1995.
[24]王阶,吴荣,周雪忠.基于支持向量机的名老中医治疗冠心病证候要素研究[J].北京中医药大学学报.2008,31(8)：540-543,560.
[1]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1997,第1版：188.
[2]钱乙.小儿药证直决[M].南京：江苏科技出版社,1983,第1版：9.
[3]王肯堂.证治准绳[M].上海：上海卫生出版社,1958,第1版：12.
[4]张璐.张氏医通[M].上海：上海科学技术出版社,1990,第1版：294.
[5]吴鞠通.温病条辨[M].上海：辽宁科学技术出版社,1997,第1版：78.
[6]郝宏文.刘弼臣治疗抽动-秽语综合征经验[J].中医杂志,2005,46(6)：417-418.
[7]陈祺.宣桂琪名老中医治疗小儿抽动-秽语综合征[J].中医药学报,2009,37(3)： 43-45.
[8]王文革,孟宪军.汪受传治疗小儿多发性抽动症的经验[J].辽宁中医杂志2004,31(3)： 181-182.
[9]季之颖,陈芳.陈昭定教授治疗儿童抽动症经验[J].中国中医急症,2006,15 (3)： 278.
[10]万亚雄.张士卿教授治疗小儿多发性抽动症的经验[J].中医儿科杂志,2007,3(6)： 3-5.
[11]张骠.小儿多发性抽动症中医证治特点及其研究述略[J].江苏中医药2004,25(9)： 1-3.
[12]李丹, 肖应耀.李宜瑞从肝肾论治儿童抽动秽语综合征[J].辽宁中医杂志,2008,35(12)：1815-1816.
[13]赖东兰,李宜瑞.李宜瑞教授治疗儿童抽动-秽语综合征经验述要[J].中医药学刊,2004,22(7)：1176.
[14]陈要金.郑健治疗小儿抽动-秽语综合征经验[J].中医药临床杂志,2009,21(5)： 390-391.
[15]田建东.从肺论治小儿抽动-秽语综合征经验[J].北京中医药大学学报(中医临床版),2005,12(1)：26.
[16]吴敏,周亚兵.抽动障碍之“伏邪致动”学说初探[J].云南中医学院学报,2007,30(6)：11-13,17.
[17]薛小娜,吴琼,陈自佳,等.王素梅教授治疗多发性抽动症经验撷萃[J].四川中医,2008,26(10)：3-4.
[18]谢佑宁.平肝清胃法治疗小儿抽动秽语综合征[J].时珍国医国药,2000,11(1)：23.
[19]邹治文,文胜.从肝论治多发性抽动症[J].中华中医药杂志,2006,21(1)：38-39.
[20]李香玉.原晓风教授治疗小儿多发性抽动症经验拾萃[J].中国中西医结合儿科学,2010,2(6)：502-503.
[21]韩斐.抽动-秽语综合征辨治探讨[J].Chinese Journal of Information on TCM,2007,14 (9):88.
[22]李继君.李安源治疗小儿多发性抽动症经验[J].中医杂志,2009,50(1)：15-16.
[23]郝宏文.刘弼臣治疗抽动-秽语综合征经验[J].中医杂志,2005,46(6)：417-418.
[24]姚风莉,李海南.刘弼臣治疗抽动-秽语综合征的经验[J].辽宁中医杂志,2002,29(2)：648.
[25]原晓风,安笑然,冯晓纯,等.清心调神熄风除痰法治疗儿童抽动-秽语综合征26例[J].中国临床医生,2003,31(6)：36-37.
[26]张霞.史英杰辨治小儿多发性抽动症经验[J].北京中医药,2009,28(1)：20-21.
[27]刘奔.叶冬兰治疗儿童多发性抽动症经验[J].山东中医杂志,2010,29(5)：343-344.
[28]肖淑琴,郑军,王国玮.二陈汤加减治疗小儿抽动-秽语综合征120例[J].北京中医杂志,1991,(1)：44-45.
[29]郑宏.卞同琦老中医治疗抽动秽语综合征经验[J].中医研究,2001,14(4)：37.
[30]艾小文,马传红.抽动-秽语综合征从脾论治[J].山东中医杂志,1999,18 (5)：208.
[31]赵久龄,金红花.李宝珍治疗小儿多发性抽动症经验[J].世界中医药,2008,3(6)：348-349.
[32]刘成全.韩新民教授治疗小儿多发性抽动症验案2则[J].新中医,2007,39(8)：86.
[33]王守运,姜蕾.鲍远程治疗多发性抽动症经验[J].中医药临床杂志,2010,22(12)：1042-1043.
[34]徐佩莉.知柏地黄丸新用[J].新中医,2005,37(11)：76.
[35]郭映君.百合甘麦大枣汤治疗小儿抽动-秽语综合征30例[J].江西中医药,2005,36(270)：39.
[36]甄德江.玉真散加减治愈抽动秽语综合征[J].北京中医,1989,(5)：45.
[37]刘弼臣,陈丹.小儿抽动-秽语综合征中医分型辨治初探[J].北京中医1993,(2)：14-17.
[38]欧芳兰,柳静,李风美.裴学义治疗抽动秽语综合征的经验[J].北京中医2001,20(1)：5-6.
[39]张军,叶冬兰.胡成群主任医师辨治小儿多发性抽搐症经验[J].北京中医药[J],2008,27(1)：15-16.
[40]孙孝登,邱文菁.中医辨证分型治疗抽动-秽语综合征[J].中国中西医结合杂志,2001,21(5)：378.
[41]高鸿.从肝论治抽动-秽语综合症探析[J].实用中医内科杂志,2004,18 (3)：192-193.
[42]张莹莹,白晓玲,许波,等.抽动秽语综合征从肝论治疗效观察[J].中国中医急症,2008,17(12)：1960,1724.
[43]展玉萍.从肝辨治儿童抽动秽语综合征15例[J].新中医,2003,35(5)：56.
[44]李荣平.从肝辨治小儿抽动秽语综合征50例[J].河南中医,2008,28(5)：77.
[45]张艳琴,夏桂选.白术芍药散加味治疗抽动-秽语综合征[J].北京中医药,2008,27(11)： 875-876.
[46]徐桂萍.健脾平肝法治疗儿童多发性抽动症疗效分析[J].实用中医杂志2010,26(1)：5-7.
[47]于作洋.刘弼臣从肺论治小儿抽动-秽语综合征经验[J].中国中医药信息杂志,2006,13(4)：81.
[48]刘初生,王俊宏,刘弼臣.熄风静宁汤对抽动-秽语综合征患儿血浆多巴胺和兴奋性氨基酸的影响[J].中国中医药信息杂志,2002,9(5)：19.
[49]吴敏,倪红宝,周亚兵,等.肝肺并调法治疗儿童抽动秽语综合征临床研究[J].上海中医药杂志,2005,39(12)：35-36.
[50]李安源,牟林茂,温兆春,等.宁动颗粒治疗抽动-秽语综合征临床观察.第三界世界中西医结合大号论文摘要集.
[51]王春辉.韩斐治疗小儿抽动-秽语综合征经验[J].中国中医药信息杂志,2010,17 (3)： 91-92.
[52]王悟云.中医治疗抽动-秽语综合征102例[J].江苏中医,2000,21(10)：28-29.
[53]吴心芳,余嘉宁.补肾祛风止动汤治疗抽动-秽语综合征30例[J].河南中医,2006,26(11)：43-44.
[54]石海莎,王晓利.张建新教授治疗小儿多发性抽动症经验[J].世界中西医结合杂志,2010,5(12)：1024,1093.
[55]张合红.滋补肝肾法治疗抽动症10例[J].河南中医,2000,20(6)：37.
[56]徐菁.分期辨治小儿多发性抽动症32例[J].浙江中医杂志,2008,43(4)：229
[57]彭征屏,冀晓华.安效先治疗小儿抽动秽语综合征经验[J].中国民间疗法,2006,14(10)：8-9
[58]葛青叶,杨军.头皮针治疗小儿抽动-秽语综合征[J].四川中医,2008,16(9),114-115.
[59]祝晓忠.腹针治疗小儿抽动秽语综合征16例[J].国际医药卫生导报,2006年,12(11)：84-85.
[60]杨白燕.针刺治疗抽动-秽语综合征疗效观察[J].中医药学刊,2005,23(7)：133.
[61]龚霞.耳穴贴压治疗儿童抽动症75例[J].中国针灸,1994,(3)：40.
[62]尹传清,刘守兰,周峰然.中西医结合综合治疗抽动-秽语综合征65例[J].辽宁中医杂志,2000,27(7)：313-314.
[63]邵愚.抽动症的中西医结合治疗[J].浙江中西医结合杂志,2000,10(2)：111.
[64]黄坚明,焦鹏涛,刘培兰,等.中西医结合综合治疗儿童多发性抽动症的临床观察[J].《中外健康文摘》临床医药版,2008,5(5)：102-103.
[1]Singer HS, Loiselle C. PANDAS A commentary [J]. Psycbosom Res,2003.55 (1):31.
[2]Leonard HL, Kiessling LS. Speculations on antineuronal Antibody mediated neuropsychiatric disorders of chi ldhood[J]. Pediatrics, 1994,93 (2):323-326.
[3]Swedo SE, Leonard HL, Garvey MA, et al.Pediatric autoimmune neuro psychiatric disorders associated with streptococcal infections; clinical description of the first 50 cases[J]. Am J Psychiatry, 1998,155 (2):264-271.
[4]金嵘,徐惠琴.抽动障碍患儿A族溶血性链球菌抗体的测定[J].中华精神科杂志,2003,36(4)：231-233.
[5]Muller N, Kroll B, SchwarzMJ, et al. Increased titers of antibodies against streptococcal M12 and M19 proteins in patients with Tourette's syndrome [J]. Psychiat Res,2001,101 (2):187-193.
[6]Morshed SA, Parveen S, Leckman JF, et al. Antibodies against neural, nuclear, cytoskeletal, and streptococcal epitopes in children and adults with Tourette's syndrome, Sydenham' s chorea, and auto immune disorders[J]. Biol Psychiatry,2001,50 (8):566-577.
[7]Dale RC. Autoimmunity and the basal ganglia:New insights into old disease[J]. QJM,2003,96 (3):183,
[8]Hal let t JJ, Harling-Berg CJ, Knopf PM,et al. Anti-dtriatal antibodies in Tourette syndrome cause neuronal dysfunction [J]. J Neuroimmunol,2000,111:195-202.
[9]Church AJ, Dale RC, Lees AJ, et al. Tourette's syndrome:A across sectional study to examine the PANDAS hypothesis [J]. J Neurol Neurosurg Psychiatry,2003,74 (5):602-607.
[10]Singer HS, Giuliano JD, Hansen BH, et al.Antibodies against a neuron-like (HT B-10 neuroblastoma)cell in children with Tourette syndrome[J]. Biolpsychiatry,1999,46 (6):775-780.
[11]Swedo SE, Leonard HL, Mi tt leman BB,et al. Identifieation of children with pediatric autoimmune neuroPsychiatric disorders associated with streptococcal infections by a marker associated with rheumatic fever[J]. Am J Psychiatry,1997,154 (1):110-112.
[12]谢小玲,叶海翠,戴智勇,等.TS临床与补体C3关系的探讨[J].中国现代医学杂志,2001,11(8)：42-43.
[13]李海波,张赛,张波.抽动秽语综合征患儿免疫功能研究[J].中国实用 儿科杂志,2008,23(11)：857-858.
[14]李尔珍,赵文耀,王立文,等.抽动秽语综合征儿童的免疫功能研究[J].北京医学,1999,21(1)：13.
[15]郭淑玉,王海链,周力音,等.抽动秽语综合症与免疫学的探讨[J].中国免疫学杂志,1996,12(6)：365.
[16]陈燕惠,林秋君.抽动障碍患儿免疫功能检测与其临床意义[J].中国神经免疫学和神经病学杂志,2003,10(3)：201.
[17]Muller N, Aekenheil M. Psychoneuroimmunology and the cytokine action in the CNS:implications for psychiatric disorders[J]. Prog Neuropsychopharmacol Bio Psychiatry,1998,22 (1):1-33.
[18]Singer HS.Tourette's syndrome:from behaviour to biology[J]. The Lancet Neurology,2005,4 (3):149-159.
[19]Leckman JF, KatsovichL, Kawikoval, et al. Increased serum levels of interleukin-12 and tomor necrosis factor-alpha in Tourette' s syndrome [J]. Biol Psychiatry,2005,57 (6):667-673.
[20]阮毅燕,李尔珍,许克铭,等.细胞因子L-6、 L-8及TNF-α在Tourette综合征儿童中的表达[J]. 中国妇幼保健,2009,24(6)：808-810.
[21]常桂芬,张波,李海波,等.抽动秽语综合征患儿血清白细胞介素-12和肿瘤坏死因子-a水平变化研究[J]. 中国妇幼保健,2009,24(24)：3425.
[22]李荣,王杰军,沈毅珺,等.IL-6体外对PC12细胞株DA和NE代谢抑制的机制[J].世界华人消化杂志,2008,16(1)：45-49.
[23]成祥林,张晓琴.肿瘤坏死因子-α与癫痫[J].国外医学神经病学神经外科学分册,2003,30(3)：278-279.
[24]Muller, Michael Riedel, Stefanie F, et al. Tourette's syndrome and mycoplasma pneumoniae infect ion [J]. Am J Psychiatry,2000, 157 (3):481-482.
[25]常健,李海波,梁东,等.肺炎支原体感染与儿童多发性抽动症相关性研究[J]. 中国神经精神疾病杂志,2006,32(4)： 349-350.
[26]卢银平,董继华,刘朝,等.抽动-秽语综合征儿童巨细胞病毒感染的意义初探[J]. 中国神经医学杂志,2006,5(11)：1175-1176.
[27]陈燕惠,林桂秀.儿童抽动障碍与微小病毒B19感染和免疫功能[J].中国心理卫生杂志,2006,20(4)：218-220.
[28]金嵘,郑荣远,李健仁,等.Tourette综合征发病危险因素的条件Log istic回归分析[J].中华精神科杂志,2000,33(4)：255-256.
[29]Muller N, Riedel M, Erfurth A, et al. Immunoglobulin therapy in Gilles dela Tourette syndrome [J]. Nervenarzt,1997,68(11):914
[30]Leonard HL, Swedo SE. Pediaric autoimmune neuropsychiatric disorders associated with streptococcal infection(PANDAS)[J]. Int J Neuropsychopharmacol,2001,4(2):191-198.
[31]Singer HS, Loiselle CR, Lee 0,et al.Anti-basal ganglia antibodies in PANDAS[J].Mov Disord,2004,19 (4):406-415.
[32]Taylor JR, Morshed SA, Parveen S. et al. An animal model of Tourette's syndrome [J]. Am J Psychiatry,2002,159 (4):657-660.
[33]陈燕惠,陈珊,王勇,等.干扰素对儿童抽动障碍免疫调节作用的探讨[J]. 中国实用儿科杂志,2002,17(4)：219-221.
[34]Gadow KD, Nolan EE, Sverd J, et al. Anxiety and depression symptoms and response to me thylphenidate in children with at tent ion-deficit hyperactivity disorder and tic disorder[J]. J Clin Psychopharmacol,2002,22(3):267.
[35]Martin JB. The integration of neurology, psychiatry, and neuroscience in the 21 st century[J]. Am J Psychiatry,2002,159(5):
[1]Freeman RD, Fast DK, Burd L, et al.An international perspective on Tourette syndrome:selected findings from 3500 individuals in 22 countries [J]. Dev Med Child Neurol,2000,42:436-447.
[2]Church AJ,Dale RC, Lees AJ, et al. Tourette's syndrome:across sectional study to examine the PANDAS hypothesis [J]. J Neurol Neurosurg Psychiatry,2003,74 (5):602-607.
[3]Scahill L, Sukhodolsky D, Williams S, Leckman J. The public health importance of tics and tic di sorder s [J]. Adv Neurol,2005,96:240-248.
[4]刘智胜主编.小儿多发性抽动症[M].北京：人民卫生出版社,2004,第1版：166.
[5]徐荣谦主编.中医儿科学[M].北京：中国中医药出版社,2010,第1版：12-13.
[6]Singer HS,Walk Kup JT.Tourette Syndrome and other tie disorders diagnosis,pathophysiology and treatment[J]. Medieine,1991:71:15.
[7]Binyon S.Eye-movement tics in children.Cev Med Child [J].Neurol, 1991,33:352.
[8]刘智胜.第3届国际多发性抽动症研讨会侧记[J].实用儿科临床杂志2000,15(6)：344-345.
[9]华于静,钱连华.性激素和兴奋性神经递质与Tourette综合征[J].国外医学精神病学分册,1994,21(2)：103-104.
[10]钱乙.小儿药证直决[M].南京：江苏科技出版社,1983,第1版：9.
[11]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1977,第1版：13.
[12]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1997,第1版：65.
[13]张莹莹,白晓玲,许波,等.抽动障碍的中医病因学探讨[J].中国中医药科技,2009,16(4)：251-252.
[14]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1997,第1版：65.
[15]郑毅.抽动秽语综合征病因与发病机制的研究进展[J].中国实用儿科杂志,2002,17(4)：193-194.
[16]李忠权,龚树辉,段月鹏.儿童抽动秽语综合征与颈椎损伤[J].现代康复,1999,3(1)：24-25.
[17]陈复正.幼幼集成[M].上海：上海科技出版社,1962,第1版：50-51.
[18]金嵘,郑荣远,李健仁,等.Tourette综合征发病危险因素的条件Logistic回归分析[J].中华精神科杂志,2000,33(4)：255-256.
[19]郑毅.抽动秽语综合征病因与发病机制的研究进展[J].中国实用儿科杂志,2002,17(4)：193-194.
[20]Kano Y, Ohta M, Nagai Y.et al.A Family study of Tourette syndrome in Japan[J]. Am J Med Gent,2001,105 (5):414.
[21]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1997,第1版：188.
[22]钱乙.小儿药证直诀[M].北京：人民卫生出版社,2006,第1版：7.
[23]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：368.
[24]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：368.
[25]万全.万氏家藏育婴秘诀[M].武汉：湖北科学技术出版社,1986,第1版：25.
[26]王肯堂.证治准绳[M].上海：上海卫生出版社,1958,第1版：12.
[27]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：164.
[28]万全.万氏家传幼科发挥[M].武汉：湖北科学技术出版社,1986,第1版：21.
[29]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：228.
[30]叶天士.临证指南医案[M].上海：上海科学技术出版社,1959,第1版：18.
[31]缪遵义.吴中珍本医籍四种[M].北京：中国中医药出版社,1994,第1版：18.
[32]钱乙.小儿药证直决[M].南京：江苏科技出版社,1983,第1版：10.
[33]汪认庵.医方集解[M].上海：上海卫生出版社,1957,第1版：247.
[34]段东印.略论“肝亦为痰之源”[J].河南中医学院学报,2004,19(1)：18-19.
[35]方永奇.痰证研究思路探讨[J].中国中医基础医学杂志,1996,2(6)：20-23.
[36]张仲景.金匮要略[M].北京：中医古籍出版社,1997,第1版：31.
[37]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：302.
[38]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：492.
[39]吴鞠通.温病条辨[M].沈阳：辽宁科学技术出版社,1997,第1版：65.
[40]祁坤.外科大成[M].上海：上海科学技术出版社,1957,第1版：16.
[41]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：432.
[42]叶天士.临证指南医案[M].上海：上海科学技术出版社,1959,第1版：98.
[43]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：245.
[44]张仲景.金匮要略[M].北京：中医古籍出版社,1997,第1版：2.
[45]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：403.
[46]孙一奎.赤水玄珠全集[M].北京：人民卫生出版社,1986,第1版：47.
[47]沈金鳌.杂病源流犀烛[M].上海：上海科学技术出版社,1962,第1版：307.
[48]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：38.
[49]黄帝内经素问[M].沈阳：辽宁科学技术出版社,1997,第1版：40.
[50]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：87.
[51]喻嘉言.医门法律[M].上海：上海卫生出版社,1957,新1版：370.
[1]李燕.熄风静宁汤对小鼠免疫功能的影响[J].中国实验方剂学杂志2011,17(7)：198-201.
[2]郭淑玉,王海链,周力音,等.抽动秽语综合征与免疫学的探讨[J].中国免疫学杂志,1996,12(6)：365.
[3]谢小玲,叶海翠,戴智勇,等.TS临床与补体C3关系的探讨[J].中国现代医学杂志,2001；11(8)：42-43.
[4]李海波,张赛,张波.抽动秽语综合征患儿免疫功能研究[J].中国实用儿科杂志,2008,23(11)：857-858.
[5]李尔珍,赵文耀,王立文,等.抽动秽语综合征儿童的免疫功能研究[J].北京医学,1999,21(1)：13.
[6]杨龙飞.熄风静宁冲剂治疗Tourette征的药效及机理研究[D].北京中医药大学硕士研究生学位论文,2003：24.
[7]李仪奎.中药药理实验方法学[M].上海：上海科学技术出版社,1991,15.
[8]Kerbeshian J,Burd L,Pettid R. A possible post-streptococcal movement disorder with chorea and tics. Dev Med Child Neurol,1990,32(7):642-644.
[9]Swedo SE,Leonard HL,Garvey MA,et al.Pediatric autoimmune neuro psychiatric disorders associated with streptococcal infect ions; clinical description of the first 50 cases [J]. Am J Psychiatry,1998,155 (2):264-271.
[10]Muller N,Kroll B, Schwarz MJ,et al. Increased titers of antibodies against streptococcal M12 and M19 proteins in patients with Toutette's syndrome[J].Psychiatry Reserch,2001,101 (2):187-193.
[11]常健,李海波,梁东,等.肺炎支原体感染与儿童多发性抽动症相关性研究[J].中国神经精神疾病杂志,2006,32(4)：349-350.
[12]卢银平,董继华,刘朝,等.抽动-秽语综合征儿童巨细胞病毒感染的意义初探[J].中国神经医学杂志,2006,5(11)：1175-1176.
[13]陈燕惠,林桂秀.儿童抽动障碍与微小病毒B19感染和免疫功能[J].中国心理卫生杂志,2006,20(4)：218-220.
[14]Zang X X,Qian B C. Types of hemolysin and determination by spectrophotometric method [J]. Acta Pharmac Sin,1987,22 (4):301 304.
[15]Ho CS, Shen EY, Shyur SD,et al.Association of allergy with Tourette's syndrome [J]. J Formos Med Assoc,1999,98 (7):492-495.
[16]陈燕惠,林秋君.抽动障碍患儿免疫功能检测与其临床意义[J].中国神经免疫学和神经病学杂志,2003,10(3)：201.
[17]MullerN.Ackenheil M. Psychoneuroimmunology and the cutokine action in the CNS:implications for psychiatric disorders[J].Prog Neuropsychopharmacol Bio Psychiatry,1998,22 (1):1-33.
[18]Muller N,Rledel M,Aekenhell M,et al. The role of immune function in schizophrenia:an overview [J].Eur Arch Psychiatry Clin Neurosci,1999,249 (suppl 4):62-68.
[19]常桂芬,张波,李海波,等.抽动秽语综合征患儿血清白细胞介素-12和肿瘤坏死因子-α水平变化研究[J]. 中国妇幼保健,2009,24(24)：3425-3425.
[20]Leckman JF,Katsovich L,Kawikova I,et al. Increased serum levels of interleukin-12 and tomor necrosis factor-alpha in Tourette' s syndrome[J]. Biol Psychiatry,2005,57 (6):667-673.
[21]阮毅燕.Touret te综合征儿童链球菌感染与细胞免疫功能及细胞因子表达的相关研究[D].中国协和医科大学硕士研究生学位论文,2006：63.
[22]朱伟雄,杨晋凯,胡道伟.辛夷成分及药理应用研究综述[J].海峡药学2002,14(54)：5-7.
[23]吉晓滨,邓家德,臧林泉,等.辛夷对实验性变态性鼻炎红细胞免疫功能的影响[J].广东医学,2006,27(8)：1149-1151.
[24]左祖英.防风苍耳子水煎剂对小鼠免疫功能的影响[J].川北医学院学报,1997,12(3) ：9-10.
[25]王龙妹,傅惠娣,周志兰.细辛、苍耳子对小鼠干扰素诱生的影响[J].中国临床药学杂志,1999,8(增刊)：23-25.
[26]王龙妹,傅惠娣,周志兰.枸杞子、白术、细辛、苍耳子对白细胞介素-2受体表达的影响[J]. 中国临床药学杂志,2000,9(3)：171-173.
[27]李医明,蒋山好,朱大元.玄参属植物化学成分与药理活性研究进展[J].中草药,1999,30(4)：3074-3075.
[28]谢丽华,刘洪宇,钱瑞琴,等.哈巴苷与哈巴俄苷对阴虚小鼠免疫功能血浆环化核苷酸的影响[J].北京大学学报,2001,33(3)：283-284.
[29]胡兴昌,黄旭冬,许燕.板蓝根凝集素对小鼠胸腺发育的影响[J].解剖学杂志,2000,23(6)：559-562.
[30]郑咏秋,魏伟,汪倪萍.木瓜苷对环磷酰胺增强的小鼠接触性超敏反应的影响[J].中国药理学与毒理学杂志,2004,18(6)：415-420.
[31]Naito T.半夏厚补汤对人血浆和唾液中神经肽水平的影响[J].国外医学中医中药分册,2005,27(1)：36-37.
[32]Naito T.比较半夏泻心汤和六君子汤对人血浆CGRP和P物质水平的影响[J].上海中医药杂志,2006,40(6)：37.
[33]莫莉,皮明钧,武参荣,等.半夏泻心汤及其拆方对幽门螺杆菌感染小鼠胃粘膜CD4+、CD8+表达的影响[J].湖南中医学院学报,2006,26(1)：8-
[34]郑海兴,周忠光.伸筋草煎剂对小鼠免疫功能影响的实验研究[J].中医药学报,2005,33(4)：36-37.
[35]史之茂,韩玉生,李燕敏,等.伸筋草乙醇提取物对小鼠免疫功能影响的实验研究[J].黑龙江中医药,2010,1：55-56.
[36]熊明华,钟建国,刘永忠.钩藤颗粒剂对大鼠免疫功能的影响[J].江西中医学院学报,2000,12(4)：182.
[37]郎杏彩,李明湘,吴淑勋.酸枣仁增强小鼠免疫功能的实验研究[J].中药学报,1988,13(11)：683.
[38]鲍淑娟,李淑芳,韩国强,等.酸枣仁的抗炎作用[J].贵阳医学院学报,1994,19(4) ： 336-386.
[39]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：154.
[40]黄帝内经素问[M].北京：人民卫生出版社,1963,第1版：67.
[41]黄帝内经素问[M].北京：人民卫生出版社,1963,第1版：40.
[42]灵枢经[M].北京：人民卫生出版社,2005,第1版：53.
[43]灵枢经[M].北京：人民卫生出版社,2005,第1版：53.
[44]赵献可.医贯[M].北京：学苑出版社,1996,第1版：5.
[45]灵枢经[M].北京：人民卫生出版社,2005,第1版：150.
[46]吴谦等编.医宗金鉴·删补名医方论[M].北京：人民卫生出版社,1957,第1版：3.
[47]黄建庄.试论“肺主一身之气”[J].北京中医学院学,1989,12(4)：11-13.
[48]陈士铎.辨证奇闻[M].北京：中医古籍出版社,1993,第1版：51.
[49]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：202.
[50]黄帝内经[M].石家庄：河北科学技术出版社,1994,第1版：90.
[51]高世拭.医学真传[M].南京：江苏科学技术出版社,1983,第1版：8.
[52]张介宾.类经·下册[M].北京：人民卫生出版社,1965,第1版：722.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |