皮毛“疏泄”与“润泽”微环境表征及其立法组方调控机制研究

“Skin Guarding Function (SGF)” is the theoretical basis of the pathogenesis and treatment of skin diseases. Based on the previous research we found that although the dysfunction of “Eliminating injurant” and “Moistening” in skin disease have the same pathogenesis but there is still some differences between these two syndrome. Both famous Chinese doctors and notable clinic cases show that the treatment of these two syndrome have some similarities. Consequently, we hypothesized that the “Eliminating injurant” and “Moistening” indicated the condition of the microenvironment in the axis of “Viscera-Ying Wei-Vein-Skin”. We propose that the dysfunction and microenvironment disorders are common mechanism of skin disease in clinic and it plays an important role in pungent medicine for eliminating injurant in the treatment of skin disease. The aims of this project are: To explore correlations between the microenvironment state of “Eliminating injurant” and “Moistening” and the transparent barrier role of skin. Investigate the IgE and SP level in the serum and the correlation between the expression of aqp3 mRNA and protein; To investigate the regulation function of Xiaofeng powderand pungent and eliminating injurant medicine for dysfunction of “Eliminating injurant” and “Moistening”.Through the research to prove the scientific significance of the proposed theory.

中医皮毛“微环境”研究对皮肤病病机和组方用药的诠释更具科学性和临床指导性。我们研究发现皮毛“疏泄”与“润泽”状态在皮肤病病机方面具有普遍性和特征性，诸多名家医案对皮毛“疏泄”与“润泽”立法用药也有明显的趋同性，因此，提出皮毛“疏泄”与“润泽”是“脏腑-营卫-脉络-皮毛”功能轴作用下皮毛的微环境状态，其平衡失调是湿热蕴肤和血虚风燥证皮肤病的共性机制,辛散解表，养血润燥药在治疗中发挥了重要作用。 本项目通过常见皮毛微环境平衡失调即急性皮炎-湿疹，慢性皮炎-湿疹和脾虚证皮炎-湿疹病证结合豚鼠模型①研究皮毛微环境证候表征及其皮肤组织形态，表皮通透屏障功能，血清总IgE，SP神经肽，肥大细胞，AQP3 mRNA和蛋白表达②通过经典方剂消风散，当归饮子，消风散合四君子汤拆方实验，验证“皮毛微环境”理论的实践指导性和辛散解表，养血润燥药的调控机制和配伍意义，为皮肤病共性机制研究和辨证用药提出理论依据。

中医“皮毛微环境”研究是我们在前期大量工作基础上对皮毛“卫外”功能内涵和医家经验的挖掘、继承与理论创新性思维。它对临床常见皮肤病病机和组方用药的诠释更具科学性和临床指导性。.本项目围绕“皮毛“疏泄”与“润泽”微环境表征及其立法组方调控机制”这一科学问题，根据项目计划书，开展并完成了“皮毛微环境”表征和中医经典方剂对皮毛“疏泄”与”润泽”微环境障碍的调控机制研究，取得了如下研究成果：.通过建立“湿热蕴肤证”、“血虚风燥证”、“脾虚湿蕴证”皮毛微环境障碍豚鼠模型，与正常组对照，发现皮肤角质层含水量，经皮肤水分流失量（TEWL），组织病理，血清IgE、IL-17、IL-4、CD4+ 、CD8+浓度，AQP3mRNA及蛋白表达均有明显差异，能够不同程度客观反映出“湿热蕴肤证”、“血虚风燥证”、“脾虚湿蕴证”皮毛“疏泄”与“润泽”微环境障碍特征；通过中医经典方剂消风散、当归饮子、消风散和四君子汤调控机制研究发现，三个经典方剂对相应模型皮损形态，皮肤角质层含水量，经皮肤水分流失量（TEWL），组织病理，血清IgE、IL-17、IL-4、CD4+ 、CD8+浓度，AQP3mRNA及蛋白表达均有明显的调控作用，可能是中医调控皮毛“疏泄”与”润泽”微环境障碍的主要作用机制。.本项目研究验证并揭示中医皮毛“疏泄”与“润泽”状态和功能是“皮毛微环境”主要特征，“脏腑-营卫-脉络-皮毛”功能轴是表里相关整体性理论核心内容之一，对“皮毛微环境”调节起关键作用，皮毛“疏泄”与“润泽”微环境功能与西医学“表皮通透屏障功能”具有趋同性，中医“皮毛微环境”理论研究为“表皮通透屏障功能”调控研究提供了思路和方法，奠定了中医“皮毛微环境”理论调控经验与经典方药对“表皮通透屏障功能”调控研究的理论基础。