安肠止泻方对肝郁脾虚IBS-D大鼠血清及脑肠组织中VIP、5-HT含量影响的研究

发布时间：2018-06-18 10:17

本文选题：肠易激综合征 + 肝郁脾虚　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:肠易激综合征(irritable bowel syndrome,IBS)是一种以腹痛及腹部不适为主要特征同时伴有排便习惯的改变及大便性状改变的一种慢性反复发作性胃肠道功能紊乱性肠病。肠易激综合征给生活带来极大的不便[81]。据报道[82]2013年IBS在欧美和北美地区的发病率增长很快,已接近20%,国内的发病率约10～15%。亚洲国家的IBS发病率也正在逐渐增长,一步步向欧美国家发病率靠拢。在IBS各种证型中,肝郁脾虚是IBS的最常见证型,也是IBS的基本病机。临床上很多用疏肝健脾作为治疗方法的。其治疗机制与降低肠道的高敏感性、增加肠道的压力阈值、调节脑肠互动功能、调节胃肠激素分泌功能、调节机体免疫系统、增强免疫力有着很大的关联。目前对IBS还没有明确的发病机制。通过临床观察,我们发现安肠止泻方对肝郁脾虚型的IBS-D的治疗有着很好的效果,希望通过本次研究能了解安肠止泻方对肝郁脾虚型IBS-D大鼠血清及脑肠组织上相关激素VIP、5-HT是否有影响。方法:1.造模:SPF级SD大鼠50只,番泻叶灌胃+慢性束缚+冷水刺激应激法联合造模。造模结束后评估造模结果。2.分组:随机的将SD大鼠分为空白组、模型组、马来酸曲美布汀组、安肠止泻方低、高剂量组,按照随机数字表法分组。3.给药:正常组及模型组均以0.9%Nacl灌胃。马来酸曲美布汀组予以马来酸曲美布汀0.03g/ml灌胃,体积20ml/kg,安肠止泻方组高、低剂量组分别以1.5g/ml、0.75g/ml浓度的中药溶液灌胃,每日2次,连续两周。4.检测指标:a.大鼠一般状态的观察。b.大鼠体重的变化。c.造模阶段大鼠稀便率的变化。d.球囊扩张实验检测大鼠结肠疼痛敏感度。e.采用酶联免疫法检测血清及其脑肠组织中VIP、5-HT含量。结果:1、造模初期大鼠警惕不安、烦躁嘶叫;造模后期大鼠反抗减弱、神态疲倦、喜静靠于鼠笼边缘,毛色枯黄,皮毛杂乱没有光泽。2、造模期间大鼠体重减轻。3、大鼠造模组稀便率第3天比第一天显著升高,第7天有所降低。4、模型组肠道压力阈值比正常组肠道压力阈值明显降低,肠道敏感性增高,模型组与空白组相比差异显著(*P0.05)。造模后的大鼠经西药组治疗后,大鼠压力阈值有所升高,但仍低于正常组,西药组与造模组差异明显(#P0.05),中药高浓度组压力阈值较模型组也有所升高(#P0.05),中药高浓度组与西药组差异较小(P0.05)3、与空白组对照,模型组血清5-HT(***P0.005)、脑组织5-HT(***P0.005)、肠组织5-HT(*P0.05)含量都有明显提高,差异显著,模型组血清VIP(*P0.05)、脑组织VIP(*P0.05)、肠组织VIP(***P0.005)含量都有明显提高,差异显著。4、与模型组对照,安肠止泻方高剂量组及西药组血清5-HT(###P0.005)、脑组织5-HT(###P0.005)、肠组织5-HT(#0.05)含量均有不同程度的降低,安肠止泻方及西药组大鼠血清VIP(#P0.05)及肠组织肠组织VIP(#P0.05)显著降低,差异明显。结论:1、SD大鼠在番泻叶灌胃加束缚和冷水应激刺激下可以使得内脏的敏感性增高,结肠痛阈值降低,情志刺激造成肝郁脾虚模型,联合造模方法造成肠道功能紊乱,而肠粘膜未见病理损伤,基本符合IBS的诊断标准,证明了肝郁脾虚大鼠模型复制成功。2、安肠止泻方能够降低SD大鼠血清和脑肠粘膜中5-HT的含量以及血清、肠组织中VIP含量,并且能够提高肝郁脾虚型IBS-D大鼠的内脏痛阈值,缓解IBS-D的症状,明确了该方的基础实验效应,提示了该效应与调控5-HT、VIP的变化相关。3、从结果看,安肠止泻方高剂量组对模型组的大鼠血清和脑肠5-HT以及大鼠血清和肠组织VIP含量的降低作用与西药马来酸曲美布汀效果相当,而安肠止泻方低剂量效果不明显,所以安肠止泻方剂量大作用效果较明显,推测作用的效应与剂量呈依赖性的关系。
[Abstract]:Objective: irritable bowel syndrome (IBS) is a chronic recurrent gastrointestinal dysfunction enteropathy with abdominal pain and abdominal discomfort as the main characteristics accompanied by changes in the habit of defecation and changes in the stool character. The irritable bowel syndrome causes great inconvenience to life. [81]. is reported to be IBS in [82]2013 years. The incidence of the disease in Europe and America and North America has increased rapidly, and it is close to 20%. The incidence of IBS in the Asian countries is about 20%. The incidence of the Asian countries is increasing gradually. The incidence of the disease is closer to the European and American countries. In the various IBS syndromes, the liver depression and spleen deficiency are the most common syndrome of IBS, and also the basic pathogenesis of IBS. The treatment mechanism is related to reducing the Gao Min sensibility of the intestinal tract, increasing the threshold of the intestinal pressure, regulating the interaction of the brain and intestines, regulating the secretion function of the gastrointestinal hormone, regulating the immune system of the body and enhancing the immunity. At present, there is no clear pathogenesis for IBS. Through clinical observation, we found an antidiarrheal prescription. The treatment of liver qi stagnation and spleen deficiency type of IBS-D has a good effect. Through this study, we hope to understand the effect of an intestinal antidiarrheal prescription on the serum and brain tissue related hormone VIP and 5-HT in IBS-D rats with liver depression and spleen deficiency. Methods: 1. model: 50 SPF grade SD rats, combined with senna leaf perfusion and chronic restraint + cold water stimulation stress method. .2. groups were divided into two groups: the SD rats were randomly divided into the blank group, the model group, the maleic trimebutine group, the low Anchang antidiarrheal prescription, the high dose group, and the.3. administration according to the random number table method: the normal group and the model group were gavage with 0.9%Nacl. The maleic trimebutine group was treated with trimebutine maleic 0.03g/ml in the stomach, and the volume 20ml/ Kg, andchang antidiarrheal prescription group high, low dose group with 1.5g/ml, 0.75g/ml concentration of traditional Chinese medicine solution, 2 times a day, two weeks of continuous.4. detection index: the general state of A. rats, the changes of.B. rats' weight changes.C. model stage of rat dilute rate.D. balloon dilatation test of colon pain sensitivity.E. using enzyme linked immunosorbent assay The contents of VIP and 5-HT in serum and its brain tissue were detected. Results: 1, at the early stage of the model rats, the rats were vigilant and irritable, and the rats were tired and tired. The rats were quiet on the edge of the squirrel cage, the color of the hair was yellow, the fur was unshiny.2, the weight of the rats was reduced by.3, and the rate of dilute stool in the rat model was significantly higher than the first day in the rat model. The threshold of intestinal pressure in the model group was significantly lower than that of the normal group, and the intestinal sensitivity of the model group was significantly higher than that of the blank group (*P0.05). The pressure threshold of the rats after the model group was increased after the treatment of the western medicine group, but it was still lower than the normal group, and the difference between the western medicine group and the model group was obvious (#P0.05). The pressure threshold of high concentration group of Chinese medicine was also higher than that of the model group (#P0.05). The difference between the high concentration group and the western medicine group was smaller (P0.05) 3. Compared with the blank group, the serum 5-HT (***P0.005), the 5-HT (***P0.005) of the brain tissue and the 5-HT (*P0.05) in the intestinal tissue were obviously improved, and the difference was significant. The serum VIP (*P0.05) and VIP (*P0.05) of the brain tissue were found in the model group. The contents of VIP (***P0.005) in intestinal tissue were significantly improved, and the difference was significant.4. Compared with the model group, the high dose group and the serum 5-HT (###P0.005), the 5-HT (###P0.005) of the brain tissue and the 5-HT (#0.05) content of the intestinal tissue were reduced in different degrees, and the serum VIP (#P0.05) and intestinal tissue of the intestinal tissue in the group of intestinal antidiarrheal and Western medicine group were decreased. 0.05) significantly decrease, the difference is obvious. Conclusion: 1, SD rats can increase the sensibility of the viscera, reduce the threshold of colonic pain and cause the model of liver depression and spleen deficiency under the irritation of shackle and cold water under the irritation of senna leaf and the irritation of shackles and cold water, and the combined modeling method can cause intestinal dysfunction, but no pathological damage in the intestinal mucosa is found, which basically meets the diagnostic criteria of IBS. It was proved that the model of liver qi stagnation and spleen deficiency rat model was successful.2, and an intestinal antidiarrheal recipe could reduce the content of 5-HT in the serum and the intestinal mucosa of SD rats and the content of VIP in the intestinal tissue, and could improve the visceral pain threshold of the IBS-D rats with liver depression and spleen deficiency, alleviate the symptoms of IBS-D, and confirm the basic experimental effect of this recipe, and suggest the effect and the effect of this effect. The changes of 5-HT and VIP were related to.3. From the results, the effect of the high dose group of Anchang antidiarrheal prescription on the serum and brain intestinal 5-HT in the model group and the VIP content in the serum and intestinal tissues of the model group was equal to the western medicine of trimebutine, while the low dose effect of Anchang antidiarrheal prescription was not obvious, so the effect of Anchang antidiarrheal prescription was more effective than that of Anchang antidiarrheal prescription Obviously, the effect of speculation is dependent on dose.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R285.5

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