清解伏毒法治疗溃疡性结肠炎组方特色及作用机理研究

发布时间：2018-04-16 15:00

本文选题：清解伏毒 + 溃疡性结肠炎　；参考：《广州中医药大学》2017年硕士论文

【摘要】：第一部分:清解伏毒法治疗溃疡性结肠炎组方特色研究目的:选取近5年罗云坚教授临床治疗溃疡性结肠炎病案资料,运用Excel软件进行中医症候、中药频次统计,总结罗云坚教授清解伏毒法治疗溃疡性结肠炎的组方用药特色。方法:选取罗云坚教授2012年1月至2017年2月期间诊断为溃疡性结肠炎的门诊病案,将所有采集的临床资料进行整理和筛选,通过运用Excel表进行中医证候、中药频数统计,总结罗云坚教授清解伏毒法治疗UC的临床遣方用药特色。结果:罗云坚教授临床治疗脾虚湿蕴证型时以四君子汤加黄芪、黄连、白头翁、薏米、藿香、地榆、槐花、炒山楂、蛇舌草、木香、丹皮为基础方加减,治疗大肠湿热证型时以白头翁汤加薏米、甘草、丹皮、黄芪、蛇舌草、木香、地榆、茯苓、藿香、槐花、炒山楂为基础方加减,治疗寒热错杂证型时以连理汤去干姜加炮姜炭、白头翁、黄芪、藿香、地榆、炒山楂、当归、薏米、陈皮、熟附子、槐花为基础方加减,治疗脾肾阳虚证型时用四君子汤加补骨脂、黄芪、干姜、山药、肉豆蔻、芡实、益智仁、陈皮、乌药、黄连、五味子为基础方加减。结论:罗云坚教授在中医药治疗溃疡性结肠炎时以"清解伏毒"为大法,即以解毒、托毒之法辅以清热、祛湿、行气、活血;祛毒兼顾正气,时时顾护中焦脾胃;从厥阴肝经论治。第二部分:清解伏毒法治疗溃疡性结肠炎作用机理研究目的:以制备成功的慢性复发性溃疡性结肠炎大鼠为研究对象,通过以清解伏毒法立方的高中低剂量的调肠消炎片治疗,同时选择美沙拉秦、雷帕霉素、康士得作对照研究,检测血清IL-1 β与IL-4细胞因子的表达水平,探讨清解伏毒法治疗溃疡性结肠炎作用机理。方法:将正常大鼠随机分为实验组和正常组,实验组使用三硝基苯磺酸(TNBS)-30%乙醇溶液二次致炎法制备慢性复发性溃疡性结肠炎大鼠模型,实验组分为调肠消炎片高中低剂量组、康士得组、美沙拉秦组、雷帕霉素组及模型组,模型组、正常组予灌喂生理盐水,各组疗程均为8天。各组大鼠处死前,行腹腔注射麻醉后,剖开腹腔观察大鼠结肠组织大体形态,腹腔动脉采血后检测血清IL-1β、IL-4细胞因子的表达水平。将记录的数据资料输入SPSS Statistics 19.0软件包进行统计学分析。计量资料以(x±s)表示,如为正态分布,则采用单因素的方差分析;如为非正态分布,则采用非参数秩和检验。结果:在大鼠CMDI比较中,与模型组比较,除调肠消炎片低剂量组外各治疗组大鼠CDMI均显著下降(P0.05)。在大鼠血清IL-1β水平比较中,与正常组比较,模型组和康士得组大鼠血清IL-1β水平均显著升高(P0.05),与模型组比较,各治疗组大鼠血清IL-1β水平均显著降低(P0.05)。康士得组与调肠消炎片高剂量组比较,两组差异有统计学意义(P0.05)。在大鼠血清IL-4水平比较中,模型组与正常组比较差异没有统计学意义(P0.05),与模型组比较,调肠消炎片高剂量组、雷帕霉素组、康士得组、美沙拉秦组皆显著升高(P0.05)。与正常组比较,调肠消炎片高剂量组、雷帕霉素组、康士得组大鼠血清IL-4水平显著升高(P0.05)。与调肠消炎片低剂量组、中剂量和美沙拉秦组比较,调肠消炎片高剂量组、雷帕霉素组、康士得组大鼠血清IL-4水平升高显著(P0.05)。结论:清解伏毒法立方的调肠消炎片能够有效减轻慢性复发性UC大鼠结肠组织炎症,促进溃疡灶愈合,从而起到治疗慢性复发性UC大鼠的目的。其作用机理为通过降低溃疡性结肠炎大鼠血清IL-1 β的表达而提高血清IL-4的表达,促炎因子IL-1 β是中医伏毒的微观表现之一,抗炎因子IL-4是中医正气的微观表现之一。
[Abstract]:The first part: Qingjie toxin treatment to ulcerative colitis prescription characteristics research: select nearly 5 years of Professor Luo Yunjian's clinical treatment of ulcerative colitis clinical data of TCM Syndrome by using Excel software, statistical summary of traditional Chinese medicine, Professor Luo Yunjian Qing prescription characteristics of toxin solution method in the treatment of ulcerative colitis. Methods: from Professor Luo Yunjian from January 2012 to February 2017 for the diagnosis of ulcerative colitis of outpatient medical records, clinical data collection all collected and screened by using Excel table of TCM syndrome, Chinese medicine frequency statistics, summarize professor Luo Yunjian Qing prescriptions characteristic solution toxin treatment UC. Results: Professor Luo Yunjian treatment of spleen deficiency wefness type of syndrome in four gentleman Decoction with Radix Astragali, Rhizoma Coptidis, Radix Pulsatillae, barley, patchouli, Sanguisorba, Huaihua, fried hawthorn, diffusa, radix, paeonol based Decoction Treatment Treatment of damp heat syndrome type in Baitouweng Decoction and barley, licorice, astragalus, paeonol, Oldenlandia, radix, Sanguisorba, Poria, patchouli, Huaihua, fried Hawthorn based decoction, cold and heat syndrome type treatment to Dalian dry ginger soup to add ginger charcoal, Pulsatilla chinensis, astragalus, patchouli, Sanguisorba officinalis, fried hawthorn. Angelica, barley, dried tangerine peel, cooked aconite, Huaihua based decoction, spleen kidney yang deficiency type treated with four Tonga psoralen, astragalus, dried ginger, nutmeg, yam, Gorgon, Alpinia oxyphylla, tangerine peel, Radix Linderae, Coptis chinensis, Fructus schisandrae chinensis based decoction. Conclusion: Professor Luo Yunjian in the Chinese Medicine treatment of ulcerative colitis when the "Qingjie toxin" method to detoxification, detoxication method with heat, dampness, Qi and blood; Qudu balanced upright, always protecting the spleen and stomach; from the liver meridian differentiation. The second part: Qingjie toxin therapy objective to study the mechanism of ulcerative colitis for: Chronic recurrent ulcerative colitis rats successfully as the research object, through anti-inflammatory tablets in the treatment of Qingjie toxin cubic high low dose of bowel, and choose the United States salad Qin, rapamycin, cascodex were studied, the expression level of serum IL-1 and beta IL-4 cytokines, to explore the clear solution toxin treatment of ulcerative colitis mechanism. Methods: the rats were randomly divided into experimental group and control group, the experimental group used three trinitrobenzene sulfonic acid (TNBS) -30% ethanol solution two times inflammatory preparation of rat model of chronic ulcerative colitis, experimental group S.D low dose group were divided into high school tiaochang, Casodex group, beauty salad Qin group, rapamycin group and model group, model group, normal group were fed with normal saline, were treated for 8 days. All the rats were sacrificed after intraperitoneal injection before anesthesia, open the abdominal cavity to observe the colon tissue of rats The body shape, the detection of serum IL-1 beta of celiac artery blood, the expression level of IL-4 cytokines. The data input SPSS Statistics recorded 19 software package was used for statistical analysis. Measurement data in (x + s) said, such as normal distribution, using the single factor analysis of variance; for non normal distribution then, using the nonparametric Wilcoxon test. Results: in comparison to CMDI in rats, compared with the model group, in addition to Tiaochangxiaoyan tablets of low dose group rats in each treatment group CDMI decreased significantly (P0.05). The comparison of serum IL-1 in rats, compared with the normal group, model group and Kang people have to serum IL-1 group rats were significantly increased (P0.05), compared with the model group, the serum IL-1 levels of rats in each treatment group were significantly decreased (P0.05). Cascodex Tiaochangxiaoyan tablets group and high dose group, there was significant difference between two groups (P0.05) in serum. The level of IL-4 in rats In the difference between the model group and the normal group was not statistically significant (P0.05), compared with the model group, Tiaochangxiaoyan tablets in high dose group, rapamycin group, Casodex group, the group is significantly increased in Qin salad (P0.05). Compared with the normal group, the high dose group of Tiaochangxiaoyan tablets, by ray Palmer in group A, cascodex group of rats serum IL-4 level increased significantly (P0.05). Tiaochangxiaoyan tablets with low dose group, middle dose group and the comparison of salad Qin, Tiaochangxiaoyan tablets in high dose group, rapamycin group, cascodex group of rats serum IL-4 level increased significantly (P0.05). Conclusion: the Qing Dynasty solution of toxin cubic Tiaochangxiaoyan tablets can effectively alleviate the colon tissue of rats with chronic recurrent UC inflammation, promote ulcer healing, so as to the treatment of chronic recurrent UC rats. The mechanism for increased serum IL-4 expression by reducing the expression of serum IL-1 beta in rats with ulcerative colitis. Pro The inflammatory factor IL-1 beta is one of the microscopic manifestations of traditional Chinese medicine, and the anti-inflammatory factor IL-4 is one of the microscopic manifestations of traditional Chinese medicine.

【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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