穴位注射治疗支气管哮喘机理研究

发布时间：2018-04-02 02:00

本文选题：穴位注射　切入点：哮喘　出处：《重庆医科大学》2007年硕士论文

【摘要】： 支气管哮喘(bronchial asthma)是以嗜酸性粒细胞浸润为主、多种炎症细胞介导的慢性变态反应性炎症疾病,反复发作可使气道上皮损伤,造成不可逆的气道狭窄,影响患者的健康。糖皮质激素是治疗哮喘的有效药物,可改善哮喘患者的肺功能和生活质量。但长期给予糖皮质激素可产生激素类的副作用,表现为肌无力、肌萎缩、向心性肥胖、满月脸、水牛背等,造成患者不能坚持用药。穴位注射是一种中西医结合的治疗方法,具有临床效果显著、见效迅速,简单易行,节约药物,便于推广等优点。肺俞穴与大椎穴为针灸治疗哮喘的主要穴位,可用于各种呼吸道疾病,如肺炎、支气管炎、肺结核等的治疗。本实验以地塞米松磷酸钠为工具药物,对大椎穴进行穴位注射,考察穴位注射与肌肉注射、静脉注射在组织中的分布和药物动力学差异,以探讨穴位注射治疗哮喘的机理。第一部分:穴位的确定采用数字万用表测定人合谷穴及距穴位0.5cm, 1cm, 1.5cm处的针刺电阻与皮肤电阻,证实穴位处的电阻低于非穴位电阻,表明可通过电阻值确定穴位。通过测定大鼠基准点及基准点2mm, 4mm, 8mm, 1cm处的电阻值,确定了大椎穴和肺俞穴,同时表明以往根据图谱确定穴位的方法存在着误差,以穴位的低电阻性来确定穴位更为科学。第二部分:血浆及组织中地塞米松的HPLC测定方法的建立以地塞米松磷酸钠为工具药物,氢化可的松为内标,建立了HPLC的测定方法,其血浆及组织中回收率均在95%以上,日内RSD与日间RSD均小于5%,测定样品在96小时内稳定。表明该方法准确、可靠,符合实验要求。第三部分:地塞米松穴位与静脉、肌肉注射的分布和药物动力学采用HPLC测定方法,测定了SD大鼠穴位与静脉、肌肉注射的药物分布和药物动力学。体内分布研究表明:穴位注射在血中的药物浓度较静脉、肌肉注射低,而在肝、肺、肾、脾中的药物含量较静脉、肌肉注射高。药物动力学研究表明:穴位注射给药后0.17, 0.5, 1, 2, 4, 8小时的血浆药物浓度低于静脉、肌肉注射,而在肝、肺、肾、脾中的药物含量却较静脉、肌肉注射高,其中肺部药物分布第二高。表明穴位注射可影响药物在组织的分布和药物动力学参数,提高药物在肺部的分布,有利于哮喘的治疗。本实验证实了可通过测定电阻值确定穴位,在皮肤电阻确定穴位的基础上发展了针刺电阻的穴位确定方法,可更准确的确定穴位的位置;建立了HPLC测定地塞米松磷酸钠的血和组织中的含量测定方法;首次证实穴位注射地塞米松磷酸钠可改变药物在组织中的分布和药物动力学参数,提高药物在肺部的分布,有利于哮喘的治疗。
[Abstract]:Bronchial asthma is a chronic allergic inflammatory disease with eosinophilic granulocyte infiltration and many kinds of inflammatory cells. Repeated attacks can damage the airway epithelium, cause irreversible stenosis of the airway, and affect the health of the patients.Glucocorticoid is an effective drug for the treatment of asthma, which can improve the lung function and quality of life of asthmatic patients.But long-term glucocorticoids can produce hormone side effects, such as myasthenia, muscle atrophy, heart obesity, full moon face, buffalo back and so on.Acupoint injection is a method of integrated Chinese and western medicine, which has the advantages of obvious clinical effect, quick effect, simple and easy to carry out, saving medicine and easy to be popularized.The points of Feshu and Dazhui are the main points of acupuncture and moxibustion for the treatment of asthma, which can be used in the treatment of various respiratory diseases such as pneumonia, bronchitis, tuberculosis and so on.Using dexamethasone sodium phosphate as a drug, the point injection at Dazhui point was used to investigate the difference of distribution and pharmacokinetics between acupoint injection and intramuscular injection, so as to explore the mechanism of acupoint injection in the treatment of asthma.The first part: the determination of acupoints using digital multimeter to determine the acupuncture resistance and skin resistance at the point of human Hegu and the distance of 0.5 cm, 1 cm, 1.5cm. It is proved that the resistance of the acupoint is lower than that of the non-acupoint, which indicates that the acupoint can be determined by the resistance value.Dazhui point and Feshu point were determined by measuring the electrical resistance values at 2 mm, 4 mm, 8 mm and 1cm of the reference points in rats. It was also indicated that there were errors in the methods of determining acupoints according to the atlas, and it was more scientific to determine the acupoints by the low electrical resistance of the acupoints.The second part: the method for the determination of dexamethasone in plasma and tissue was established by using dexamethasone sodium phosphate as the drug and hydrocortisone as the internal standard. The method for the determination of dexamethasone in plasma and tissue was established. The recovery of dexamethasone in plasma and tissue was over 95%.Both intraday RSD and daytime RSD were less than 5 and the samples were stable within 96 hours.The results show that the method is accurate, reliable and in line with the experimental requirements.Part three: the distribution and pharmacokinetics of dexamethasone at acupoints and veins and intramuscular injection were determined by HPLC method. The drug distribution and pharmacokinetics of intramuscular injection were determined in SD rats.The results of distribution in vivo showed that the concentration of drugs in blood was lower in acupoint injection than in intravenous injection, but higher in liver, lung, kidney and spleen than in intravenous injection.Pharmacokinetic study showed that the plasma drug concentration at 0.17,0.5, 1,2,4,8 hours after acupoint injection was lower than that by intramuscular injection, but the content of drugs in liver, lung, kidney and spleen was higher than that in intravenous, intramuscular injection.Pulmonary drug distribution was the second highest.The results showed that acupoint injection could affect the distribution of drugs in tissues and pharmacokinetic parameters, increase the distribution of drugs in lung, and be beneficial to the treatment of asthma.This experiment confirmed that the point can be determined by measuring the resistance value, on the basis of the skin resistance to determine the acupoint, the development of acupuncture resistance point determination method, can more accurately determine the point position;A method for the determination of dexamethasone sodium phosphate in blood and tissue by HPLC was established, and it was proved for the first time that injection of dexamethasone phosphate at acupoint could change the distribution of drugs in tissues and pharmacokinetic parameters, and increase the distribution of drugs in lung.It is beneficial to the treatment of asthma.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R246

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