小型猪胃经与肾经“经脉不通”病理模型的比较研究

发布时间：2018-06-15 20:39

本文选题：病理模型 + 低流阻通道　；参考：《北京中医药大学》2016年硕士论文

【摘要】：[目的]经脉不通是导致肢体和内脏病候的病理机制之一。疏通经络是针灸最主要的治疗作用。本研究通过制造小型猪胃经和肾经“经脉不通”的病理模型,观察该模型产生的整体病候表现和脏器的病理变化,以发现阻塞循经低流阻通道的相关病理特征与经脉病候之间的关系,从而建立一套研究“经脉不通”病理模型的宏观定量观察方法,并与组织学检测方法相结合,为中医的实验研究提供新的思路和方法。[方法]选用同品系小型猪19只,分为胃经不通组(胃经组)7只、肾经不通组(肾经组)7只和空白对照组(对照组)5只,每日给予定量的饮用水和饲料。使用凝胶注射法分别堵塞胃经组的胃经低流阻通道和肾经组的肾经低流阻通道,对照组只做麻醉处理。观察造模后取材前7天每日的饮水量、尿量、粪便湿重和烘干后的粪便干重。其中,每组选取1只小型猪(胃经猪、肾经猪和对照猪)进行造模前后每日饮水量和尿量的连续观察。造模当天和取材当天测量小型猪的体重与体尺(胸围、腰围、腹围、体长),抽取耳背静脉血进行血清尿素氮与肌酐的检测；取材当天经膀胱壁抽取尿液,进行尿液的常规生化指标检测。使用游标卡尺测量门齿和犬齿的长度、前臼与臼齿的宽度,使用电子秤称量各脏器的离体重量,拍照记录面积测定盘上各脏器的离体面积,根据照片用数格法计算各脏器的投影面积。在上述已获数据的基础上,计算粪便含水量、体躯指数、脏器重量系数、脏器面积系数和肠长度系数。随机取心、肝、脾、肺、肾、胃、睾丸、胰腺、膀胱、前列腺、十二指肠、空肠、回肠、盲肠、结肠和直肠的一块组织放入固定液中固定,制作并观察各组织的HE染色切片,测量小肠的绒毛长度和隐窝深度,大肠的黏膜厚度。用免疫组化技术处理胃的石蜡切片,测定胃泌素的阳性信号面积密度。[结果]1.宏观观察：1.1饮水量及二便量连续观察的3只小型猪造模前后的饮水量及尿量比较结果显示,胃经猪造模后的饮水量比造模前增加49.31%(P0.01),造模后的尿量比造模前增加56.54%(P0.01)。肾经猪造模前后饮水量与尿量的变化无统计学意义(P0.05),且造模后的饮水量和尿量均未增加,反而略有下降。对照猪造模后的饮水量比造模前增加35.00%(P0.01),造模后的尿量比造模前增加37.45%(P0.05)。造模后的饮水量、尿量和粪便含水量比较结果显示,胃经组的饮水量比肾经组高37.52%(P0.01),比对照组高30.62%(P0.05)；肾经组与对照组的饮水量相比无统计学意义(P0.05)。胃经组的尿量比肾经组高57.40%(P0.01),比对照组高41.24%(P0.05)；肾经组与对照组的尿量相比无统计学意义(P0.05)。胃经组的粪便含水量比肾经组低35.10%(P0.01)；对照组的粪便含水量分别与胃经组和肾经组相比均无统计学意义(P0.05)。1.2体重各组小型猪造模前后的体重差值均无统计学意义(P0.05)。1.3多脏器剖检观察各组肺的颜色、胃经组和对照组肺的质地和黏膜均见不同程度的异常；胃经组心脏的内容物和对照组心脏的黏膜见不同程度的异常。对照组肝脏的质地、黏膜及肾经组肝脏的表面偶见异常。对照组脾的质地和黏膜偶见异常。胃经组的胰腺颜色偶见异常。肾经组膀胱内偶见粉末状白色颗粒。各组小肠与大肠均见不同程度臌气。1.4牙齿肾经组的双侧第1门齿长度分别大于胃经组30.79%(P0.01)和对照组20.62%(P0.01)。1.5体躯指数胃经组的腰围体躯指数大于对照组6.78%(P0.05)。1.6脏器重量系数胃经组的肾脏脏器重量系数高于对照组23.60%(P0.01)；肾经组的肾脏脏器重量系数高于对照组12.82%(P0.05)。肾经组心脏脏器重量系数低于对照组24.14%(P0.05)。肾经组的睾丸脏器重量系数低于胃经组22.22%(P=0.054),低于对照组26.32%(P=0.36)。1.7脏器面积系数肾经组的心脏脏器面积系数小于胃经组20.00%(P0.05)。肾经组的脾脏器面积系数小于对照组35.48%(P0.01)。1.8肠长度系数各组小肠和大肠的长度系数之间无统计学意义(P0.05)。2.微观检测与观察：2.1血液指标各组尿素氮造模前后的组间比较均无统计学意义(P0.05)。胃经组与对照组血清肌酐水平造模前均小于参考范围,各组造模后的血清肌酐水平均比造模前显著增高。造模后的组间比较结果显示,肾经组造模后的血清肌酐水平比胃经组低13.76%(P0.05),比对照组低14.51%(P0.01)；各组造模后的组间比较均无统计学意义(P0.05)。2.2尿液指标肾经组与对照组的尿葡萄糖均为阳性；肾经组的尿比重大于参考范围；各组隐血、尿蛋白均为阳性；胃经组与肾经组尿胆红素、酮体和白细胞均呈阳性。2.3组织学观察3组小型猪均出现不同程度的心肌纤维坏死；肝中央静脉、小叶间静脉和肝窦可见不同程度的淤血,狄氏隙显现,汇管区有少量炎性细胞浸润；肺脏出现肺泡轻度扩张,肺静脉毛细血管淤血。各组偶见胃黏膜出血、水肿及淤血；肾小管、肾小球病变。肾经组4/7例睾丸曲细精管萎缩,其内未见(或数量减少)正常的各级生精细胞,间质增宽。肾经组与对照组偶见膀胱黏膜轻度充血及水肿,胃经组未见明显异常。各组前列腺均未见明显异常。小肠绒毛长度结果显示,各组十二指肠、空肠与回肠小肠绒毛长度之间均无统计学意义(P0.05)。各组小肠隐窝深度结果显示,胃经组的十二指肠隐窝深度高于正常组18.33%(P0.05)；肾经组的十二指肠隐窝深度高于正常组20.84%(P0.01)；胃经组回肠隐窝深度小于肾经组13.60%(P0.01)；各组小肠隐窝深度总平均值之间均无统计学意义(P0.05)。各组小肠绒毛长度与隐窝深度比值(V/C)的统计结果显示,肾经组的十二指肠V/C值小于对照组15.74%(P0.05)；胃经组的空肠V/C值小于肾经组16.44%(P0.05)；胃经组回肠V/C值大于肾经组25.91%(P0.01)。各组大肠黏膜厚度统计结果显示,胃经组结肠黏膜厚度大于对照组53.28%(P0.01)；肾经组结肠黏膜厚度大于对照组68.15%(P0.01)；胃经组的大肠黏膜层总厚度大于对照组7.32%(P0.05)。各组胃黏膜胃泌素阳性信号面积密度统计结果显示,肾经组比胃经组高28.65%(P0.05),比对照组高32.83%(P0.05)。[结论]1.堵塞胃经低流阻道小型猪出现了与胃经和胃肠特异相关的病候；堵塞肾经低流阻通道小型猪出现了与肾经和肾膀胱特异相关的病候,证明低流阻通道是经络的解剖结构之一,“经脉不通”是导致相关经脉脏腑病变的病理机制之一。2.初步建立了小型猪“经脉不通”病理模型的宏观定量观察法,使用该方法对经脉不通进行研究具有可行性,为经络研究提供了新的思路和方法。
[Abstract]:In this study , we studied the relationship between the pathological characteristics of small pigs and the pathological changes of the organs , and established a set of macroscopic quantitative observation methods for the pathological models of the stomach meridian and the kidney meridian of the small pigs .
The water content , body index , organ weight coefficient , organ area coefficient and intestinal length coefficient were measured by using vernier caliper . The water content , body index , organ weight coefficient , organ area coefficient and intestinal length coefficient were calculated .
Compared with the control group , there was no significant difference between the two groups ( P0.05 ) . The urine volume of the stomach meridian group was 57.40 % higher than that of the control group ( P0.01 ) , which was 41.24 % higher than that of the control group ( P0.05 ) .
Compared with the control group , there was no significant difference in urine volume between the kidney meridian group and the control group ( P0.05 ) . The stool water content of the stomach meridian group was 35.10 % lower than that of the renal meridian group ( P0.01 ) .
There was no significant difference ( P0.05 ) . 1 . 2 The body weight difference before and after the small - sized pigs in each group had no statistical significance ( P0.05 ) .
In the control group , there was no abnormality in the texture , the mucous membrane and the kidneys of the control group . The texture and the mucous membrane of the liver in the control group were abnormal . The size of the spleen in the group of the control group was more than that of the control group .
There was no significant difference between the two groups ( P = 0 . 05 ) . Compared with the control group , there was no significant difference between the two groups ( P = 0 . 05 ) .
There was no significant difference between the groups after modeling ( P0.05 ) . The urine glucose in the urine index kidney meridian group and the control group was positive ;
The urine specific gravity of the kidney meridian group was larger than that of the reference range ;
All groups of occult blood and urine protein were positive ;
The urine bilirubin , ketone bodies and white blood cells of the stomach meridian group were positive . 2 . 3 histological observation showed that the three groups of small pigs had different degrees of cardiac muscle fiber necrosis ;
The hepatic central vein , interlobular vein and hepatic sinus can be seen with different degrees of stasis , with a small number of inflammatory cell infiltration in the manifold area .
In the lungs , the pulmonary alveolar was slightly dilated and pulmonary venous capillary stasis . Gastric mucosal bleeding , edema and congestion were occasionally seen in each group .
The results showed that there was no statistically significant difference between the two groups ( P0.05 ) . The results showed that the depth of duodenum recess in the stomach meridian group was higher than that in the normal group ( 18.33 % ) ( P0.05 ) .
The depth of duodenum recess in the renal meridian group was higher than that in the normal group ( 20.84 % ) ( P0.01 ) .
The depth of ileum in gastric meridian group was less than 13.60 % ( P0.01 ) .
There was no significant difference ( P0.05 ) between the total mean values of small intestinal villi and the depth of recess depth ( V / C ) in each group . The results showed that the value of duodenum V / C in the renal meridian group was less than 15.74 % in the control group ( P0.05 ) .
The fasting V / C value of the stomach meridian group was lower than that in the kidney meridian group ( 16.44 % ) ( P0.05 ) .
The results showed that the colonic mucosa thickness of the gastric meridian group was greater than that of the control group ( 53.28 % ) ( P0.01 ) .
The thickness of colonic mucosa in renal meridian group was higher than that in control group 68.15 % ( P0.01 ) .
The results showed that the total thickness of gastric mucosa in gastric mucosa was higher than that in the control group ( 7.32 % ) ( P0.05 ) . The results showed that the renal meridian group was 28.65 % higher than that in the control group ( P0.05 ) .
It is proved that the low - flow resistance channel is one of the anatomical structures of the channels and collaterals , which is one of the pathological mechanisms leading to the pathological changes of the related meridians .
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R245

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