补中益气汤对Ⅲ度脱垂性内痔组织中Fibulin-5表达的影响研究
发布时间：2018-08-27 20:10
【摘要】：目的：通过分析脾虚气陷型Ⅲ°脱垂性内痔患者在补中益气汤干预后的临床表现,初步探讨补中益气汤治疗Ⅲ°脱垂性内痔的临床应用价值。进一步在分子生物学研究的层面上,对比脾虚气陷型Ⅲ°脱垂性内痔患者服用补中益气汤及草木犀浸液片与单纯服用草木犀浸液片后,其内痔组织中Fibulin-5 mRNA与蛋白表达的变化差异,评估补中益气汤对脾虚气陷型Ⅲ°脱垂性内痔的临床疗效,以期探讨补中益气汤治疗Ⅲ°脱垂性内痔的分子生物学的作用机制,进一步探究脱垂性内痔的发病机理。方法：将59例证型为脾虚气陷的Ⅲ°脱垂性内痔的患者依门诊号顺序,按随机数字表分为3组,其中治疗组(A组)20例,对照组(B组)20例,空白组(C组)19例。治疗前均根据评分标准进行评分；A组病人口服草木犀流浸液片,每次1600mg,每日3次,同时服用补中益气汤,黄芪20g、人参9g、当归12g、陈皮9g、升麻15g、柴胡6g、白术12g、甘草6g,饭后温服,每日一剂,每日3次,每次100m1；B组病人口服草木犀流浸液片,每次1600mg,每日3次；C组仅做空白对照,不服用任何药物,均治疗1疗程(1周)。疗程停止后第2天,各组患者均按照疗效判断标准及评分标准予行临床评价、评分。通过广州中医药大学第一附属医院伦理委员会审批后,服从患者手术意愿,签署知情同意书,行手术治疗后,收取Ⅲ度脱垂性内痔肛垫组织标本30例,分别来源于A、β、C组患者,各10例,重新分组为A1、B1、C1组,采用PCR. Western-blot技术从基因-蛋白层次系统研究比较各组患者内痔组织中Fibulin-5 mRNA与蛋白的表达分布差异。结果：1.临床研究中,A组与B组比较,治疗后便血评分无统计学意义(P0.017),痔核脱出评分有统计学意义(P0.017)；A组与C组比较,治疗后便血评分、痔核脱出评分均有统计学意义(P0.017)；B组与C组比较,治疗后便血评分有统计学意义(P0.017),痔核脱出评分无统计学意义(P0.017)。2.临床研究中,A组治疗前后便血评分比较差异有统计学差异(P0.05),B组治疗前后便血评分比较差异有统计学差异(P0.05),C组治疗前后便血评分比较差异有统计学差异(P0.05)；A组治疗前后痔核脱出评分比较差异有统计学差异(P0.05),B组治疗前后痔核脱出评分比较差异无统计学差异(P0.05),C组治疗前后痔核脱出评分比较差异无统计学差异(P0.05)：三组疗效结果比较,差异有统计学意义(P0.05),A组的有效率明显优于B组及C组。3.实验研究中,三组疗效结果比较差异有统计学意义(P0.05),A1组Ⅲ°。脱垂性内痔组织中Fibulin-5mRNA、Fibulin-5蛋白的表达多于B1组及C1组。结论：1.补中益气汤治疗脾虚气陷型Ⅲ°。脱垂性内痔内痔得到满意的效果,补中益气汤可以明显改善脾虚气陷型Ⅲ度脱垂性内痔痔核脱出症状,对脾虚气陷型Ⅲ度内痔便血症状改善不明显。2.补中益气汤可促进Ⅲ°脱垂性内痔组织中Fibulin-5蛋白及Fibulin-5mRNA的表达。3. Fibulin-5蛋白及Fibulin-5mRNA的表达水平的降低,可能是脱垂性内痔形成的病理学机制之一。4.补中益气汤治疗脱垂性内痔的机制可能是促进Fibulin-5蛋白及Fibulin-5mRNA的表达,从而促进弹性纤维的合成与再生,抑制新生血管的生成,稳定血管结构,促进肛垫复位而发挥治疗作用。
[Abstract]:Objective:To investigate the clinical value of Buzhong Yiqi Decoction in the treatment of prolapsed internal hemorrhoids with spleen-deficiency and qi-depression type III degree by analyzing the clinical manifestations of the patients with prolapsed internal hemorrhoids with spleen-deficiency and qi-depression type III degree after the intervention of Buzhong Yiqi Decoction. The changes of Fibulin-5 mRNA and protein expression in internal hemorrhoids of Cao Mu Xi Extract Tablets and Cao Mu Xi extract tablets were compared with those of Cao Mu Xi extract tablets. The clinical effect of Bu Zhong Yi Qi Decoction on prolapsed internal hemorrhoids with spleen deficiency and qi depression type III was evaluated in order to explore the molecular biological mechanism of Bu Zhong Yi Qi Decoction in treating prolapsed internal hemorrhoids with III degree prolapse. Methods: 59 cases of prolapsed internal hemorrhoids with spleen deficiency and qi depression were randomly divided into three groups according to the order of outpatient numbers, including 20 cases in treatment group (group A), 20 cases in control group (group B) and 19 cases in blank group (group C). Buzhong Yiqi Decoction, Astragalus 20g, Ginseng 9g, Angelica Sinensis 12g, Orange Peel 9g, Cimicifu 15g, Chaihu 6g, Atractylodes macrocephala 12g, Glycyrrhiza 6g, Warm-taking after meals, one dose a day, three times a day, 100m1 each time; Patients in group B took orally Cao Mu Xiliu extract tablets, 1600mg each time, three times a day; Patients in group C only took blank control, without any drugs, all treated 1 time. Course of treatment (1 week). On the second day after stopping the course of treatment, all the patients in each group were evaluated according to the criteria of curative effect and score. After approval by the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, the patients were subjected to surgical wishes, signed informed consent, and after surgical treatment, the anal pad tissue specimens of third degree prolapsed hemorrhoids were collected. The expression of Fibulin-5 mRNA and protein in the hemorrhoid tissues of each group was systematically studied by PCR-Western-blot. Results: 1. There was no significant difference between group A and group B in the clinical study (P 0.01). 017, hemorrhoids protrusion score was statistically significant (P 0.017); A group compared with C group, after treatment stool blood score, hemorrhoids protrusion score were statistically significant (P 0.017); B group compared with C group, after treatment stool blood score was statistically significant (P 0.017), hemorrhoids protrusion score was not statistically significant (P 0.017). 2. There were significant differences in the scores of stool blood before and after treatment in group B (P 0.05). There were significant differences in the scores of stool blood before and after treatment in group C (P 0.05). There were significant differences in the scores of hemorrhoids prolapse before and after treatment in group A (P 0.05). There was no significant difference in the scores of hemorrhoids prolapse before and after treatment in group B (P 0.05). There was no significant difference in the score of hemorrhoids prolapse before and after treatment in group C (P 0.05). There was a significant difference in the curative effect among the three groups (P 0.05). The effective rate of group A was significantly better than that of group B and group C. 3. In the experimental study, there was a significant difference in the curative effect among the three groups (P 0.05). The prolapsed internal hemorrhoids tissue in group A1 (III degree) Conclusion: 1. Buzhong Yiqi Decoction has a satisfactory effect on the treatment of prolapsed internal hemorrhoids of spleen-deficiency-qi-depression type III. Buzhong Yiqi Decoction can obviously improve the symptoms of prolapsed internal hemorrhoids of spleen-deficiency-qi-depression type III. The improvement of the symptoms of prolapsed internal hemorrhoids of spleen-deficiency-qi-depression type III is not clear. 2. Buzhong Yiqi Decoction can promote the expression of Fibulin-5 protein and Fibulin-5mRNA in the tissues of prolapsed internal hemorrhoids. 3. The decrease of Fibulin-5 protein and Fibulin-5mRNA expression may be one of the pathological mechanisms of prolapsed internal hemorrhoids. 4. Buzhong Yiqi Decoction may promote the expression of Fibulin-5 protein and Fibul-5mRNA in prolapsed internal hemorrhoids. The expression of in-5mRNA promotes the synthesis and regeneration of elastic fibers, inhibits angiogenesis, stabilizes vascular structure and promotes anal pad reduction.
【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】：2016
【分类号】：R266
本文编号：2208322
[Abstract]:Objective:To investigate the clinical value of Buzhong Yiqi Decoction in the treatment of prolapsed internal hemorrhoids with spleen-deficiency and qi-depression type III degree by analyzing the clinical manifestations of the patients with prolapsed internal hemorrhoids with spleen-deficiency and qi-depression type III degree after the intervention of Buzhong Yiqi Decoction. The changes of Fibulin-5 mRNA and protein expression in internal hemorrhoids of Cao Mu Xi Extract Tablets and Cao Mu Xi extract tablets were compared with those of Cao Mu Xi extract tablets. The clinical effect of Bu Zhong Yi Qi Decoction on prolapsed internal hemorrhoids with spleen deficiency and qi depression type III was evaluated in order to explore the molecular biological mechanism of Bu Zhong Yi Qi Decoction in treating prolapsed internal hemorrhoids with III degree prolapse. Methods: 59 cases of prolapsed internal hemorrhoids with spleen deficiency and qi depression were randomly divided into three groups according to the order of outpatient numbers, including 20 cases in treatment group (group A), 20 cases in control group (group B) and 19 cases in blank group (group C). Buzhong Yiqi Decoction, Astragalus 20g, Ginseng 9g, Angelica Sinensis 12g, Orange Peel 9g, Cimicifu 15g, Chaihu 6g, Atractylodes macrocephala 12g, Glycyrrhiza 6g, Warm-taking after meals, one dose a day, three times a day, 100m1 each time; Patients in group B took orally Cao Mu Xiliu extract tablets, 1600mg each time, three times a day; Patients in group C only took blank control, without any drugs, all treated 1 time. Course of treatment (1 week). On the second day after stopping the course of treatment, all the patients in each group were evaluated according to the criteria of curative effect and score. After approval by the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, the patients were subjected to surgical wishes, signed informed consent, and after surgical treatment, the anal pad tissue specimens of third degree prolapsed hemorrhoids were collected. The expression of Fibulin-5 mRNA and protein in the hemorrhoid tissues of each group was systematically studied by PCR-Western-blot. Results: 1. There was no significant difference between group A and group B in the clinical study (P 0.01). 017, hemorrhoids protrusion score was statistically significant (P 0.017); A group compared with C group, after treatment stool blood score, hemorrhoids protrusion score were statistically significant (P 0.017); B group compared with C group, after treatment stool blood score was statistically significant (P 0.017), hemorrhoids protrusion score was not statistically significant (P 0.017). 2. There were significant differences in the scores of stool blood before and after treatment in group B (P 0.05). There were significant differences in the scores of stool blood before and after treatment in group C (P 0.05). There were significant differences in the scores of hemorrhoids prolapse before and after treatment in group A (P 0.05). There was no significant difference in the scores of hemorrhoids prolapse before and after treatment in group B (P 0.05). There was no significant difference in the score of hemorrhoids prolapse before and after treatment in group C (P 0.05). There was a significant difference in the curative effect among the three groups (P 0.05). The effective rate of group A was significantly better than that of group B and group C. 3. In the experimental study, there was a significant difference in the curative effect among the three groups (P 0.05). The prolapsed internal hemorrhoids tissue in group A1 (III degree) Conclusion: 1. Buzhong Yiqi Decoction has a satisfactory effect on the treatment of prolapsed internal hemorrhoids of spleen-deficiency-qi-depression type III. Buzhong Yiqi Decoction can obviously improve the symptoms of prolapsed internal hemorrhoids of spleen-deficiency-qi-depression type III. The improvement of the symptoms of prolapsed internal hemorrhoids of spleen-deficiency-qi-depression type III is not clear. 2. Buzhong Yiqi Decoction can promote the expression of Fibulin-5 protein and Fibulin-5mRNA in the tissues of prolapsed internal hemorrhoids. 3. The decrease of Fibulin-5 protein and Fibulin-5mRNA expression may be one of the pathological mechanisms of prolapsed internal hemorrhoids. 4. Buzhong Yiqi Decoction may promote the expression of Fibulin-5 protein and Fibul-5mRNA in prolapsed internal hemorrhoids. The expression of in-5mRNA promotes the synthesis and regeneration of elastic fibers, inhibits angiogenesis, stabilizes vascular structure and promotes anal pad reduction.
【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】：2016
【分类号】：R266
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