本文關(guān)鍵詞： 脾胃 神志 胃潰瘍 血管活性腸肽 生長抑素　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:五臟藏神理論是《黃帝內(nèi)經(jīng)》臟象學(xué)說的重要部分,脾胃為五臟之樞,在五臟整體協(xié)調(diào)神志中,起著關(guān)鍵作用。本課題旨在通過理論和實驗研究,對脾胃病理狀態(tài)下與精神情志之間的相互關(guān)系和作用機制進行探討,以期揭示脾胃對神志活動的調(diào)節(jié)作用,為脾藏神理論提供實驗依據(jù)。方法:本課題實驗研究以Wistar大鼠為研究對象,分為正常組、模型組、四君子湯組(造模加灌胃四君子湯)、雷尼替丁組(造模加灌胃雷尼替丁)。采用苦寒瀉下、饑飽失常加食醋灌胃相結(jié)合的方法,復(fù)制脾虛胃潰瘍動物模型。觀察大鼠的體重、外觀、精神活動,飲食排便等體征表現(xiàn),并進行HE常規(guī)染色檢測。采用免疫組化法檢測胃組織中MTL、VIP、SS、EGF的表達變化,采用酶聯(lián)免疫(ELISA)法檢測血清中VIP、SS的表達變化。結(jié)果:1.一般情況:正常組大鼠整體狀況良好,二便、飲食、活動正常;模型組大鼠便溏、消瘦、精神萎靡、喜扎堆、毛色不榮,脾虛癥狀明顯;四君子湯組大鼠體重不及正常組,其他脾虛癥狀均有改善,精神、活動等正常;雷尼替丁組大鼠癥狀體征與模型組相近。2.光鏡下HE染色觀察大鼠胃組織病理切片,模型組大鼠胃黏膜損傷明顯,黏膜上皮消失,基底層暴露,有血液滲出。正常組和四君子湯組胃組織形態(tài)結(jié)構(gòu)大體正常;雷尼替丁組黏膜下層細胞有炎性滲出。3.免疫組化法觀察大鼠胃黏膜MTL、VIP、SS、EGF的表達,模型組MTL、VIP、SS、EGF較正常組明顯降低,差異有統(tǒng)計學(xué)意義(P0.05);四君子湯組、雷尼替丁組MTL、VIP、SS、EGF表達較模型組有升高趨勢,差異有統(tǒng)計學(xué)意義(P0.05)。4.ELISA檢測大鼠血清內(nèi)VIP、SS的含量,模型組VIP、SS較正常組明顯降低,差異有統(tǒng)計學(xué)意義(P0.05);四君子湯組、雷尼替丁組VIP、SS表達較模型組升高,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1.胃潰瘍患者往往存在焦慮、抑郁等精神情志障礙,精神情志異常在胃潰瘍的發(fā)生和發(fā)展中具有重要意義。胃潰瘍與精神情志相互影響,是中醫(yī)"脾藏神"理論的重要體現(xiàn)。2.在研究中,我們采用苦寒瀉下加食醋灌胃并配合饑飽失常法,復(fù)制脾虛胃潰瘍病證結(jié)合動物模型。模型大鼠除出現(xiàn)飲食減少,體重增加緩慢甚至降低,稀便或黏液便,肛周毛色污穢,懶動扎堆,瞇眼,乏力,耳尖色淡,背毛松散,毛色不榮等脾虛表現(xiàn),亦見胃黏膜病理損害,HE染色光鏡下觀察,可見損傷深至黏膜肌層,因此判定模型復(fù)制成功。3.腦腸相關(guān)神經(jīng)肽是在中樞系統(tǒng)和胃腸系統(tǒng)中均有分布的活性物質(zhì),具有胃腸激素和神經(jīng)遞質(zhì)的雙重作用。本次試驗研究脾虛胃潰瘍大鼠胃黏膜和血清腦腸肽分泌異常。推測胃潰瘍患者存在腦腸神經(jīng)肽分泌失常,腦-腸軸調(diào)節(jié)紊亂,可能是胃潰瘍患者伴隨精神情志障礙的主要機制。4.四君子湯干預(yù)治療作用,能夠有效改善大鼠脾虛癥狀,預(yù)防胃潰瘍的發(fā)生,同時對脾虛胃潰瘍大鼠胃黏膜和血清中腦腸肽的表達也有明顯的改善作用。提示益氣健脾(四君子湯)改善脾胃功能,運化氣血,調(diào)理氣機,可能是是通過腦-腸軸調(diào)節(jié)腦腸肽的分泌,糾正異常表達的腦腸肽,從而發(fā)揮調(diào)節(jié)神志的作用。
[Abstract]:Objective: the five internal organs theory of God is < Neijing > dirty an important part as the theory of the spleen and stomach to 5 of the pivot, in five overall coordination consciousness, plays a key role. The aims of the theoretical and experimental research to explore the relationship and mechanism between the spleen and stomach and pathological state of the mind and spirit. In order to reveal the role of the spleen and stomach of mental activities, to provide the experimental basis for the spleen theory of God. Methods: this project research in Wistar rats as the research object, divided into normal group, model group, Sijunzi Decoction group (four rats with gastric perfusion of Four Gentlemen Decoction), ranitidine group (model + irrigation ranitidine). The stomach cold diarrhea, method of hunger and vinegar lavage combined model, spleen deficiency gastric ulcer rats. Animal weight, appearance, mental activity, diet, defecation symptoms, routine HE staining and immunohistochemical group. The detection method of gastric tissue in MTL, VIP, SS, EGF expression changes, using enzyme-linked immunosorbent assay (ELISA) method for detection of serum VIP, the expression of SS. Results: 1. general condition: the overall situation of the rats in the normal group, two, diet, normal activities; loose stools, the rats in the model group. Thin, apathetic, like to get together, the hair color is not glory, spleen deficiency symptoms; weight four Sijunzi Decoction group rats than in normal group, spleen deficiency and other symptoms were improved, mental activities, normal; ranitidine group rats signs and symptoms similar to model group to observe the pathological sections of gastric tissue of rats with.2. HE staining under light microscope. The model of gastric mucosal injury in rats were obvious, the mucosal epithelium disappeared, basal layer exposed, with oozing of blood. Four normal group and Sijunzi Decoction group stomach morphology in normal group; submucosal cells and inflammatory exudation of ranitidine.3. immunohistochemical method to observe the gastric mucosa of MTL rats, VIP, SS, EGF expression, The model group MTL, VIP, SS, EGF significantly decreased compared with normal group, the difference was statistically significant (P0.05); four Sijunzi Decoction group, ranitidine group MTL, VIP, SS, EGF expression increased compared with the model group, the difference was statistically significant (P0.05).4.ELISA rats were detected in serum VIP, SS content the VIP model group, SS significantly decreased compared with normal group, the difference was statistically significant (P0.05); four Sijunzi Decoction group, ranitidine group VIP, the expression of SS was higher than that in model group, the difference was statistically significant (P0.05). Conclusion: 1. gastric ulcer patients often suffer from anxiety, depression and other mental disorders, mental abnormalities is important the significance in the occurrence and development of gastric ulcer. Gastric ulcer and emotional interaction, is the Chinese medicine "the spleen God" theory an important manifestation of.2. in the study, we use cold diarrhea with vinegar and gavage with irregular diet, spleen deficiency gastric ulcer disease combined with syndrome animal model. The rats in the diet decreased, body weight increased slowly and even lower stools or mucus, perianal fur dirty, lazy get together, squinting, fatigue, ear apex pale, back hair loose and hair color glory with performance, see also the pathological damage of gastric mucosa, observe HE staining under light microscope visible damage, deep to the muscularis mucosa, therefore determine the model successfully reproduced.3. brain gut related neuropeptides are in the central nervous system and gastrointestinal system in both the distribution of active substances, with the dual role of gastrointestinal hormones and neurotransmitters. The abnormal secretion of this experimental study of spleen deficiency gastric mucosa of rats with gastric ulcer and serum ghrelin. That stomach ulcer patients have brain neuropeptides secretion disorders, brain gut axis adjustment disorder, may be the main mechanism of therapeutic effect of gastric ulcer in patients with mental disorders.4. Four Gentlemen Decoction intervention can effectively improve the symptoms of spleen deficiency rats, prevent occurrence of gastric ulcer, At the same time on the expression of spleen deficiency gastric mucosa of rats with gastric ulcer and serum brain gut peptide plays a significant role in improving the prompt. Qi and spleen (Four Gentlemen Decoction) to improve the function of the spleen and stomach, and blood transport, air conditioning machine, may be the secretion and regulation of brain gut peptide by brain gut axis, correct the abnormal expression of brain gut peptide as, to regulate the function of mental function.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R22

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