本文選題：銀萊湯　切入點：解熱機制　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】：溫病是感受溫邪引起的,以發(fā)熱為主癥,具有明顯季節(jié)性的一類急性外感熱病的總稱。發(fā)熱作為溫病的主癥,是機體對溫邪的一種全身性反應(yīng),可見于溫病發(fā)展的各個階段。外感發(fā)熱初期病位在肺衛(wèi),與中焦胃腸密切相關(guān)。陽明胃腸對發(fā)熱的程度與轉(zhuǎn)歸具有影響。銀萊湯以肺胃同治立法,清宣通降并用,清肺和胃,調(diào)和衛(wèi)氣,是治療溫病衛(wèi)氣分發(fā)熱的經(jīng)驗方,在臨床運用中取得了較好療效,但其解熱機制尚未明確,需進一步研究闡明。現(xiàn)代病理生理學(xué)基于"調(diào)定點"學(xué)說,認為發(fā)熱是由于致熱源作用使體溫調(diào)定點上移而引起的調(diào)節(jié)性體溫升高。近年來關(guān)于中藥解熱機制的研究主要圍繞"調(diào)定點"學(xué)說展開,其主要解熱機制包括:調(diào)控中樞體溫調(diào)節(jié)介質(zhì)、調(diào)控內(nèi)生致熱源、調(diào)節(jié)溫度敏感神經(jīng)元放電頻率和阻斷Toll樣信號通路的傳導(dǎo)。由于中藥復(fù)方可能通過對不同通路的共同干預(yù)發(fā)揮解熱作用,故對其相關(guān)解熱機制仍有待進一步研究。腦-腸軸是中樞神經(jīng)系統(tǒng)與胃腸道功能相互作用的雙向調(diào)節(jié)軸,神經(jīng)-內(nèi)分泌-免疫網(wǎng)絡(luò)是腦-腸之間的重要連接方式,腦-腸神經(jīng)內(nèi)分泌細胞分泌和釋放的腦腸肽是腦-腸軸的重要作用靶標,由于部分腦腸肽與發(fā)熱過程密切相關(guān),故探索中藥復(fù)方干預(yù)相關(guān)腦腸肽水平對研究其解熱機制具有重要意義。本研究通過動物實驗方法研究中藥復(fù)方銀萊湯對干酵母致熱大鼠的解熱機制,闡述銀萊湯在解熱過程中的作用途徑和調(diào)控靶標,以及腦腸肽與炎癥細胞因子之間可能存在的聯(lián)系,為肺胃同治法解熱提供現(xiàn)代研究依據(jù)。本研究綜述部分包含兩方面:從現(xiàn)代實驗研究角度,對中藥解熱作用機制的研究進展進行整理和總結(jié);從中醫(yī)理論角度,對溫病衛(wèi)、氣分發(fā)熱的病因病機、治療進展及導(dǎo)師辨治經(jīng)驗進行整理和總結(jié)。本研究實驗部分:目的:明確銀萊湯解熱效果,探索銀萊湯解熱作用機制,闡述銀萊湯在解熱過程中相關(guān)的作用途徑和主要靶標,探討腦腸肽與炎癥因子的聯(lián)系,為肺胃同治法治療發(fā)熱提供實驗依據(jù)。方法:運用動物實驗方法,選擇干酵母致熱大鼠模型,觀察銀萊湯的解熱效果,通過運用ELISA和RIA的方法檢測發(fā)熱大鼠血清IL-1 β、IL-6、TNF-α及下丘腦體溫調(diào)節(jié)介質(zhì)cAMP、腦腸肽5-HT和Ghrelin的含量變化,進而分析銀萊湯對炎癥途徑和腦腸肽途徑的調(diào)控作用。結(jié)果:各組大鼠的基礎(chǔ)體溫?zé)o統(tǒng)計學(xué)差異(P0.05);造模后5h,與正常組對比,模型組、銀萊湯各劑量組、阿司匹林組體溫有顯著差異(P0.01);末次給藥后3h,與模型組對比,銀萊湯各劑量組、阿司匹林組體溫有顯著差異(P0.01)。銀萊湯各劑量組IL-1 β、IL-6、TNF-α及cAMP的含量與模型組比較均有統(tǒng)計學(xué)差異(P0.05),均數(shù)比較均低于模型組。銀萊湯各劑量組5-HT的含量與模型組比較均有統(tǒng)計學(xué)差異(P0.05),均數(shù)比較均低于模型組;銀萊湯各劑量組Ghrelin的含量與模型組比較均有統(tǒng)計學(xué)差異(P0.05),均數(shù)比較均高于模型組。結(jié)論:銀萊湯對干酵母致熱大鼠具有解熱作用,中劑量組解熱作用效果最佳,其解熱作用體現(xiàn)在降低體溫高峰值,促使體溫高峰平臺期前移,降低熱勢。銀萊湯的解熱作用可能通過降低發(fā)熱大鼠血清內(nèi)生致熱源IL-1β、IL-6、TNF-α和下丘腦體溫調(diào)節(jié)介質(zhì)cAMP的含量實現(xiàn)。銀萊湯的解熱作用與降低發(fā)熱大鼠下丘腦5-HT的含量、升高發(fā)熱大鼠下丘腦Ghrelin的含量相關(guān)。綜上所述,銀萊湯的解熱機制既可能通過降低內(nèi)源性致熱源、中樞體溫調(diào)節(jié)介質(zhì)的含量實現(xiàn),又與調(diào)控相關(guān)腦腸肽的含量相關(guān)。通過對不同途徑的調(diào)節(jié)和干預(yù),共同實現(xiàn)銀萊湯的解熱療效。
[Abstract]:Seasonal febrile disease is caused by pathogenic warm feelings, with main symptom of fever, which has a kind of acute exogenous febrile diseases by seasonal febrile disease. As the main symptoms of fever, the body is a systemic reaction of warm pathogens, each stage is seen in the febrile disease development. Exogenous fever early in lung disease a guard, and in gastrointestinal are closely related. The degree of Yangming stomach fever and prognosis. Yinlai decoction has influence to lung and stomach Tongzhi legislation, clearing and Tongjiang, clearing the lungs and stomach, and Wei Qi, is the experience of treating febrile disease Wei Qi fever, has good curative effect in clinical application, but its antipyretic mechanism has not yet clearly, need further investigation. Modern pathophysiology based on "set point" theory, that is due to the effect of pyrogen fever caused by the temperature set point up regulation of body temperature. In recent years, research on Chinese medicine antipyretic mechanism mainly around the set point" The theory, including: the Antipyretic Mechanism of media regulation and regulation of central temperature regulation, endogenous pyrogen, regulate the temperature sensitive neurons discharge frequency and blocking Toll like signal transduction. Because the traditional Chinese medicine compound may be through joint intervention on different pathways of antipyretic action, so the related antipyretic mechanism remains to be further studied. The brain gut axis is a two-way adjustment shaft of the central nervous system and gastrointestinal function interaction, nerve endocrine immune network is an important connection between brain gut, brain gut neuroendocrine cells and secretion of brain gut peptide is an important function of brain gut axis targets due to related brain gut peptide with the heating process, the exploration of traditional Chinese medicine compound intervention related brain gut peptide level has important significance to study Its Antipyretic Mechanism. This study by animal experiment method to study traditional Chinese medicine compound yinlai Decoction on dry fermentation The Antipyretic Mechanism of thermal mother rats, elaborated yinlai Decoction in the antipyretic effects in the process of pathway and regulation of the target, and may exist between brain gut peptide and inflammatory cytokines linked to lung and stomach with treatment of antipyretic provide modern research basis. This review part includes two aspects: from the perspective of modern experimental research, research the progress of traditional Chinese medicine antipyretic effect and mechanism of collation and summary; Chinese medicine from the theoretical point of view, of the disease etiology and pathogenesis of Wei, Qi fever, analyze and summarize the treatment progress and mentor treatment experience. In this study, experimental part: Objective: To investigate the effect of antipyretic yinlai decoction, explore yinlai Decoction Antipyretic Mechanism, this silver Levin Decoction in antipyretic effects in the process of way and main target of brain gut peptide and inflammatory factors, to provide the experimental basis for the treatment of lung and stomach with fever. Methods: using animal experiment method, selection of dry yeast The thermal model of rats caused by the mother, to observe the antipyretic effect of yinlai decoction, through the methods of ELISA and RIA in the detection of serum IL-1 fever rat beta, IL-6, medium cAMP regulation of TNF- alpha and body temperature, the content changes of brain gut peptides 5-HT and Ghrelin, and the regulating effect of yinlai Decoction on inflammatory pathways and brain gut peptide approach. Results: there was no significant difference in basal body temperature of rats in each group (P0.05); 5h after modeling, compared with the normal group, model group, silver Laitangge dose group, aspirin group and temperature had significant difference (P0.01); 3h after the last administration, compared with model group, silver Laitangge dose group. The aspirin group temperature had significant difference (P0.01). The silver Laitangge dose group IL-1 beta, IL-6, TNF- alpha and cAMP content and model group were statistically significant (P0.05), were significantly lower than in the model group. The content of 5-HT Laitangge silver dose group and model group were statistically significant (P0.05), were significantly lower than in the model group; the content of Ghrelin Laitangge silver dose group and model group were statistically significant (P0.05), mean comparison were higher than the model group. Conclusion: yinlai decoction has antipyretic effect on yeast induced fever rats, medium dose group and antipyretic effects of its antipyretic effect is the best. In lower temperature is high peak temperature peak period, prompted the platform forward, reduce the heat potential. The antipyretic effect of yinlai decoction can reduce the fever rat serum endogenous pyrogen of IL-1 beta, IL-6, TNF- and cAMP content of the media regulation of hypothalamic temperature is alpha. The antipyretic effect of yinlai Decoction and reduce the content of 5-HT in fever rats, increased the content of Ghrelin in hypothalamus in fever rats. In conclusion, the Antipyretic Mechanism of yinlai decoction can reduce the endogenous pyrogen, realize the content of the media central regulation of body temperature, and the regulation of brain gut peptide The effect of the antipyretic effect of Yin Lai soup was achieved through the regulation and intervention of different ways.

【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】：R285.5

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