發(fā)布時間：2018-06-13 16:51

  本文選題：術(shù)后腸梗阻 + 腑安沖劑��； 參考：《大連醫(yī)科大學(xué)》2011年碩士論文

【摘要】：目的:建立術(shù)后腸梗阻動物模型,探討腹部手術(shù)后血清IL-6、TNF-α表達(dá)水平與術(shù)后腸梗阻的關(guān)系及中藥腑安的保護作用機制。 方法:KM小鼠45只,體重20±2g,隨機分為3組,即腑安組、生理鹽水組及空白對照組,每組15只。腑安組及生理鹽水組小鼠均接受開腹手術(shù)以建立術(shù)后腸梗阻模型,術(shù)后2h兩組分別給予腑安藥液0.3ml及生理鹽水0.3ml灌胃。空白對照組未行手術(shù)。采用酚紅定量法及酚紅排空法測定術(shù)后24h胃排空率及小腸推進率,處死前摘眼球取血1ml測定血清IL-6及TNF-α水平。應(yīng)用SPSS17.0統(tǒng)計軟件進行數(shù)據(jù)分析,以P0.05為顯著性標(biāo)準(zhǔn)。各組間計量資料比較采用方差分析,兩變量相關(guān)性分析采用線性相關(guān)并繪制散點圖。 結(jié)果: 1、空白對照組術(shù)后24h胃排空率(%)為49.33±6.22;生理鹽水組術(shù)后24h胃排空率(%)為26.25±2.73;腑安組術(shù)后24h胃排空率(%)為44.76±4.07;生理鹽水組與空白對照組相比術(shù)后24h胃排空率顯著降低(P0.05);腑安組與生理鹽水組相比術(shù)后24h胃排空率顯著改善(P0.05)。 2、空白對照組術(shù)后24h小腸推進率(%)為50.82±5.07;生理鹽水組術(shù)后24h小腸推進率(%)為33.86±3.13;腑安組術(shù)后24h小腸推進率(%)為48.48±5.12;生理鹽水組與空白對照組相比術(shù)后24h小腸推進率顯著降低(P0.05);腑安組與生理鹽水組相比術(shù)后24h小腸推進率顯著改善(P0.05)。 3、空白對照組血清IL-6濃度(pg/ml)為103.29±14.16;生理鹽水組血清IL-6濃度(pg/ml)為202.41±17.08;腑安組血清IL-6濃度(pg/ml)為126.59±19.64;生理鹽水組血清IL-6水平顯著高于空白對照組(P0.05);腑安組血清IL-6水平顯著低于生理鹽水組(P0.05)。 4、空白對照組血清TNF-α濃度(pg/ml)為27.58±11.05;生理鹽水組血清TNF-α濃度(pg/ml)為61.43±15.23;腑安組血清TNF-α濃度(pg/ml)為35.52±11.31;生理鹽水組血清TNF-α水平明顯高于空白對照組(P0.05);腑安組血清TNF-α水平顯著低于生理鹽水組(P0.05)。 5、術(shù)后24h胃排空率與血清IL-6呈負(fù)相關(guān),r=㧟0.948;術(shù)后24h小腸推進率與血清IL-6呈負(fù)相關(guān),r=㧟0.844;術(shù)后24h胃排空率與血清TNF-α呈負(fù)相關(guān),r=㧟0.877;術(shù)后24h小腸推進率與血清TNF-α呈負(fù)相關(guān),r=㧟0.779。 結(jié)論: 1、生理鹽水組與空白對照組相比術(shù)后24h胃排空率及術(shù)后24h小腸推進率明顯降低;腑安組與生理鹽水組相比術(shù)后24h胃排空率及術(shù)后24h小腸推進率顯著改善。這表明手術(shù)操作對胃腸動力具有明顯抑制作用,腑安沖劑能夠顯著增加小鼠的術(shù)后24h胃排空率及小腸推進率,對于術(shù)后胃腸動力具有明顯的改善作用。 2、生理鹽水組血清IL-6及TNF-α水平明顯高于空白對照組;腑安組血清IL-6及TNF-α水平顯著低于生理鹽水組。這表明手術(shù)操作能夠?qū)е卵装Y介質(zhì)的釋放,腑安沖劑能夠抑制炎癥介質(zhì)的釋放,對術(shù)后腸道炎癥具有明顯的抑制作用。 3、術(shù)后24h胃排空率與血清IL-6呈負(fù)相關(guān),r=㧟0.948;術(shù)后24h小腸推進率與血清IL-6呈負(fù)相關(guān),r=㧟0.844;術(shù)后24h胃排空率與血清TNF-α呈負(fù)相關(guān),r=㧟0.877;術(shù)后24h小腸推進率與血清TNF-α呈負(fù)相關(guān),r=㧟0.779。這表明術(shù)后胃腸動力的抑制與血清IL-6及TNF-α水平升高密切相關(guān),胃腸的炎癥反應(yīng)程度與胃腸動力呈明顯負(fù)相關(guān)。
[Abstract]:Objective: to establish an animal model of postoperative intestinal obstruction and to explore the relationship between the expression of serum IL-6, TNF- alpha and intestinal obstruction after abdominal operation and the protective mechanism of the traditional Chinese medicine.
Methods: 45 KM mice, with a weight of 20 + 2G, were randomly divided into 3 groups, namely, Fu An Group, physiological saline group and blank control group, 15 rats in each group. The abdominal operation was performed to establish the intestinal obstruction model in the Fu An Group and the normal saline group. After the operation, the 2H two groups were given the 0.3ml and the physiological saline 0.3ml respectively. The blank control group was not operated. The rate of 24h gastric emptying and the propulsive rate of small intestine were measured by phenol red quantitative method and phenol red emptying method. The levels of serum IL-6 and TNF- alpha were measured by 1ml before death. The data were analyzed with SPSS17.0 statistical software and P0.05 was a significant standard. The measurement data of each group were compared with variance analysis, and the correlation analysis of two variables was linear correlation. And draw the scatter plot.
Result:
1, the gastric emptying rate (%) of 24h in the blank control group was 49.33 + 6.22, and the 24h gastric emptying rate (%) was 26.25 + 2.73 after operation in the normal saline group, and the 24h gastric emptying rate (%) was 44.76 + 4.07 after the operation in the Fu An group. The 24h gastric emptying rate in the physiological saline group and the blank control group were significantly lower than that in the blank control group (P0.05), and the 24h gastric emptying rate was significant compared with the normal saline group after operation. Improvement (P0.05).
2, the 24h small intestinal propulsive rate (%) in the blank control group was 50.82 + 5.07, and the 24h small intestinal propulsion rate (%) was 33.86 + 3.13 after operation in the normal saline group, and the 24h small intestinal propulsive rate (%) was 48.48 + 5.12 in the Fu group after operation, and the 24h small intestinal propulsive rate in the physiological saline group compared with the blank control group was significantly lower than that in the blank control group (P0.05), and the 24h small intestine was compared with the normal saline group after operation compared with the saline group. The propelling rate improved significantly (P0.05).
3, the serum concentration of IL-6 (pg/ml) in the blank control group was 103.29 + 14.16, the serum IL-6 concentration (pg/ml) in the normal saline group was 202.41 + 17.08, the serum IL-6 concentration (pg/ml) was 126.59 + 19.64 in the Fu An Group, and the serum IL-6 level in the saline group was significantly higher than that in the blank control group (P0.05), and the serum IL-6 level was significantly lower than that of the normal saline group (P0.05).
4, the serum TNF- alpha concentration (pg/ml) in the blank control group was 27.58 + 11.05, the serum TNF- alpha concentration (pg/ml) in the saline group was 61.43 + 15.23, the serum TNF- alpha concentration (pg/ml) was 35.52 + 11.31 in the Fu An Group, and the serum level of TNF- a in the saline group was significantly higher than that in the blank control group (P0.05), and the serum TNF- alpha level was significantly lower than that of the normal saline group (P0.05).
5, 24h gastric emptying rate was negatively correlated with serum IL-6, r=? 0.948, and 24h small intestinal propulsion rate was negatively correlated with serum IL-6, r=? 0.844; 24h gastric emptying rate was negatively correlated with serum TNF- a after operation, r=? 0.877; 24h small intestine propelling rate was negatively correlated with TNF- alpha in serum after operation, r=? R=?
Conclusion:
1, compared with the blank control group, the gastric emptying rate of 24h and the 24h intestinal propulsive rate after operation were significantly lower than those in the blank control group, and the gastric emptying rate and the 24h small intestinal propulsion rate after operation were significantly improved after the operation in the Fu An Group and the normal saline group. This showed that the operation has obvious inhibitory effect on the gastrointestinal motility, and the Fu Fu an granule can significantly increase the operation of the mice. Post 24h gastric emptying rate and intestinal propulsion rate significantly improved gastrointestinal motility after operation.
2, the level of serum IL-6 and TNF- a in the normal saline group was significantly higher than that in the blank control group; the level of serum IL-6 and TNF- a in the Fu An group was significantly lower than that in the normal saline group. This indicated that the operation could lead to the release of the inflammatory mediators, and the Fu an granule could inhibit the release of the inflammatory mediators, and had an obvious inhibitory effect on the intestinal inflammation after the operation.
3, 24h gastric emptying rate was negatively correlated with serum IL-6, r=? 0.948, and 24h small intestinal propulsion rate was negatively correlated with serum IL-6, r=? 0.844; 24h gastric emptying rate was negatively correlated with serum TNF- a after operation, r=? 0.877; 24h small intestinal propulsion rate was negatively correlated with serum TNF- alpha after operation; r=? The level of gastrointestinal inflammation was significantly negatively correlated with gastrointestinal motility.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R-332;R285.5

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