發(fā)布時間：2018-07-05 01:11

  本文選題：腦梗死 + 氣虛血瘀��； 參考：《北京中醫(yī)藥大學(xué)》2007年碩士論文

【摘要】： 證候是疾病發(fā)生發(fā)展不同階段的病情動態(tài)時空變化的概括,是中醫(yī)辨證論治的核心,證候研究是中醫(yī)學(xué)術(shù)研究的中心。證候與疾病密不可分,研究證候離不開疾病,研究疾病也離不開證候,這是中醫(yī)對疾病與證候關(guān)系的經(jīng)典認(rèn)識方法。腦梗死是臨床常見疾病,氣虛血瘀證可貫穿于該病全程。本課題以腦梗死氣虛血瘀證為切入點,通過線栓法和力竭性游泳,把腦梗死模型與氣虛血瘀證候模型復(fù)為一體,力求使氣虛作為始動因素、主要因素而貫穿氣虛血瘀模型的全過程,建立與臨床原型相似的腦梗死氣虛血瘀證的病證結(jié)合模型,比較觀察模型動物氣虛血瘀表征與生物學(xué)指標(biāo)變化,進(jìn)一步探索腦梗死氣虛血瘀證模型動物的敏感表征與指標(biāo)變化的關(guān)系,確立該模型的評價體系。 1.目的: 本實驗擬以力竭性游泳復(fù)合線栓法復(fù)制腦梗死氣虛血瘀證病證結(jié)合動物模型,探索病證結(jié)合動物模型的制作方法,通過對宏觀表征、神經(jīng)病學(xué)評分、腦組織病理變化及相關(guān)生化指標(biāo)變化的觀察,尋找表征與其他相關(guān)指標(biāo)的關(guān)系,建立病證結(jié)合模型的評價體系。 2.方法: 健康雄性SD大鼠64只,體重(200±10)g,適應(yīng)性喂養(yǎng)3天后,隨機(jī)分為4組:正常組、單純游泳組、單純手術(shù)組、病證結(jié)合模型組,每組大鼠16只。正常組與單純手術(shù)組正常喂養(yǎng)3周,不進(jìn)行任何干預(yù);單純游泳組與病證結(jié)合模型組每天進(jìn)行力竭性游泳訓(xùn)練,持續(xù)3周。3周后單純手術(shù)組與病證結(jié)合模型組通過線栓法建立缺血2小時,再灌24小時的腦梗死模型。對比觀察游泳與非游泳大鼠體重、進(jìn)食量、活動量及手術(shù)死亡率;對比觀察手術(shù)前后大鼠一般狀態(tài),術(shù)后6小時按照Zea-longa評分標(biāo)準(zhǔn)對大鼠進(jìn)行神經(jīng)癥狀體征評分;術(shù)后24小時:○1每組大鼠隨機(jī)各取3只心臟灌注固定后取腦,再以4%的多聚甲醛固定1周后石蠟包埋制作患側(cè)大腦冠狀切片,進(jìn)行常規(guī)HE染色后光鏡觀察腦組織形態(tài)學(xué)改變;○2剩余大鼠斷頭取腦,制成腦組織勻漿進(jìn)行生化指標(biāo)檢測,包括:丙二醛(MDA)含量及超氧化物歧化酶(SOD)活性測定,一氧化氮(NO)含量及一氧化氮合酶(NOS)活性測定,乳酸(LD)含量及乳酸脫氫酶酶(LDH)活性測定。所得數(shù)據(jù)用Excel軟件處理,應(yīng)用SPSS11.0軟件行單因素方差分析。 3.結(jié)果: 通過三周游泳訓(xùn)練,單純游泳組及病證結(jié)合模型組大鼠與正常組及單純手術(shù)組相比,飲食量減少、體重增長緩慢;倦怠嗜睡,喜欠伸,攻擊性、對抗性行為減少或消失;舌質(zhì)明顯暗淡,舌下脈絡(luò)增粗,瘀紫。線栓法造成腦梗死模型后,單純手術(shù)組死亡率(13%)明顯低于病證結(jié)合模型組死亡率(37%),神經(jīng)癥狀體征較輕;再灌24小時后,前組大鼠恢復(fù)好,活動能力較強(qiáng)。兩組舌質(zhì)較正常組更加黯淡,舌下脈絡(luò)有不同程度的瘀紫,增長,但復(fù)合模型組舌象變化較單純手術(shù)組明顯。 正常組及單純游泳組大鼠腦組織無缺血損傷改變,但單純游泳組大鼠腦組織血管增生明顯;單純手術(shù)組及復(fù)合模型組大鼠腦組織結(jié)構(gòu)出現(xiàn)缺血性形態(tài)改變,復(fù)合模型組大鼠腦組織損傷更為嚴(yán)重。復(fù)合模型組腦組織中SOD活性(81.58±24.47)和單純手術(shù)組腦組織中SOD活性(61.41±20.74)較正常組(106.66±6.40)顯著降低P0.05。復(fù)合模型組腦組織中脂質(zhì)過氧化產(chǎn)物MDA的含量(1.26±0.19)和單純手術(shù)組腦組織中脂質(zhì)過氧化產(chǎn)物MDA含量(1.03±0.31)較正常組(0.0.64±0.07)明顯增多(P0.05)。 4.結(jié)論: 4.1在單次和反復(fù)多次力竭性游泳,造成氣虛血瘀的基礎(chǔ)上再復(fù)合腦梗死制作病證結(jié)合動物模型,從動物生活習(xí)性改變、一般狀態(tài)改變,神經(jīng)功能改變等表征觀察,以及相關(guān)的病生理指標(biāo)、生化指標(biāo)檢測,一定程度上綜合模擬出腦梗死氣虛血瘀證候特點。 4.2從宏觀表征和微觀指標(biāo)較為客觀評價氣虛血瘀狀態(tài)和相關(guān)病生理基礎(chǔ)變化,為建立病證結(jié)合的評價方法提供了依據(jù)。
[Abstract]:Syndrome is the generalization of the dynamic and spatio-temporal change of disease dynamics in different stages of disease and development. It is the core of TCM syndrome differentiation and treatment. Syndrome research is the center of TCM academic research. Syndrome and disease are inseparable, research syndrome can not be separated from disease, and the study of disease is also inseparable from syndrome. This is the classic method of understanding the relationship between disease and syndrome in Chinese medicine. Infarction is a common clinical disease. Qi deficiency and blood stasis syndrome can run through the whole course of the disease. This subject takes the syndrome of qi deficiency and blood stasis of cerebral infarction as the breakthrough point. The model of cerebral infarction and Qi deficiency and blood stasis syndrome are integrated into one, and the whole process of Qi deficiency and blood stasis model is made through the whole process of qi deficiency and blood stasis model. To establish the model of syndrome combination of cerebral infarction and blood stasis syndrome of cerebral infarction, the characteristics of qi deficiency and blood stasis in model animals and the changes of biological indexes were compared, and the relationship between the sensitive characterization and index changes of the model animals of cerebral infarction and blood stasis syndrome was further explored, and the evaluation system of the model was established.
1. purpose:
In this experiment, we should use the method of exhausting swimming compound thread to copy the animal model of the syndrome of cerebral infarction and blood stasis syndrome, explore the method of making the disease syndrome combined with animal model, through the observation of the macroscopic characterization, neurology score, the pathological changes of the brain tissue and the changes of the related biochemical indexes, looking for the relationship between the characterization and other related indexes, and establishing the disease. The evaluation system of the combination model.
The 2. method:
64 healthy male SD rats, body weight (200 + 10) g, 3 days after adaptive feeding, were randomly divided into 4 groups: normal group, simple swimming group, simple operation group, syndrome combination model group and 16 rats in each group. Normal group and simple operation group were fed for 3 weeks without any intervention; the simple swimming group and the combination model group were exhausted every day for exhaustive swimming. After 3 weeks of training, 3 weeks after the operation, the model group with the combination of the simple operation group and the disease syndrome group established the cerebral infarction model after 2 hours of ischemia and reperfusion for 24 hours by the thread thrombus method. The body weight, food intake, activity and operation mortality of the swimming and non swimming rats were compared and observed, and the general state of the rats before and after the operation was compared and the Zea-longa score standard was observed after 6 hours after the operation. Rats were given neurological signs and signs, 24 hours after the operation: 0. 1 rats in each group were randomly selected for 3 heart perfusion and then taken the brain, then 4% paraformaldehyde was fixed for 1 weeks to make paraffin embedded cerebral coronal section, and the conventional HE staining was used to observe the morphological changes of the brain tissue. 2 the remaining rats were broken head to take the brain to make brain tissue homogenization. The pulp was tested for biochemical indexes, including the determination of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity, the determination of nitric oxide (NO) and nitric oxide synthase (NOS) activity, the content of lactic acid (LD) and the activity of lactate dehydrogenase (LDH). The obtained data were processed by Excel software, and the single factor variance analysis of SPSS11.0 software was applied.
3. results:
After three weeks of swimming training, the rats in the simple swimming group and the disease syndrome combined model group were compared with the normal group and the normal group and the simple operation group. The diet was reduced and the weight growth was slow; the burnout lethargy, yawning, aggressive, antagonistic behavior decreased or disappeared; the tongue quality was dull, the sublingual vein was thickened and the blood stasis. After the cerebral infarction model, the simple operation was caused by the thread thrombus method. The mortality of the group (13%) was significantly lower than that of the combination model group (37%), and the signs of neurologic symptoms were lighter. After 24 hours of reperfusion, the rats in the former group recovered well and had stronger activity. The two groups of tongue were more gloomy than the normal group, and the sublingual veins had different degrees of blood stasis and growth, but the changes of tongue image in the compound model group were more obvious than those in the simple operation group.
There was no ischemia injury in the brain tissue of the normal group and the rats in the simple swimming group, but the cerebral tissue of the rats in the simple group and the compound model group had the ischemic morphologic changes. The brain tissue injury in the compound model group was more serious. The activity of SOD in the compound model group was (81.58 + 24.47). The activity of SOD in the brain tissue of the operation group (61.41 + 20.74) was significantly lower than that of the normal group (106.66 + 6.40). The content of the lipid peroxidation product MDA in the brain tissue of the P0.05. complex group (1.26 + 0.19) and the lipid peroxidation product MDA content in the brain tissue of the simple operation group (1.03 + 0.31) were significantly increased (P0.05) compared with the normal group (0.0.64 + 0.07).
4. conclusion:
4.1 on the basis of single and repeated exhaustive swimming, causing Qi deficiency and blood stasis on the basis of complex cerebral infarction, the disease syndrome combined with animal model, from animal life habit change, general state change, nerve function change and other characterization observation, related diseases physiological index, biochemical index detection, to a certain extent, simulate the deficiency of cerebral infarction Qi deficiency. Characteristics of syndrome of blood stasis.
4.2 the changes in the state of qi deficiency and blood stasis and the physiological basis of related diseases were objectively evaluated from the macroscopic and microscopic indexes, which provided the basis for the establishment of the evaluation method of the combination of disease and syndrome.
【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】：2007
【分類號】：R-332

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