本文選題：黃連解毒湯加減方 + 痔急性期相近模型　； 參考：《西南醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過觀察黃連解毒湯加減方熏洗對大鼠痔相近動物模型一般情況、肛周潰瘍情況、肛周病理組織形態(tài)及誘導(dǎo)型一氧化氮合酶(iNOS)、血管內(nèi)皮生長因子(VEGF)、前列腺素E2(PGE2)的影響,探討黃連解毒湯加減方治療大鼠痔相近動物模型的療效及作用機(jī)制,為痔急性期治療提供非手術(shù)選擇及黃連解毒湯加減方在臨床中使用提供動物實(shí)驗(yàn)依據(jù)。方法:準(zhǔn)備SD大鼠44只,采用肛周注射冰醋酸法復(fù)制痔急性期大鼠相近模型,從中隨機(jī)選取4只觀察肛周潰瘍病理切片以確認(rèn)造模是否成功。然后將余下40只大鼠隨機(jī)分為實(shí)驗(yàn)H1組(高劑量)、實(shí)驗(yàn)H2組(低劑量)、實(shí)驗(yàn)對照H3組(馬應(yīng)龍痔瘡膏)及模型對照H4組(蒸餾水),共4組,每組10只。實(shí)驗(yàn)H1組給予黃連解毒湯加減方高濃度熏洗,實(shí)驗(yàn)H2組給予黃連解毒湯加減方低濃度熏洗,實(shí)驗(yàn)對照H3組給予馬應(yīng)龍痔瘡膏涂抹,模型對照H4組給予無菌蒸餾水熏洗,以上各組每日給藥2次,間隔4h,治療周期均為7天。給藥期間觀察大鼠的一般情況,同時于第2天、第4天、第7天觀察肛周潰瘍面積、腫脹程度并進(jìn)行記錄。給藥結(jié)束后,取肛周潰瘍組織進(jìn)行病理學(xué)觀察并采用免疫組化分析肛周潰瘍組織iNOS、VEGF、PGE2陽性率。結(jié)果:1.造模結(jié)束后各組大鼠肛周觀察指標(biāo)對比:(1)各組大鼠一般情況良好。(2)實(shí)驗(yàn)動物模型局部炎癥評分、肛周局部標(biāo)本病理檢測均符合痔急性期表現(xiàn)。(3)造模結(jié)束后,實(shí)驗(yàn)H1組、實(shí)驗(yàn)H2組、實(shí)驗(yàn)對照H3組及模型對照H4組于用藥前局部炎癥評分值及潰瘍面積統(tǒng)計(jì)值都無統(tǒng)計(jì)學(xué)意義(p0.05),具有可比性。2.給藥結(jié)束后各組大鼠肛周潰瘍面積對比:(1)高濃度湯劑、低濃度湯劑促進(jìn)肛周局部潰瘍面積愈合的作用明顯優(yōu)于馬應(yīng)龍痔瘡膏(p0.05);(2)高濃度湯劑和低濃度湯劑對肛周局部潰瘍愈合的作用在統(tǒng)計(jì)學(xué)上無明顯的差異(p0.05)。3.給藥結(jié)束后各組大鼠肛周潰瘍病理學(xué)檢查對比:高濃度湯劑、低濃度湯劑肛周局部潰瘍病理學(xué)改變評分與馬應(yīng)龍痔瘡膏均具有統(tǒng)計(jì)學(xué)意義(p0.05)。4.給藥結(jié)束后各組大鼠肛周潰瘍組織iNOS、VEGF、PGE2對比:(1)高濃度湯劑、低濃度湯劑抑制iNOS、VEGF、PGE2表達(dá)的作用都優(yōu)于馬應(yīng)龍痔瘡膏的抑制作用(P0.05);(2)低濃度湯劑和高濃度湯劑抑制i NOS、VEGF、PGE2表達(dá)的作用在統(tǒng)計(jì)學(xué)上無明顯的差異(p0.05)。結(jié)論:1.黃連解毒湯加減方能改善大鼠痔相近動物模型的肛周局部的水腫、潰瘍癥狀,且本實(shí)驗(yàn)中高、低劑量湯劑對大鼠痔相近模型癥狀改善效果差別不大;2.黃連解毒湯加減方可改善大鼠痔相近模型肛周局部病理癥狀,具有抑制炎癥反應(yīng)作用和促進(jìn)潰瘍愈合的作用;3.黃連解毒湯加減方對動物模型痔急性期治療的作用機(jī)制可能與iNOS、VEGF、PGE2三者因子的參與有關(guān);4.本實(shí)驗(yàn)證實(shí)黃連解毒湯加減方熏洗法對大鼠痔相近模型療效確切,可為臨床上痔病的治療提供一種非手術(shù)治療方法。
[Abstract]:Objective: to observe the effects of Huanglian jiedu decoction fumigation and washing on rat hemorrhoids similar animal model, perianal ulcer, perianal histopathology and inducible nitric oxide synthase (iNOS), vascular endothelial growth factor (VEGF) and prostaglandin E _ 2 (PGE _ 2). To explore the therapeutic effect and mechanism of Huanglian jiedu decoction in treating rat hemorrhoid model, to provide non-operative choice for acute hemorrhoids treatment and to provide animal experimental basis for clinical use of Huanglian jiedu decoction. Methods: Forty-four Sprague-Dawley rats were randomly selected to observe the pathological sections of perianal ulcer in order to confirm whether the model was successful or not. Then the remaining 40 rats were randomly divided into experimental H1 group (high dose group), experimental H2 group (low dose group), experimental control group H3 group (Ma Yinglong hemorrhoid ointment) and model control group H4 (distilled water group, 10 rats in each group). Experimental group H1 was treated with high concentration fumigation of Huanglian jiedu decoction, experimental group H2 was given low concentration of Huanglian jiedu decoction, experimental control group H3 was smeared with Ma Yinglong hemorrhoid ointment, model control group H4 was fumigated with aseptic distilled water. The above groups were given 2 times daily for 4 hours, and the treatment cycle was 7 days. The general condition of rats was observed during administration, and the area of perianal ulcer and the degree of swelling were observed and recorded on day 2, day 4 and day 7. After administration, the tissue of perianal ulcer was taken for pathological observation and the positive rate of iNOS VEGFN PGE2 in perianal ulcer tissue was analyzed by immunohistochemistry. The result is 1: 1. Comparison of perianal observation indexes of rats in each group after model making: (1) the rats in each group were generally in good condition. 2) the local inflammation score of experimental animal model, the pathological examination of perianal local specimen all accord with hemorrhoids in acute phase, and the experimental H1 group was treated with H1 group after the model was made. Experimental H2 group, experimental control H3 group and model control H4 group had no significant difference in local inflammatory score and ulcer area statistical value before medication. The perianal ulcer area of rats in each group was compared with that of the control group after administration. The effect of low concentration decoction on the healing of perianal local ulcer area was significantly better than that of Ma Ying long hemorrhoids ointment (p0.05P0. 05) 2) the effect of high concentration decoction and low concentration decoction on the healing of perianal local ulcer was not statistically significant difference (p 0. 05. 3). Comparison of pathological examination of perianal ulcer in rats of each group after administration: the pathological changes of perianal ulcer of high concentration decoction and low concentration decoction and Ma Yinglong hemorrhoid ointment all had statistical significance (P 0.05). 4. After administration, the rats in each group had perianal ulcer tissue (iNOS) and VEGFGE-2 (contrast with 1: 1) high concentration decoction. The inhibitory effect of low concentration decoction on the expression of iNOS VEGFN PGE2 was better than that of Ma Yinglong hemorrhoid ointment (P 0.05). There was no statistical difference between low concentration decoction and high concentration decoction in inhibiting the expression of iNOS VEGFN PGE2. There was no statistically significant difference in the effect of low concentration decoction and high concentration decoction on the expression of iNOS VEGFN PGE2. Conclusion 1. Huanglian jiedu decoction can improve the symptoms of edema and ulcer around the anus of rat hemorrhoids similar animal model, and there is no significant difference in the effect of high and low dosage decoction in improving symptoms of similar model of hemorrhoids in rats. Huanglian jiedu decoction can improve the perianal pathological symptoms of rat hemorrhoid model and has the effect of inhibiting inflammatory reaction and promoting ulcer healing. The mechanism of Huanglian jiedu decoction in treating hemorrhoids in acute stage may be related to the involvement of iNOS VEGFN PGE2 in the treatment of hemorrhoids. This experiment proved that Huanglian jiedu decoction fumigation washing method for rat hemorrhoids similar model is effective and can provide a non-operative treatment for hemorrhoids.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R285.5;R-332

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