本文選題：功能性胃腸病 + C型鈉尿肽　； 參考：《大連醫(yī)科大學》2013年碩士論文

【摘要】：第一部分非器質(zhì)性胃動力障礙患者抑郁量表分析 目的：胃動力學及其相關(guān)疾病的研究已成為胃疾病至關(guān)重要的一部分，隨著抑郁癥患者的日益增多，由此引起的胃功能障礙性疾病也逐漸增多。本部分通過胃鏡及其他相關(guān)檢查得到20例功能性消化不良（functional dyspepsia，F(xiàn)D)患者，進一步行全胃腸鋇餐透視、胃電檢測及抑郁自評量表評分，，對FD患者胃動力及其合并抑郁癥情況進行分析，并及時給予合理治療。 方法：入組2012年3月至2013年4月于大連醫(yī)科大學附屬第一醫(yī)院消化科門診及住院患者為研究對象。通過全胃腸鋇餐透視、胃電檢測及抑郁自評量表測定20例FD和20例正常組患者胃動力水平及FD合并抑郁癥情況。 結(jié)果：全胃腸鋇餐透視下FD組胃張力、胃蠕動較正常組減弱，胃排空時間FD組較正常組延長(5.59±0.58h vs1.69±0.08h，P0.05)；胃電圖FD組較正常組有差異(P0.05)；對已確診的20例FD患者通過抑郁自評量表評分并分析，抑郁癥患病率為30%。 結(jié)論：功能性消化不良患者胃動力降低；30%功能性消化不良患者合并有抑郁癥。 第二部分抑郁引起胃運動障礙大鼠鈉尿肽信號通路的變化及逍遙散的干預作用 目的：本部分實驗在之前臨床實驗的前提下，采用免疫組化、RT-qPCR及Western-blot技術(shù)，探討抑郁引起胃運動障礙大鼠鈉尿肽信號通路的變化及逍遙散的干預作用。 方法：雄性SD大鼠75只，由大連醫(yī)科大學實驗動物中心提供，通過開野實驗選取50只，適應性喂養(yǎng)1wk后隨機分為A-E5組（依次是正常組、抑郁組、逍遙散低、中、高濃度組），實驗持續(xù)3wk。A組正常飼養(yǎng)；B-E4組采取采用經(jīng)典慢性綜合應激模式，每天給予一種應激刺激（24h禁水，夾尾，束縛），每種重復2~3次；C-E3組分別于刺激前1小時低、中、高濃度逍遙散灌胃，同時A、B組生理鹽水灌胃.3wk結(jié)束時處死動物，留取胃竇標本，行免疫組化、RT-qPCR、Western-blot技術(shù)測定大鼠C型鈉尿肽（C-type natriuretic peptide，CNP）及其受體B型鈉尿肽受體（B-type natriuretic peptide receptor，NPR-B）的表達情況。 結(jié)果：抑郁大鼠胃竇環(huán)形肌自發(fā)性收縮對CNP抑制反應敏感性明顯增加而逍遙散對其有改善作用；抑郁組大鼠CNP及NPR-B表達顯著高于正常組（均P0.01）；逍遙散高濃度組較正常組差異無統(tǒng)計學意義，逍遙散中、高濃度組較抑郁組差異顯著（均P0.01）；逍遙散低濃度組較正常組及抑郁組差異顯著（均P0.01）。 結(jié)論：鈉尿肽信號通路上調(diào)是抑郁引起胃運動障礙的原因之一，逍遙散通過下調(diào)NP信號通路改善抑郁引起胃運動障礙。
[Abstract]:Part I analysis of depression scale in patients with non-organic gastric motility disorder Objective: the study of gastric dynamics and related diseases has become a vital part of gastric diseases. With the increasing number of depression patients, the resulting gastric dysfunction disease is also increasing. In this part, 20 patients with functional dyspepsia (FDD) were obtained by gastroscopy and other related examinations. The patients with FD were further examined with total gastrointestinal barium meal fluoroscopy, electrogastrogram examination and self-rating depression scale (SDS). The gastric motility and its associated depression in FD patients were analyzed. And give reasonable treatment in time. Methods: from March 2012 to April 2013, inpatients and outpatients from Department of Digestive Medicine, the first affiliated Hospital of Dalian Medical University were selected as subjects. Gastric motility and depression in 20 patients with FD and 20 normal controls were measured by total gastrointestinal barium meal fluoroscopy, gastric electrical examination and self rating depression scale. Results: gastric tension and gastric peristalsis in FD group were lower than those in normal group under total gastrointestinal barium meal fluoroscopy. The gastric emptying time in FD group was 5.59 鹵0.58h vs1.69 鹵0.08hP0.05U longer than that in the normal group, and there was a difference between the FD group and the normal group (P0.05A). The prevalence of depression was 30% in 20 patients with FD who had been diagnosed by self-rating depression scale (SDS). Conclusion: gastric motility in patients with functional dyspepsia is 30% with depression. The second part: the changes of natriuretic peptide signaling pathway in rats with gastric motility disorder induced by depression and the intervention effect of Xiaoyao San Objective: to investigate the changes of natriuretic peptide signaling pathway in rats with gastric motility disorder induced by depression and the intervention effect of Xiaoyao Powder by using immunohistochemical RT-qPCR and Western-blot techniques under the premise of previous clinical trials. Methods: 75 male Sprague-Dawley rats, provided by Experimental Animal Center of Dalian Medical University, were randomly divided into A-E5 group (normal group, depression group, Xiaoyao powder low, middle group) after feeding 1wk adaptively. In the high concentration group, the 3wk.A group was fed with the classical chronic comprehensive stress model. The rats were given a stress stimulation for 24 hours to ban water, clip the tail, and restrain the rats. The C-E3 group was low and moderate at 1 hour before the stimulation. Rats in group A were sacrificed at the end of oral administration of normal saline for 3 wk, and antral specimens were collected. The expression of C-type natriuretic peptide and B type natriuretic peptide receptor (B-type natriuretic peptide receptor, NPR-BB) was determined by immunohistochemistry with RT-qPCRX Western-blot. Results: the sensitivity of spontaneous contraction of antral annular muscle to CNP in depressed rats was significantly increased, while Xiaoyao San could improve it. The expression of CNP and NPR-B in the depression group was significantly higher than that in the normal group (P0.01), but there was no significant difference between the high concentration group of Xiaoyao Powder and the normal group. There was significant difference between the high concentration group and the depression group (all P 0.01), and the low concentration group of Xiaoyao San was significantly higher than that of the normal group and the depression group (all P 0.01). Conclusion: upregulation of natriuretic peptide signaling pathway is one of the causes of gastric motility disorder caused by depression. Xiaoyao Powder can improve gastric motility disorder caused by depression by down-regulating NP signal pathway.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R749.4;R573

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