本文關(guān)鍵詞： 針刀 內(nèi)臟弓弦 慢性盆腔炎 模型　出處：《湖北中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：實(shí)驗(yàn)?zāi)康?以針刀醫(yī)學(xué)內(nèi)臟弓弦原理對慢性盆腔炎的認(rèn)識為理論依據(jù),采用機(jī)械損傷新西蘭兔子宮闊韌帶的方法建立慢性盆腔炎的模型,旨在探索一種新的理論指導(dǎo)下慢性盆腔炎動物模型的造模方法,為針刀醫(yī)學(xué)內(nèi)臟弓弦理論及針刀臨床治療慢性內(nèi)臟疾病提供實(shí)驗(yàn)學(xué)基礎(chǔ)。實(shí)驗(yàn)方法:將普通級康健雌性未孕新西蘭大白兔28只適應(yīng)性飼養(yǎng)一周,隨機(jī)分為空白對照組、假手術(shù)組、造模組和機(jī)械損傷加混合菌對照組,每組各7只。其中,空白對照組不采取任何干預(yù)措施,正常飼養(yǎng);其余三組在造模前一天禁食、禁水12h,10%水合氯醛(3ml/kg)耳緣靜脈麻醉后備皮,在嚴(yán)格遵守?zé)o菌手術(shù)條件下開腹,假手術(shù)組不作任何處理,分層關(guān)腹;造模組找到子宮闊韌帶用刀柄刮劃2-3下、局部折疊縫合使子宮失去正常位置后分層關(guān)腹;機(jī)械損傷加混合菌對照組用注射器抽插損傷子宮內(nèi)膜后,在子宮角向卵巢方向呈銳角向兩側(cè)輸卵管各注入0.15ml混合菌液(大腸埃希氏菌、金黃色葡萄球菌、乙型溶血性鏈球菌按2:1:1比例用無菌生理鹽水稀釋,配成3×109個(gè)/ml濃度)。術(shù)后常規(guī)飼養(yǎng),按實(shí)驗(yàn)設(shè)定日期空白對照組、假手術(shù)組和機(jī)械損傷加混合菌對照組21天取材,造模組60天取材。肉眼觀察子宮及盆腔組織形態(tài)學(xué)變化后,取子宮組織HE染色,在光鏡下觀察其病理改變;心臟取血2ml置于肝素抗凝管中,用酶聯(lián)免疫法測各組兔血清的炎癥細(xì)胞因子IL-1β、IL-6、TNF-α水平。實(shí)驗(yàn)結(jié)果:(1)肉眼觀察:造模組可見子宮表面淺表血管擴(kuò)張、色鮮紅,子宮增粗、腫脹迂曲或積水,質(zhì)脆、彈性差,與周圍臟器、盆腔組織有不同程度的纖維組織粘連,不易分離,或有串珠狀改變,內(nèi)可見淡黃色液體。(2)光鏡下:造模組子宮黏膜內(nèi)的上皮細(xì)胞遭到破壞,構(gòu)造失常、層次模糊不清;黏膜層、肌層有慢性炎性細(xì)胞浸潤及纖維結(jié)締組織增生,以淋巴細(xì)胞為主;腺體破壞甚至壞死。(3)指標(biāo)檢測結(jié)果:造模組兔血清酶聯(lián)免疫吸附法測得IL-1β、IL-6、TNF-α值均較空白對照組和假手術(shù)組升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05);與機(jī)械損傷加混合菌對照組比,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。實(shí)驗(yàn)結(jié)論:根據(jù)針刀醫(yī)學(xué)內(nèi)臟弓弦力學(xué)解剖系統(tǒng)理論對慢性盆腔炎的認(rèn)識,采用人為機(jī)械損傷子宮闊韌帶、局部折疊縫合使子宮失去正常位置的方法初步探索慢性盆腔炎動物模型,其形態(tài)學(xué)觀察有病理改變、血清指標(biāo)有炎性變化,但需進(jìn)一步減少人為干預(yù)、完善檢測指標(biāo)造模方法仍須進(jìn)一步完善。
[Abstract]:Objective: to establish a model of chronic pelvic inflammatory disease by mechanical injury of the broad uterine ligament in New Zealand rabbits based on the understanding of chronic pelvic inflammatory disease based on the principle of visceral bow string in needle knife medicine. The purpose of this study was to explore a new method for modeling chronic pelvic inflammatory disease (CPI) animal model under the guidance of new theory. Objective: to provide experimental basis for the treatment of chronic visceral diseases by acupuncture knife medical visceral bow string theory and clinical treatment of chronic visceral diseases. Methods: 28 healthy female New Zealand white rabbits were fed adaptively for one week. They were randomly divided into blank control group, sham operation group, model making group and mechanical injury plus mixed bacteria control group with 7 rats in each group. The other three groups fasted one day before the model and banned 10% chloral hydrate (10% chloral hydrate) 3 ml / kg for 12 hours. The patients in the sham operation group were treated without any treatment under strict compliance with aseptic operation. Stratified closed abdomen; In the model group, the broad ligament of uterus was scraped 2-3 times with the knife handle, and the uterus lost its normal position by local folding and suture, then the uterus was laminated and closed. Mechanical injury and mixed bacteria control group were injected with 0.15 ml mixed bacteria solution (Escherichia coli) in the direction of uterus horn to ovary and oviduct in the direction of acute angle after the injury of endometrium was inserted with syringe in the control group. Staphylococcus aureus and Streptococcus B hemolytic streptococcus were diluted with aseptic saline at the ratio of 2: 1: 1 to form 3 脳 10 9 / ml of saline. The sham-operation group and the mechanical injury plus mixed bacteria control group were taken for 21 days and the model group for 60 days. After observing the morphological changes of uterus and pelvic tissues with naked eyes, the uterine tissues were stained with HE. The pathological changes were observed under light microscope. 2ml blood was taken from the heart and placed in the heparin anticoagulant tube. The inflammatory cytokine IL-1 尾 -IL-6 was measured by enzyme-linked immunosorbent assay (Elisa). Experimental results: the model group showed superficial vasodilation, bright red color, thickening of uterus, swelling, detour or hydrops, brittle, poor elasticity, and surrounding organs. Pelvic tissue has different degrees of fibrous tissue adhesion, not easy to be separated, or beaded changes, the light yellow liquid can be seen in the light microscope: the model group uterine mucosa epithelial cells were destroyed, the structure is abnormal. The level is not clear; There were chronic inflammatory cell infiltration and fibrous connective tissue proliferation in mucous membrane and myometrium, mainly lymphocytes. Results: the serum IL-1 尾 -IL-6 TNF- 偽 values of the model group were higher than those of the control group and the sham-operation group, compared with the control group and the sham-operation group. The serum enzyme linked immunosorbent assay (Elisa) of the model group was higher than that of the blank control group and the sham-operated group. The difference was statistically significant (P 0.05). Compared with the control group of mechanical injury and mixed bacteria, there was no significant difference between the two groups (P0.055.Experimental conclusion: according to the theory of mechanical anatomy system of visceral bow string in needle knife medicine, the understanding of chronic pelvic inflammatory disease. The animal model of chronic pelvic inflammatory disease was preliminarily explored by artificial mechanical injury of the broad ligament of uterus and local folding and suture to make the uterus lose its normal position. There were pathological changes in morphology and inflammatory changes in serum indexes. However, it is necessary to further reduce human intervention and improve the method of modeling detection index.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R245;R-332

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