發(fā)布時(shí)間：2018-04-21 21:53

  本文選題：直接灸法 + 原發(fā)性肝癌��； 參考：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：直接灸法是有著數(shù)千年歷史的中醫(yī)針灸特色療法之一,方法是將從艾草中提取的艾絨纖維做成米粒大小的小艾炷,然后放在選取的穴位上點(diǎn)燃,小艾炷燃燒會(huì)產(chǎn)生一定的熱度,使施灸部位發(fā)生輕微的燒傷,可直接刺激穴位,起到溫通陽(yáng)氣、疏通經(jīng)脈、軟堅(jiān)散結(jié)、化ve止痛、活血祛瘀、促進(jìn)新生、扶正祛邪等作用。近年來(lái)對(duì)直接灸法的研究發(fā)現(xiàn),在防病治病方面,直接灸法能夠提高人體的自身免疫功能,增強(qiáng)機(jī)體的抗病能力。在對(duì)腫瘤的治療中發(fā)現(xiàn),直接灸法可通過(guò)提高患者的自身免疫能力,促進(jìn)癌細(xì)胞凋亡,抑制腫瘤的生長(zhǎng)。現(xiàn)代一些中醫(yī)專家運(yùn)用直接灸法對(duì)防治原發(fā)性肝癌(Hepatic cellular cancer,HCC)的臨床實(shí)驗(yàn)研究表明,直接灸對(duì)乙肝、肝硬化、HCC等確有防治作用。其中從醫(yī)60余年,提倡"灸科學(xué)'"的承淡安先生的弟子謝錫亮先生,在實(shí)踐中發(fā)現(xiàn)直接灸法對(duì)防治各類重型肝病療效顯著,并總結(jié)了多例直接灸防治HCC的臨床驗(yàn)案。本研究在其基礎(chǔ)上,以HCC成模期大鼠為研究對(duì)象,艾灸"肝俞穴"后,通過(guò)重點(diǎn)觀察模型大鼠肝組織病理形態(tài)、腫瘤特異性生長(zhǎng)因子(Tumor specific growth factor,TSGF)、凋亡抑制因子Livin的含量變化,深入探討了直接灸"肝俞穴"防治HCC的效應(yīng)及作用機(jī)理。目的本實(shí)驗(yàn)采用HCC成模期大鼠為研究對(duì)象,采用腹腔注射二乙基亞硝(Dieth ylnitrosamine,DEN)的方法建立大鼠病變模型。通過(guò)給予對(duì)象在肝俞穴上不同程度施灸治療,觀察直接灸肝俞穴對(duì)大鼠血清TSGF、肝組織中Livin的影響,探究直接灸肝俞穴對(duì)大鼠HCC發(fā)生發(fā)展的作用和機(jī)理。方法將70只雄性Wistar大鼠,采用隨機(jī)數(shù)字表法分為空白組(10只)、HCC模型組(15只)、直接灸1組(15只)、直接灸2組(15只)及隔姜灸組(15只),其中,模型組、施灸組通過(guò)在腹腔部位注射DEN誘導(dǎo)產(chǎn)生HCC模型,方法為每周注射2次,以10周為期;從造模開始同時(shí)給予大鼠施灸肝俞穴進(jìn)行干預(yù),具體為:3壯/直接灸1組,6壯/直接灸2組,3壯/隔姜灸組,每隔一天施灸1次,以10周為期�？瞻捉M無(wú)治療。待造模完成,先大鼠尾靜脈采血后,在大鼠腹腔注射10%的水合氯醛溶液麻醉,進(jìn)行取肝組織檢測(cè)。稱肝質(zhì)量,計(jì)算肝指數(shù);用HE染色法,對(duì)大鼠肝臟的病理形態(tài)學(xué)進(jìn)行觀察;ELISA法檢測(cè)血清TSGF,免疫組化法檢測(cè)Livin在肝組織中的表達(dá)情況。結(jié)果1.肝組織病理形態(tài)學(xué)變化:HE染色顯示,模型組,腫瘤灶誘導(dǎo)形成,小葉結(jié)構(gòu)完全破壞,核/質(zhì)比增大,細(xì)胞核深染,異型性增加,肝細(xì)胞壞死;直接灸1組,核/質(zhì)比略增大,癌細(xì)胞數(shù)量較少,細(xì)胞核異型性低,有少量結(jié)節(jié)形成;直接灸2組,細(xì)胞核深染、核/質(zhì)比增大,肝細(xì)胞有雙核;隔姜灸組,細(xì)胞核深染、核/質(zhì)比略增大,未發(fā)現(xiàn)結(jié)節(jié)�？瞻捉M肝細(xì)胞的形態(tài)正常,肝排列、肝小梁均沒有異常變化。2.血清TSGF的表達(dá)情況:造模結(jié)束后,與空白組相比,模型組TSGF含量均顯著增高(P0.05);與模型組相比,直接灸1組、直接灸2組TSGF含量無(wú)顯著性改變(P0.05),但有降低趨勢(shì);與模型組相比,隔姜灸組TSGF含量均顯著降低(P0.05)。3.肝組織中Livin表達(dá)情況:造模結(jié)束后,與空白組相比,模型組、施灸組Livin表達(dá)均明顯升高(P0.05);與模型組相比,直接灸1組Livin表達(dá)均有降低趨勢(shì),但無(wú)顯著性改變(P0.05);直接灸2組和隔姜灸組Livin表達(dá)均明顯降低(P0.05)。結(jié)論1.本實(shí)驗(yàn)所用的HCC大鼠模型是通過(guò)在其腹腔注射DEN的方法獲得,所采用的造模方法可靠。2.在肝俞穴上直接灸和隔姜灸治療方法對(duì)HCC模型大鼠可改善肝臟病理形態(tài),減輕細(xì)胞癌變程度。但直接灸法和隔姜灸法改善程度無(wú)明顯差異3.直接灸肝俞穴和隔姜灸可有效降低血清TSGF,肝組織中Livin的表達(dá)水平。4.直接灸肝俞穴對(duì)HCC模型大鼠的發(fā)生具有一定的預(yù)防作用,其能延緩癌變進(jìn)程,但不能完全阻止,由此認(rèn)為:直接灸肝俞穴可以下調(diào)血清TSGF,肝組織中Livin的表達(dá)水平,與抑制癌變細(xì)胞的形成有關(guān)。
[Abstract]:Direct moxibustion is one of the characteristics of acupuncture and moxibustion, which has a history of thousands of years. The method is to make a small Ai Zhu extracted from the acupoint, and then ignite on the selected acupoint. The burning of small Ai Zhu will produce a certain heat, so that the parts of the moxibustion can be burned slightly, which can directly stimulate the acupoint and act as Wen Tongyang. In recent years, direct moxibustion can improve the immune function of the human body and enhance the body's ability to resist disease. The direct moxibustion method can be found in the treatment of tumor. Direct moxibustion can improve the patients by improving the patient's treatment. The autoimmune ability promotes the apoptosis of cancer cells and inhibits the growth of the tumor. Some modern Chinese traditional Chinese medicine experts use direct moxibustion to prevent and control primary liver cancer (Hepatic cellular cancer, HCC). It shows that direct moxibustion has the preventive effect on hepatitis B, liver cirrhosis, HCC and so on. Among them, Mr. Cheng Shen An, who advocates "moxibustion science" for more than 60 years, has been promoted. Mr. Xie Xiliang, the disciple, found that direct moxibustion was effective in the prevention and treatment of all kinds of severe liver diseases, and summed up the clinical cases of multiple direct moxibustion on the prevention and treatment of HCC. On the basis of this study, the rat model of HCC moxibustion was taken as the research object. After moxibustion "Gan Shu point", the pathological morphology and tumor specificity of the rat liver tissue were observed and the tumor specificity was observed by the heavy point. Tumor specific growth factor (TSGF) and the change of apoptosis inhibitory factor Livin content, and the effect and mechanism of Direct Moxibustion "Gan Shu point" on the prevention and treatment of HCC. The objective of this experiment was to establish a rat model of pathological change by intraperitoneal injection of two ethyl nitrite (Dieth ylnitrosamine, DEN). Type. The effect and mechanism of direct moxibustion at Gan Shu point on rat serum TSGF and Livin in liver tissue were observed through the treatment of different degrees of moxibustion on the liver Yu acupoint. Methods 70 male Wistar rats were divided into blank group (10 rats) and HCC model group (15 rats). Direct moxibustion in 1 groups (15), direct moxibustion in 2 groups (15) and ginger separated moxibustion group (15), in which the model group and the moxibustion group were induced by the injection of DEN into the abdominal cavity to induce the HCC model, and the method was to be injected 2 times a week for 10 weeks, and the rats were treated with moxibustion at the same time for 10 weeks. The concrete was: 3 Zhuang / direct moxibustion 1 groups, 6 strong / direct moxibustion 2 groups, 3 Zhuang / Shen Zhuang. Ginger moxibustion group was given 1 times every other day for 10 weeks. There was no treatment in the blank group. After the model was completed, after the rat tail vein was collected, the rat's caudal vein was injected with 10% chloral chloral solution, and the liver tissue was detected. The liver quality was measured and the liver index was calculated. The HE staining method was used to observe the pathomorphology of the rat liver; ELISA method was used to detect the blood. TSGF, immunohistochemical method was used to detect the expression of Livin in liver tissue. Results 1. the pathological changes of liver tissue: HE staining showed that the model group, tumor induction was induced, the structure of the lobule was completely destroyed, the nucleus / mass ratio increased, the nucleus deep staining, the heteromorphic increase, the liver cell death, the 1 groups of direct moxibustion, the nucleus / mass ratio slightly increased, the number of cancer cells was less, The nuclear heteromorphity was low and a small number of nodules were formed; the 2 groups of direct moxibustion, the nucleus deep staining, the nucleus / mass ratio increased, the hepatocytes had a double nucleus; the ginger moxibustion group, the nucleus deep dyed, the nucleus / mass ratio slightly increased, not found the nodules. The liver cells in the blank group were normal, the liver arrangement, and the liver small Liang Jun had no abnormal changes in the expression of.2. serum TSGF: after model end, and Compared with the blank group, the content of TSGF in the model group increased significantly (P0.05). Compared with the model group, there was no significant change in the content of TSGF in the 1 groups of direct moxibustion and the 2 groups of direct moxibustion (P0.05), but it had a decreasing trend. Compared with the model group, the TSGF content of the ginger moxibustion group decreased significantly (P0.05) the expression of Livin in the liver tissue of.3.: after the end of the model, the model group was compared with the blank group. The expression of Livin in the moxibustion group increased significantly (P0.05). Compared with the model group, the expression of Livin in the 1 groups of direct moxibustion had a decreasing trend, but no significant change (P0.05); the expression of Livin in the 2 groups and the ginger moxibustion group was significantly decreased (P0.05). Conclusion the HCC rat model used in the 1. experiments was obtained by intraperitoneal injection of DEN. Model method reliable.2. in liver Shu point direct moxibustion and ginger separated moxibustion treatment on HCC model rats can improve the liver pathological morphology and reduce the degree of cell carcinogenesis, but the improvement degree of the direct moxibustion and ginger moxibustion method has no obvious difference 3. direct moxibustion Gan Shu point and ginger separated moxibustion can effectively reduce the serum TSGF, the expression level of Livin in liver tissue is.4. direct moxibustion liver Yu Xue has a certain preventive effect on the occurrence of HCC model rats. It can delay the process of cancer, but it can not be completely prevented. Therefore, the direct moxibustion at the Gan Shu point can reduce the serum TSGF, the expression level of Livin in the liver tissue, and be related to the inhibition of the formation of cancerous cells.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R245

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