本文選題：PCOS + 補(bǔ)腎化痰方�。� 參考：《河南中醫(yī)學(xué)院》2014年碩士論文

【摘要】：目的：本課題以傳統(tǒng)中醫(yī)學(xué)理論為基礎(chǔ)，通過觀察補(bǔ)腎化痰方對PCOS模型大鼠激素水平和卵巢組織形態(tài)的影響。揭示補(bǔ)腎化痰方降低大鼠促黃體生成素和雄激素水平，并改善大鼠卵巢組織形態(tài)的作用機(jī)理，為補(bǔ)腎化痰方治療PCOS提供有效性科學(xué)依據(jù)。 方法：該課題選用95只同種系雌性SPF清潔級21日齡大鼠，隨機(jī)選擇25只大鼠作為正常對照組，每日頸背部皮下注射0.2ml注射油劑，連續(xù)20d；其余70只大鼠作為病理模型組，每日頸背部皮下注射脫氫表雄酮（DHEA）6mg/100g體重+0.2ml注射油劑，連續(xù)20d。造模結(jié)束后，先行大鼠動情周期測定及OGTT實驗，再從正常組和模型組中分別隨機(jī)選取10只大鼠進(jìn)行模型評估，選擇造模成功大鼠進(jìn)入下一步實驗。有造模成功大鼠60只和正常組大鼠15只，將模型組大鼠60只隨機(jī)分為模型對照組、二甲雙胍組、中藥低劑量組、中藥高劑量組；每組各15只大鼠，正常組15只大鼠作為正常對照組。對各組大鼠連續(xù)灌胃4周后，觀察其陰道涂片結(jié)果，對各組實驗大鼠動情間期禁食不禁水12小時處理后稱重、水合氯醛（10%）麻醉、腹主動脈取血、分離血清。對各組大鼠行斷頸處死，卵巢組織用4%多聚甲醛固定，分離血清并測定激素水平，光鏡下觀察卵巢組織形態(tài)學(xué)的變化。 結(jié)果：①實驗過程中實驗動物一般狀態(tài)的變化：模型組大鼠于頸背部皮下注射脫氫表雄酮后出現(xiàn)活動量減少、飲食量增加、飲水量增加、尿量增加，體重增加不明顯。以上變化隨灌胃給藥天數(shù)的增加而加劇，正常組大鼠體重逐漸增長、精神體征、活動反應(yīng)如常。灌胃后，部分中藥組大鼠體重下降，飲食、飲水較前減少。②本實驗中大鼠血清水平的影響：模型組的大鼠血清促黃體生成素（LH）和雄激素（T）水平均高于正常組，差別有統(tǒng)計學(xué)意義（P0.05）；與模型組比較，二甲雙胍組、中藥高劑量組、低劑量治療組血清LH和T水平均明顯降低，差別有統(tǒng)計學(xué)意義(P0.05)；與二甲雙胍組比較，高劑量中藥組和低劑量中藥治療組血清LH和T水平均有下降，差別有統(tǒng)計學(xué)意義(P0.05)；中藥高劑量組與低劑量組血清LH水平未見差別，結(jié)果無統(tǒng)計學(xué)意義（P0.05）；中藥高劑量組大鼠血清T水平明顯高于中藥低劑量組，差別有統(tǒng)計學(xué)意義(P0.05)。③對實驗大鼠卵巢組織形態(tài)學(xué)的影響：正常組卵巢組織：其可見各級卵泡，如初級卵母細(xì)胞、次級卵母細(xì)胞，生長卵泡細(xì)胞等，卵母細(xì)胞有放射冠，細(xì)胞結(jié)構(gòu)排列緊密。可見數(shù)個顆粒細(xì)胞，黃體數(shù)有一定數(shù)目。模型組大鼠卵巢組織：其可見多個囊泡，其囊泡即是空卵泡。正常形態(tài)的各級細(xì)胞少見，甚至沒有。見多個閉鎖細(xì)胞，卵母細(xì)胞放射冠消失，顆粒細(xì)胞較少，細(xì)胞排列疏松，黃體數(shù)目較少。二甲雙胍組大鼠卵巢組織：其可見極少數(shù)囊泡細(xì)胞，，各級卵泡細(xì)胞均在視野中可見且數(shù)量增多，可見到初級卵母細(xì)胞、次級卵母細(xì)胞、生長卵泡、成熟卵泡，即其成熟卵泡的卵泡膜也充分發(fā)育，內(nèi)層細(xì)胞增大。卵母細(xì)胞可見放射冠、透明帶。且看到顆粒細(xì)胞增多，細(xì)胞排列緊密；黃體數(shù)目增多。中藥高劑量組大鼠卵巢組織：其可見少數(shù)囊泡細(xì)胞，視野中可見到少數(shù)初級卵母細(xì)胞、次級卵母細(xì)胞、生長卵泡以及成熟卵泡，顆粒細(xì)胞數(shù)目較模型組增多，可見一定數(shù)目黃體。中藥低劑量組大鼠卵巢組織：其可見囊泡細(xì)胞數(shù)目減少，黃體數(shù)目稍有增加。可見少數(shù)生長卵泡細(xì)胞，以及少數(shù)閉鎖細(xì)胞。各組大鼠鏡下各級卵泡數(shù)目以及黃體數(shù)目比較：模型組大鼠的各級卵泡數(shù)及黃體數(shù)均低于正常組，差別有統(tǒng)計學(xué)意義（P0.05）。與模型組大鼠相比，二甲雙胍組、高劑量治療組、低劑量治療組大鼠的各級卵泡數(shù)及黃體數(shù)均較多，差別有統(tǒng)計學(xué)意義（P0.05）。與二甲雙胍組比較，高劑量治療組、低劑量治療組大鼠的各級卵泡數(shù)及黃體數(shù)數(shù)目有變化，差別有統(tǒng)計學(xué)意義（P0.05）。中藥高劑量組與低劑量組大鼠的各級卵泡數(shù)及黃體數(shù)目間統(tǒng)計學(xué)數(shù)據(jù)無差異，無統(tǒng)計學(xué)意義（P0.05），統(tǒng)計結(jié)果雖然沒有統(tǒng)計學(xué)意義，但卵泡數(shù)目和黃體數(shù)目有升高趨勢。 結(jié)論：①補(bǔ)腎化痰方能改善大鼠的生殖功能。②補(bǔ)腎化痰方能能直接作用于卵巢，并通過改善PCOS模型大鼠生殖內(nèi)分泌的功能紊亂趨于穩(wěn)定，從而影響大鼠卵巢的生殖功能，使得分泌的激素水平趨于正常。③本實驗證實補(bǔ)腎化痰方能從根本上改善PCOS患者卵巢功能，進(jìn)而能明顯改善卵巢的組織形態(tài)結(jié)構(gòu)，使其趨于正常卵巢功能。
[Abstract]:Objective: on the basis of traditional Chinese medicine theory, the effect of tonifying kidney and resolving phlegm prescription on hormone level and ovarian tissue morphology of PCOS model rats was observed, and the mechanism of tonifying kidney and eliminating phlegm prescription to reduce the level of luteinizing hormone and androgen in rats and to improve the morphology of ovarian tissue in rats was provided to provide the treatment of PCOS with the prescription of Tonifying the kidney and removing phlegm. Effective scientific basis.
Methods: 95 female SPF 21 day old rats were selected as the normal control group, and 25 rats were randomly selected as the normal control group. 0.2ml injection was injected subcutaneously on the back of the neck and 20d, and the other 70 rats were used as the pathological model group. The daily neck and back were subcutaneously injected with dehydroepiandrosterone (DHEA) 6mg/100g weight +0.2ml injection. After the end of 20d. model, 10 rats were randomly selected from the normal group and the model group. The model group and the model group were randomly selected for the model evaluation. The model rats were selected to enter the next experiment. There were 60 rats and 15 rats in the normal group, and 60 rats in the model group were randomly divided into the model control group and two a double group. Guanidine group, low dose group of traditional Chinese medicine, high dose group of traditional Chinese medicine, 15 rats in each group, and 15 rats in normal group as normal control group. After 4 weeks of continuous perfusion, the results of vaginal smear were observed in each group of rats. After 12 hours' treatment, the rats in each group were weighed, chloral hydrate (10%), abdominal aorta were taken blood, and blood was separated. The rats in each group were executed with broken neck, the ovarian tissue was fixed with 4% polyformaldehyde, the serum was separated and the level of hormone was measured. The morphological changes of the ovary were observed under light microscope.
Results: (1) changes in the general state of experimental animals during the experiment: after the hypodermic injection of dehydroepiandrosterone on the back of the model group, the amount of activity decreased, the amount of diet increased, the amount of drinking water increased, the amount of urine increased, and the increase of weight was not obvious. The above changes were aggravated with the increase in the number of days of administration of the stomach. The weight of the normal rats increased gradually. The influence of the serum level of rats in this experiment: the level of serum luteinizing hormone (LH) and androgen (T) in the rat model group was higher than that in the normal group, and the difference was statistically significant (P0.05); compared with the model group, metformin group, The serum levels of LH and T in the low dose group were significantly decreased, and the difference was statistically significant (P0.05). Compared with the metformin group, the level of serum LH and T decreased in the high dose group and the low dose treatment group, the difference was statistically significant (P0.05). There was no difference in the serum LH level between the high dose group and the low dose group. The results were not statistically significant (P0.05); the level of serum T in the high dose group of Chinese medicine was significantly higher than that of the low dose group of traditional Chinese medicine (P0.05). The effect of the difference was statistically significant (3) on the ovarian histomorphology of the experimental rats: the normal group of ovarian tissue: the follicles in the normal groups, such as primary oocytes, secondary oocytes, follicle cells, and so on, were found in the normal group. A number of granular cells and the number of corpus luteum have a certain number. The model group of rat ovarian tissue: it can be seen a number of vesicles, its vesicles are empty follicles. The normal form of cells at all levels are rare, even no. See multiple atresia cells, oocyte radiated crowns disappear, granulosa cells are fewer, cell rows are less. In the group of metformin group, the ovary tissue of metformin group: it can be seen in a few vesicles, and the follicle cells at all levels are visible and increased in the field of vision. It can be seen that the primary oocyte, secondary oocyte, growth follicle, mature follicle, that is, the follicular membrane of its mature follicle is fully developed, and the inner cell enlargement. The number of granulosa cells increased, the cells were arranged closely, and the number of corpus luteum increased. The high dose group of Chinese medicine showed a few vesicular cells, and a few primary oocytes, secondary oocytes, growth follicles and mature follicles in the field of vision, and the number of granulosa cells was more than that of the model group. The number of follicle cells and the number of corpus luteum increased slightly. The number of follicles at all levels and the number of corpus luteum were compared: the number of follicles and the number of corpus luteum at all levels in the model group were lower than that of normal rats. The difference was statistically significant (P0.05). Compared with the model group, the number of follicles and corpus luteum at all levels in the metformin group, the high dose treatment group and the low dose treatment group were more, the difference was statistically significant (P0.05). Compared with the metformin group, the number of follicles and the number of corpus luteum numbers in the low dose treatment group and the low dose treatment group were in the high dose treatment group. The difference was statistically significant (P0.05). There was no statistical difference between the number of follicles and the number of corpus luteum in the high dose group and the low dose group, and there was no statistical significance (P0.05). Although the statistical results were not statistically significant, the number of follicles and the number of corpus luteum increased.
Conclusion: (1) the prescription of Tonifying the kidney and removing phlegm can improve the reproductive function of the rat. (2) the prescription of Tonifying the kidney and removing phlegm can directly act on the ovary, and improve the functional disorder of the reproductive endocrine of the PCOS model rats, thus affecting the reproductive function of the rat ovary and the secretion of the hormone level to the normal. It can fundamentally improve ovarian function in PCOS patients, which can significantly improve the ovarian morphology and structure, and make it tend to normal ovarian function.
【學(xué)位授予單位】：河南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R285.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張鮮桃;辨證治療多囊卵巢綜合征[J];四川中醫(yī);2004年05期

2 李燕紅;;導(dǎo)痰種子方聯(lián)合地屈孕酮治療多囊卵巢綜合征患者黃體功能不全的臨床觀察[J];四川中醫(yī);2012年01期

3 徐建升;;補(bǔ)腎調(diào)周治療多囊卵巢綜合征[J];山西中醫(yī);2008年02期

4 趙榮;;針灸配合經(jīng)絡(luò)循按治療多囊卵巢不孕癥20例[J];上海針灸雜志;2011年06期

5 楊悅婭;;朱南孫治療多囊卵巢綜合征的思路與方法[J];上海中醫(yī)藥雜志;2006年01期

6 范明明;王建英;韓鳳娟;吳效科;侯麗輝;;多囊卵巢綜合征的中醫(yī)探究[J];世界中西醫(yī)結(jié)合雜志;2009年06期

7 孔桂茹;;清肝補(bǔ)腎法治療多囊卵巢綜合征35例[J];時珍國醫(yī)國藥;2007年09期

8 王針織;俞超芹;;補(bǔ)腎活血化痰法治療多囊卵巢綜合征的臨床觀察[J];實用中西醫(yī)結(jié)合臨床;2010年01期

9 鮑維雅;;補(bǔ)腎化痰佐以活血法治療多囊卵巢綜合征的臨床研究[J];天津中醫(yī)藥;2009年05期

10 俞瑾;多囊卵巢綜合征的中西醫(yī)治療[J];中國實用婦科與產(chǎn)科雜志;2002年11期

本文編號：1949483