本文選題：慢性阻塞性肺疾病 + 寒飲蘊(yùn)肺證�。� 參考：《山東中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：目的:根據(jù)前期自然基金課題的研究，對(duì)慢性阻塞性肺疾病(chronicobstructive pulmonary disease，COPD)及寒飲蘊(yùn)肺證進(jìn)行理論探索和系統(tǒng)總結(jié)，，以肺組織生長(zhǎng)因子VEGF、TGF-β1的動(dòng)態(tài)演變?yōu)橹饕^測(cè)對(duì)象，探討COPD寒飲蘊(yùn)肺證病機(jī)動(dòng)態(tài)演變與肺組織生長(zhǎng)因子VEGF、TGF-β1的關(guān)系，以豐富和發(fā)展COPD寒飲蘊(yùn)肺證理論。此課題延續(xù)采用寒涼刺激法結(jié)合煙熏及氣管內(nèi)滴注內(nèi)毒素（LPS）以建立COPD寒飲蘊(yùn)肺證大鼠模型，通過(guò)觀察模型大鼠60天自然演變過(guò)程以及自擬溫陽(yáng)化飲方,布地奈德干預(yù)下肺組織生長(zhǎng)因子VEGF、TGF-β1病機(jī)演變，來(lái)闡釋COPD寒飲蘊(yùn)肺證模型大鼠的肺組織生長(zhǎng)因子VEGF、TGF-β1、肺功能、肺組織形態(tài)學(xué)的動(dòng)態(tài)演變，及自擬溫陽(yáng)化飲方對(duì)COPD寒飲蘊(yùn)肺證的模型大鼠肺組織生長(zhǎng)因子VEGF、TGF-β1干預(yù)作用，來(lái)確定自擬溫陽(yáng)化飲方的作用性和時(shí)效性，為此病證防治提供新的思路和理論支撐。方法:運(yùn)用煙熏結(jié)合氣管內(nèi)滴注LPS，飲用冰水（0℃冰箱中冷凍成冰水混合物）復(fù)制成COPD寒飲蘊(yùn)肺證病證大鼠模型，觀察（其中間隔10天，共60天）該模型的自然狀態(tài)下的病機(jī)動(dòng)態(tài)演變，并運(yùn)用自擬溫陽(yáng)化飲方、布地奈德對(duì)該病證模型進(jìn)行動(dòng)態(tài)干預(yù)，并進(jìn)一步觀察該模型的一般情況，肺組織學(xué)，檢測(cè)相關(guān)肺功能指標(biāo)，肺組織生長(zhǎng)因子VEGF、TGF-β1。結(jié)果:此實(shí)驗(yàn)是在前課題的基礎(chǔ)上加以改進(jìn)后復(fù)制而成COPD寒飲蘊(yùn)肺證的大鼠模型，該模型的形態(tài)及行為、指標(biāo)變化與COPD寒飲蘊(yùn)肺證臨床表現(xiàn)相符。模型大鼠吸氣阻力、呼氣阻力升高,肺順應(yīng)性下降，肺組織生長(zhǎng)因子VEGF表達(dá)降低，TGF-β1表達(dá)升高，同時(shí)病理切片示肺組織出現(xiàn)了炎性損傷和纖維化變。在去除寒涼刺激因素后60天內(nèi)，模型大鼠的癥狀、各項(xiàng)指標(biāo)沒有明顯好轉(zhuǎn)，并且有出現(xiàn)惡化的趨勢(shì)，在40天左右大鼠寒飲蘊(yùn)肺證開始弱化，有可能轉(zhuǎn)變?yōu)槠渌C型。用自擬溫陽(yáng)化飲方進(jìn)行干預(yù)的模型大鼠癥狀出現(xiàn)好轉(zhuǎn)，肺功能有所改善，肺組織生長(zhǎng)因子VEGF表達(dá)升高，TGF-β1表達(dá)降低，病理切片顯示炎性損傷減輕，在40天左右達(dá)到峰值，基本接近正常大鼠水平。用布地奈德進(jìn)行干預(yù)的模型大鼠癥狀也有所好轉(zhuǎn)，但不能接近正常大鼠水平,其肺組織生長(zhǎng)因子VEGF表達(dá)升高不明顯，TGF-β1也無(wú)明顯降低，病理切片能顯示炎性損傷減輕。結(jié)論:運(yùn)用寒涼刺激加煙熏且氣管內(nèi)滴注LPS造模的COPD寒飲蘊(yùn)肺證大鼠模型是符合臨床試驗(yàn)動(dòng)物模型，具有良好的可靠性和穩(wěn)定性。肺組織血管的改變對(duì)COPD寒飲蘊(yùn)肺證影響頗大，肺組織生長(zhǎng)因子VEGF表達(dá)降低，TGF-β1表達(dá)升高與肺組織血管的形成關(guān)系密切。運(yùn)用自擬溫陽(yáng)化飲方干預(yù)能上調(diào)肺組織中生長(zhǎng)因子VEGF的表達(dá)和下調(diào)TGF-β1的表達(dá)，對(duì)COPD寒飲蘊(yùn)肺證療效肯定，且對(duì)該病證的治療上有時(shí)效性，肺組織生長(zhǎng)因子VEGF、TGF-β1是其作用靶點(diǎn)之一。
[Abstract]:Objective: to explore and systematically summarize the theory of chronic obstructive pulmonary disease (pulmonary) and the syndrome of cold drink retention of the lung according to the research of natural fund, and to observe the dynamic evolution of lung tissue growth factor (VEGF) TGF- 尾 1. To explore the relationship between the dynamic evolution of COPD cold drink syndrome and the lung tissue growth factor VEGF-尾 1 in order to enrich and develop the theory of COPD cold drink accumulation lung syndrome. This subject continued to establish the rat model of COPD cold drink accumulation of lung syndrome by using the cold stimulation method combined with smoking and intratracheal instillation of endotoxin. By observing the natural evolution process of the model rats in 60 days and the self-made warming Yanghua decoction. The pathogenesis of lung tissue growth factor (VEGF) TGF- 尾 1 was induced by budesonide to elucidate the dynamic evolution of lung tissue growth factor (VEGF) TGF- 尾 1, lung function and lung tissue morphology in rats with COPD cold drink syndrome. And the intervention effect of WYYY decoction on lung tissue growth factor (VEGF) TGF- 尾 1 in model rats with COPD cold drink syndrome, to determine the function and timeliness of WYY decoction, and to provide new ideas and theoretical support for the prevention and treatment of the disease syndrome. Methods: the rat model of COPD cold drink syndrome of lung syndrome was established by smoking and intratracheal instillation of LPSand freezing ice water mixture in refrigerator at 0 鈩

本文編號(hào)：1875800