本文選題：穴位注射　切入點(diǎn)：哮喘　出處：《重慶醫(yī)科大學(xué)》2007年碩士論文

【摘要】： 支氣管哮喘(bronchial asthma)是以嗜酸性粒細(xì)胞浸潤(rùn)為主、多種炎癥細(xì)胞介導(dǎo)的慢性變態(tài)反應(yīng)性炎癥疾病,反復(fù)發(fā)作可使氣道上皮損傷,造成不可逆的氣道狹窄,影響患者的健康。 糖皮質(zhì)激素是治療哮喘的有效藥物,可改善哮喘患者的肺功能和生活質(zhì)量。但長(zhǎng)期給予糖皮質(zhì)激素可產(chǎn)生激素類的副作用,表現(xiàn)為肌無(wú)力、肌萎縮、向心性肥胖、滿月臉、水牛背等,造成患者不能堅(jiān)持用藥。 穴位注射是一種中西醫(yī)結(jié)合的治療方法,具有臨床效果顯著、見(jiàn)效迅速,簡(jiǎn)單易行,節(jié)約藥物,便于推廣等優(yōu)點(diǎn)。肺俞穴與大椎穴為針灸治療哮喘的主要穴位,可用于各種呼吸道疾病,如肺炎、支氣管炎、肺結(jié)核等的治療。 本實(shí)驗(yàn)以地塞米松磷酸鈉為工具藥物,對(duì)大椎穴進(jìn)行穴位注射,考察穴位注射與肌肉注射、靜脈注射在組織中的分布和藥物動(dòng)力學(xué)差異,以探討穴位注射治療哮喘的機(jī)理。 第一部分:穴位的確定采用數(shù)字萬(wàn)用表測(cè)定人合谷穴及距穴位0.5cm, 1cm, 1.5cm處的針刺電阻與皮膚電阻,證實(shí)穴位處的電阻低于非穴位電阻,表明可通過(guò)電阻值確定穴位。通過(guò)測(cè)定大鼠基準(zhǔn)點(diǎn)及基準(zhǔn)點(diǎn)2mm, 4mm, 8mm, 1cm處的電阻值,確定了大椎穴和肺俞穴,同時(shí)表明以往根據(jù)圖譜確定穴位的方法存在著誤差,以穴位的低電阻性來(lái)確定穴位更為科學(xué)。 第二部分:血漿及組織中地塞米松的HPLC測(cè)定方法的建立以地塞米松磷酸鈉為工具藥物,氫化可的松為內(nèi)標(biāo),建立了HPLC的測(cè)定方法,其血漿及組織中回收率均在95%以上,日內(nèi)RSD與日間RSD均小于5%,測(cè)定樣品在96小時(shí)內(nèi)穩(wěn)定。表明該方法準(zhǔn)確、可靠,符合實(shí)驗(yàn)要求。 第三部分:地塞米松穴位與靜脈、肌肉注射的分布和藥物動(dòng)力學(xué)采用HPLC測(cè)定方法,測(cè)定了SD大鼠穴位與靜脈、肌肉注射的藥物分布和藥物動(dòng)力學(xué)。體內(nèi)分布研究表明:穴位注射在血中的藥物濃度較靜脈、肌肉注射低,而在肝、肺、腎、脾中的藥物含量較靜脈、肌肉注射高。藥物動(dòng)力學(xué)研究表明:穴位注射給藥后0.17, 0.5, 1, 2, 4, 8小時(shí)的血漿藥物濃度低于靜脈、肌肉注射,而在肝、肺、腎、脾中的藥物含量卻較靜脈、肌肉注射高,其中肺部藥物分布第二高。表明穴位注射可影響藥物在組織的分布和藥物動(dòng)力學(xué)參數(shù),提高藥物在肺部的分布,有利于哮喘的治療。 本實(shí)驗(yàn)證實(shí)了可通過(guò)測(cè)定電阻值確定穴位,在皮膚電阻確定穴位的基礎(chǔ)上發(fā)展了針刺電阻的穴位確定方法,可更準(zhǔn)確的確定穴位的位置;建立了HPLC測(cè)定地塞米松磷酸鈉的血和組織中的含量測(cè)定方法;首次證實(shí)穴位注射地塞米松磷酸鈉可改變藥物在組織中的分布和藥物動(dòng)力學(xué)參數(shù),提高藥物在肺部的分布,有利于哮喘的治療。
[Abstract]:Bronchial asthma is a chronic allergic inflammatory disease with eosinophilic granulocyte infiltration and many kinds of inflammatory cells. Repeated attacks can damage the airway epithelium, cause irreversible stenosis of the airway, and affect the health of the patients.Glucocorticoid is an effective drug for the treatment of asthma, which can improve the lung function and quality of life of asthmatic patients.But long-term glucocorticoids can produce hormone side effects, such as myasthenia, muscle atrophy, heart obesity, full moon face, buffalo back and so on.Acupoint injection is a method of integrated Chinese and western medicine, which has the advantages of obvious clinical effect, quick effect, simple and easy to carry out, saving medicine and easy to be popularized.The points of Feshu and Dazhui are the main points of acupuncture and moxibustion for the treatment of asthma, which can be used in the treatment of various respiratory diseases such as pneumonia, bronchitis, tuberculosis and so on.Using dexamethasone sodium phosphate as a drug, the point injection at Dazhui point was used to investigate the difference of distribution and pharmacokinetics between acupoint injection and intramuscular injection, so as to explore the mechanism of acupoint injection in the treatment of asthma.The first part: the determination of acupoints using digital multimeter to determine the acupuncture resistance and skin resistance at the point of human Hegu and the distance of 0.5 cm, 1 cm, 1.5cm. It is proved that the resistance of the acupoint is lower than that of the non-acupoint, which indicates that the acupoint can be determined by the resistance value.Dazhui point and Feshu point were determined by measuring the electrical resistance values at 2 mm, 4 mm, 8 mm and 1cm of the reference points in rats. It was also indicated that there were errors in the methods of determining acupoints according to the atlas, and it was more scientific to determine the acupoints by the low electrical resistance of the acupoints.The second part: the method for the determination of dexamethasone in plasma and tissue was established by using dexamethasone sodium phosphate as the drug and hydrocortisone as the internal standard. The method for the determination of dexamethasone in plasma and tissue was established. The recovery of dexamethasone in plasma and tissue was over 95%.Both intraday RSD and daytime RSD were less than 5 and the samples were stable within 96 hours.The results show that the method is accurate, reliable and in line with the experimental requirements.Part three: the distribution and pharmacokinetics of dexamethasone at acupoints and veins and intramuscular injection were determined by HPLC method. The drug distribution and pharmacokinetics of intramuscular injection were determined in SD rats.The results of distribution in vivo showed that the concentration of drugs in blood was lower in acupoint injection than in intravenous injection, but higher in liver, lung, kidney and spleen than in intravenous injection.Pharmacokinetic study showed that the plasma drug concentration at 0.17,0.5, 1,2,4,8 hours after acupoint injection was lower than that by intramuscular injection, but the content of drugs in liver, lung, kidney and spleen was higher than that in intravenous, intramuscular injection.Pulmonary drug distribution was the second highest.The results showed that acupoint injection could affect the distribution of drugs in tissues and pharmacokinetic parameters, increase the distribution of drugs in lung, and be beneficial to the treatment of asthma.This experiment confirmed that the point can be determined by measuring the resistance value, on the basis of the skin resistance to determine the acupoint, the development of acupuncture resistance point determination method, can more accurately determine the point position;A method for the determination of dexamethasone sodium phosphate in blood and tissue by HPLC was established, and it was proved for the first time that injection of dexamethasone phosphate at acupoint could change the distribution of drugs in tissues and pharmacokinetic parameters, and increase the distribution of drugs in lung.It is beneficial to the treatment of asthma.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R246

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 董月靈;轉(zhuǎn)移因子、VitK_3穴位注射治療兒童支氣管哮喘48例[J];安徽中醫(yī)臨床雜志;2003年05期

2 楊華元，夏錦杉，顧訓(xùn)杰，封蘇宇;經(jīng)穴皮膚電阻動(dòng)態(tài)參數(shù)測(cè)定系統(tǒng)及其應(yīng)用[J];北京生物醫(yī)學(xué)工程;1997年01期

3 李自雙,歐陽(yáng)克清,張顯全,俞為群,蔡紹皙;大白鼠皮膚低電阻點(diǎn)的成因初探[J];重慶大學(xué)學(xué)報(bào)(自然科學(xué)版);1998年03期

4 劉曉，，趙建清;針刺肺俞穴致死兩例報(bào)告[J];法律與醫(yī)學(xué)雜志;1995年04期

5 郭燕;錢(qián)寶延;;穴位注射為主治療老年慢性支氣管哮喘86例臨床觀察[J];光明中醫(yī);2006年09期

6 張力琴;定喘穴位注射治療支氣管哮喘急性發(fā)作60例[J];河北中醫(yī);2003年08期

7 梁萬(wàn)增,俞淑花;654-2定喘穴注射治療支氣管哮喘急性發(fā)作32例[J];河北中醫(yī);2004年11期

8 康曉娥,卓玉翠,趙福氣,黎中濤,楊娜英;化膿灸對(duì)支氣管哮喘發(fā)作期血漿中白三烯C_4的影響[J];湖南中醫(yī)雜志;2000年03期

9 楊生緒;中西醫(yī)結(jié)合治療支氣管哮喘126例總結(jié)[J];湖南中醫(yī)雜志;2003年04期

10 李青堂,李保香,張智敏,周彥芳;肺炎治療儀治療小兒肺炎180例[J];河南醫(yī)藥信息;2003年02期

本文編號(hào)：1698259