發(fā)布時(shí)間：2017-12-30 17:59

  本文關(guān)鍵詞：蔡氏健脾通便湯治療脾虛型便秘的實(shí)驗(yàn)研究和臨床觀察　出處：《廣州中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 蔡氏健脾通便湯 慢性便秘 脾虛型 實(shí)驗(yàn)研究 臨床觀察

【摘要】：目的：本研究通過(guò)綜合整理導(dǎo)師治療便秘的思維模式及臨床經(jīng)驗(yàn),結(jié)合既往的實(shí)驗(yàn)研究資料,試圖從臨床療效觀察和基礎(chǔ)實(shí)驗(yàn)研究?jī)蓚�(gè)角度探索“蔡氏健脾通便湯”治療脾虛型便秘的短期療效及遠(yuǎn)期效果。方法：動(dòng)物實(shí)驗(yàn)研究部分：選用昆明小鼠156只,雌雄各半,體重(20±2)g,應(yīng)用復(fù)合因素造模法建立脾虛便秘的小鼠模型,隨機(jī)分為6組：空白對(duì)照組(正常組)、造模組、蔡氏健脾通便湯高劑量組(高劑量組)、蔡氏健脾通便湯中劑量組(中劑量組)、蔡氏健脾通便湯低劑量組(低劑量組)、乳果糖組,造模完成后,各治療組小鼠分別給藥治療,連續(xù)7天,觀察各組小鼠的一般情況、體重和大便改變情況。在每組中隨機(jī)選出8只小鼠觀察停藥后各組小鼠一般情況、體重及大便情況,余小鼠分別用墨汁推進(jìn)試驗(yàn)檢測(cè)腸道推進(jìn)功能,用比色分析法測(cè)定各組血清D-木糖含量,用蘇木素—伊紅(HE)染色法觀察結(jié)腸病理改變。臨床病例研究部分：將2015年3月—2016年3月至湛江市第一中醫(yī)醫(yī)院門診及住院的42例脾虛型便秘患者隨機(jī)分為蔡氏健脾通便湯組(治療組)和乳果糖組(對(duì)照組),每組各21例,比較兩組患者臨床療效、便秘的主要臨床癥狀和伴隨癥狀、結(jié)腸傳輸功能改善情況、不良反應(yīng)及停藥2月后便秘復(fù)發(fā)情況。結(jié)果：動(dòng)物實(shí)驗(yàn)研究部分 1.體重：治療后及停藥8天后,與正常組相比,造模組的體重明顯下降(P0.05)；與造模組相比,各治療組小鼠體重明顯增加(P0.05)且在治療后,高劑量組較低劑量組體重明顯增加(P0.05)。2.灌胃6h后糞便情況：與造模組相比,各治療組小鼠糞便數(shù)量、重量、粒糞便重量明顯增加(P0.05)；與正常組相比,造模組小鼠粒糞便重量、數(shù)量明顯下降(P0.05)；與正常組相比,中、低劑量組、乳果糖組及造模組小鼠糞便重量明顯下降(PO.05)。3.停藥后糞便情況：與正常組相比,造模組數(shù)量、重量、粒糞便重量明顯下降(P0.05)；與造模組比較,各治療組小鼠糞便數(shù)量、重量、粒糞便重量明顯增加(P0.05)；與高劑量組相比,中、低劑量組、乳果糖組粒糞便重量明顯下降(P0.05)；與中劑量組相比,乳果糖組及造模組粒糞便重量明顯下降(P0.05)。4.腸道推進(jìn)功能：與正常組比較,造模組小鼠腸道推進(jìn)率明顯降低(PO.05),與造模組相比,各治療組小鼠腸道推進(jìn)率明顯升高(PO.05),且高、中劑量組的腸道推進(jìn)功能明顯高于低劑量組及乳果糖組(P0.05)。5.血清D-木糖水平：與正常組相比,造模組小鼠血清D—木糖水平明顯下降(P0.05)；與造模組比較,各治療組血清D—木糖水平明顯增加(P0.05)。臨床病例研究部分 1.給藥后治療組患者總有效(95.24%)高于對(duì)照組(85.71%),但兩組之間差異性不顯著(P0.05)。2.給藥后治療組患者便秘主要臨床癥狀和伴隨癥狀均較對(duì)照組患者顯著降低(P0.05)。3.給藥后治療組結(jié)腸傳輸功能改善的總有效率顯著高于對(duì)照組(P0.05)。4.給藥過(guò)程中治療組的不良反應(yīng)率顯著低于對(duì)照組(P0.05)。5.停藥2m時(shí)治療組患者便秘的復(fù)發(fā)率均顯著低于對(duì)照組(P0.05)。結(jié)論：蔡氏健脾通便湯對(duì)脾虛便秘型小鼠療效明顯,具有健脾通便的作用,其中以高、中劑量組明顯,突出表現(xiàn)在停藥后粒糞便重量的改善及腸道推進(jìn)功能促進(jìn)方面；蔡氏健脾通便湯對(duì)脾虛型便秘患者具有較好的臨床療效,主要在服藥中的不良反應(yīng)和停藥后復(fù)發(fā)方面優(yōu)勢(shì)明顯,值得臨床推薦。
[Abstract]:Objective: To study the mode of thinking and clinical experience of comprehensive tutor in the treatment of constipation, combined with previous studies on the experimental data, attempts to explore "Chua's spleen through short-term curative effect and long-term effect Decoction" in the treatment of spleen deficiency constipation from two angles of observation and experimental study on basis of clinical curative effect. Methods: animal experiment: selection of Kunming 156 mice, male and female, weight (20 + 2) g mouse model, application of composite factors establish spleen deficiency constipation modeling method, were randomly divided into 6 groups: control group (normal group), model group, Chua's spleen Tongbian Decoction high dose group (high dose group), Chua Jianpi Tongli dose group then the soup (medium dose group), Chua's spleen Tongbian Decoction low dose group (low dose group), lactulose group. After modeling, the treatment group mice were administered for 7 consecutive days, the general condition of the mice were observed, and the changes of stool weight 2. Randomly selected in each group of 8 mice in each group were observed after discontinuation of the general condition of mice body weight and defecate, more than mice were treated with ink propelling test intestinal propulsive function, serum D- xylose content by colorimetric method, using hematoxylin - Yi Hong (HE) staining was used to observe the pathological changes of the colon. Clinical research: March 2015 - March 2016 to Zhanjiang City, the first hospital of traditional Chinese medicine outpatient hospital and 42 cases of spleen deficiency constipation patients were randomly divided into spleen group Chua's Tongbian Decoction (treatment group) and lactulose group (control group), 21 cases in each group, compared the clinical efficacy of the two groups, the main clinical symptoms of constipation and with the symptoms of colonic transit function to improve the situation, the situation of recurrent constipation adverse reaction and drug withdrawal after February. Results: part 1.: experimental study of animal weight after treatment and 8 days after drug withdrawal, compared with the normal group, model group weight Decreased (P0.05); compared with the model group, the weight of each treatment group mice significantly increased (P0.05) and after treatment, high dose group and low dose group significantly increased body weight (P0.05) stool.2. gavage after 6h: compared with the model group, the number of each treatment group, mice feces weight, feces the weight increased significantly (P0.05); compared with the normal group, model group mice feces weight number decreased significantly (P0.05); compared with the normal group, low dose group, lactulose group and model group mice feces weight decreased significantly (PO.05) after discontinuation of.3. stool: compared with the normal group, the model number, grain weight, stool weight decreased significantly (P0.05); compared with model, quantity and weight of each group of mice feces, feces weight increased significantly (P0.05); compared with the high dose group, low dose group, lactulose group significantly decreased the grain weight of feces (P0.05); and agent Volume group, lactulose group and model group were significantly decreased stool weight (P0.05).4. intestinal propulsive function: compared with the normal group, build module of mouse intestinal propulsion rate was significantly reduced (PO.05), compared with the model group, the treatment group significantly increased the intestinal propulsion rate (PO.05), and high dose group. The intestinal propulsive function was significantly higher than the low dose group and lactulose group (P0.05.5.) serum D- xylose level: compared with the normal group, model group, mice serum D xylose levels were significantly decreased (P0.05); compared with model group, each treatment group serum D xylose level increased significantly (P0.05). The clinical research part 1. after administration of the total effective treatment group (95.24%) was higher than the control group (85.71%), but no significant difference between the two groups (P0.05) in patients with constipation treatment.2. after administration of the main clinical symptoms and associated symptoms were significantly lower than that in control group (P0.05) after administration of.3. The treatment group of colonic transit function improvement of total efficiency was significantly higher than the control group (P0.05.4.) to the adverse reaction rate of the treatment group was significantly lower than the control group in the process of drug discontinuation of.5. (P0.05) 2m treatment group patients with constipation recurrence rate were significantly lower than the control group (P0.05). Conclusion: Jianpi Chua Tongbian Decoction significantly the effect of spleen deficiency constipation mice with spleen laxative effect, which was high, middle dose group, outstanding performance after the discontinuation of grain improvement and intestinal propulsive function promoting weight; spleen Chua's Tongbian decoction has good clinical curative effect on spleen deficiency constipation patients, the main adverse reaction in the treatment and the recurrence of obvious advantages, is worthy of recommendation.

【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R256.35

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