本文選題：自擬更年湯 + 圍絕經(jīng)期大鼠模型��； 參考：《貴陽(yáng)中醫(yī)學(xué)院》2016年碩士論文

【摘要】：目的:通過(guò)臨床檢測(cè)治療前后腎陽(yáng)虛及腎陰陽(yáng)俱虛型絕經(jīng)綜合征(MPS)患者血清雌二醇(E2)、卵泡刺激素(FSH)、黃體生成素(LH)水平,探討自擬更年湯對(duì)性激素的影響。并在此基礎(chǔ)上構(gòu)建腎陽(yáng)虛型圍絕經(jīng)期大鼠模型,通過(guò)觀察相關(guān)藥物對(duì)腎陽(yáng)虛型圍絕經(jīng)期模型大鼠陰道脫落細(xì)胞、子宮指數(shù)、子宮的病理改變、子宮上血管內(nèi)皮生長(zhǎng)因子(VEGF)、雌激素受體(ER)、熱休克蛋白70(HSP70)及它們的信使核糖核酸(mRNA)表達(dá)的影響,探討自擬更年湯治療MPS的相關(guān)作用機(jī)制。方法:臨床研究:將70例腎陽(yáng)虛型或腎陰陽(yáng)兩虛型絕經(jīng)前后諸證患者隨機(jī)分為治療組和對(duì)照組,治療組予以自擬更年湯,對(duì)照組予以教材方。觀察兩組患者治療前后、治療后組間的血清性激素(E2、FSH、LH)水平的變化情況。實(shí)驗(yàn)研究:采用陰道脫落細(xì)胞動(dòng)情周期及各層細(xì)胞記量法篩選出自然老化的圍絕經(jīng)期雌性SD大鼠,臀部左右交替肌注氫化可的松構(gòu)建腎陽(yáng)虛型圍絕經(jīng)期大鼠模型,造模成功的模型大鼠被隨機(jī)分為模型組、教材方組、更年湯組、替勃龍組;對(duì)照組選4月齡的青年大鼠及18月齡的老年大鼠。各給藥組給予相應(yīng)藥物灌胃15d,于末次給藥24小時(shí)后,取陰道脫落細(xì)胞于顯微鏡下觀察陰道脫落細(xì)胞成熟指數(shù)(MI);處死大鼠后,剖取大鼠子宮稱重?fù)Q算子宮指數(shù);HE染色觀察子宮組織形態(tài)學(xué)改變;運(yùn)用免疫組化、原位雜交方法檢測(cè)子宮上HSP70、VEGF、ER、HSP70mRNA、VEGFmRNA、ERmRNA 的陽(yáng)性表達(dá)情況。結(jié)果:臨床研究:與治療前比較,更年湯和教材方均能降低患者血清FSH、LH水平,上調(diào)E2水平(P均0.05);治療后,更年湯組與教材方組比較,更年湯對(duì)FSH、LH的下調(diào)及對(duì)E2的上調(diào)作用均較教材方顯著(P均0.05)。實(shí)驗(yàn)研究:①更年湯組與老年組、模型組比較,可使表層細(xì)胞百分率升高,底層細(xì)胞百分率降低,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),更年湯組與替勃龍組、教材方組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。②更年湯組、替勃龍組、教材方組與模型組比較,均能明顯增加大鼠子宮指數(shù)(P均0.01),更年湯組、替勃龍組與教材方組比較增加較顯著(P0.01)。③更年湯與模型組比較,能改善子宮萎縮情況(P0.01),更年湯組與替勃龍組比較效果相當(dāng)(P0.05),與教材方組比較,其效果更佳(P0.05)。④更年湯組、教材方組、替勃龍組均能上調(diào)ER、ERmRNA、VEGF、VEGFmRNA陽(yáng)性表達(dá)(P0.05),但教材方組的上調(diào)低于更年湯組及替勃龍組(P0.05),替勃龍組與更年湯組之間比較無(wú)顯著差異(P0.05)。⑤更年湯組、替勃龍組與模型組、教材方組比較,能上調(diào)HSP70與HSP70mRNA的表達(dá)(P0.05),更年湯組與替勃龍組作用相當(dāng)(P0.05)。結(jié)論:臨床研究:自擬更年湯及教材方對(duì)腎陽(yáng)虛型或腎陰陽(yáng)兩虛型圍絕經(jīng)期患者的血清FSH、LH、E2水平均有良性調(diào)節(jié)作用,且更年湯的作用更佳。實(shí)驗(yàn)研究:自擬更年湯能使陰道上皮細(xì)胞成熟度、子宮指數(shù)增加,具有雌激素樣作用,且可能通過(guò)發(fā)揮其雌激素樣作用上調(diào)ER、VEGF、HSP70、HSP70mRNA、VEGFmRNA、ERmRNA在子宮中的陽(yáng)性表達(dá),延緩子宮結(jié)構(gòu)和功能的退行性改變,為卵巢提供充足的血供以維持其正常的生理功能,從而達(dá)到治療MPS的目的。
[Abstract]:Objective: To investigate the effect of self drafted MPS (E2), follicular stimulating hormone (FSH) and luteinizing hormone (LH) on the effects of the self drafted geniin Decoction on sex hormones, and on this basis, the rat model of kidney yang deficiency perimenopausal period was constructed and the related drugs were observed on Kidney Yang. In virtual perimenopausal model rats, vaginal exfoliative cells, uterine index, uterine pathological changes, uterine vascular endothelial growth factor (VEGF), estrogen receptor (ER), heat shock protein 70 (HSP70) and their messenger RNA (mRNA) expression are discussed. Methods: clinical study: clinical study: 70 The patients with kidney yang deficiency or kidney yin and yang two deficiency syndrome were randomly divided into the treatment group and the control group. The treatment group was given the self-designed Decoction and the control group was given the textbook. The changes of serum sex hormones (E2, FSH, LH) between the two groups were observed before and after treatment. The experimental study: the estrous cycle of vaginal exfoliative cells and the experimental study: the estrous cycle of vaginal exfoliative cells and the experimental study The female SD rats with natural aging in perimenopausal period were screened by each layer of cell recording. The rat model of kidney yang deficiency perimenopausal period was constructed by alternately intramuscular injection of hydrocortisone on the hip, and the model rats were randomly divided into model group, textbook group, more year soup group, tiperon group, and 4 month old young rats in the control group and 18 month old old age group. Rats were given the corresponding drugs for 15d, and after the last dose of 24 hours, the vaginal exfoliative cell maturation index (MI) was observed under the microscope. After the death of the rats, the uterus index of the uterus weighed and the uterus index of the rats were calculated. The histological changes of the uterus were observed by HE staining; immunohistochemistry and in situ hybridization were used to detect the offspring. The positive expression of HSP70, VEGF, ER, HSP70mRNA, VEGFmRNA, ERmRNA in the palace. Results: clinical study: compared with before treatment, more year soup and teaching materials can reduce the serum FSH, LH, and increase E2 (P 0.05); after treatment, the more year soup group is compared with the textbook group, and the younger soup to FSH, the downregulation of LH is more than the textbook. Significant (P 0.05). Experimental study: 1. Compared with the old group, the percentage of surface cells increased and the percentage of the underlying cells decreased. The difference was statistically significant (P0.05). There was no statistical significance (P0.05). Group comparison, can significantly increase the rat uterine index (P 0.01), more than the year soup group, the more significant increase (P0.01). 3. Compared with the model group, it can improve the situation of uterine atrophy (P0.01), the comparison between the group and the test group is comparable (P0.05), and the effect is better (P0.05). (4) more years. The positive expression of ER, ERmRNA, VEGF and VEGFmRNA (P0.05) was up to up in the soup group, the teaching material group and the tren group, but the up regulation of the teaching material group was lower than that of the more year soup group and the tren group (P0.05), and there was no significant difference (P0.05) between the two groups (P0.05). The expression of A (P0.05) and the effect of the more annual soup group and the trendron group (P0.05). Conclusion: clinical study: the self-designed Decoction and teaching materials have a benign regulating effect on the serum FSH, LH, E2 level in the patients with kidney yang deficiency or kidney yin and yang two deficiency perimenopausal period, and the use of more year soup is better. The degree of maturity, the uterus index increases, has the estrogenic effect, and may increase the positive expression of ER, VEGF, HSP70, HSP70mRNA, VEGFmRNA, ERmRNA in the uterus by exerting its estrogen like action, delaying the degenerative changes of the uterus structure and function, providing sufficient blood supply for the ovary to maintain its normal physiological function, so as to achieve the treatment of MPS The purpose.

【學(xué)位授予單位】：貴陽(yáng)中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R271.116

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