發(fā)布時間：2018-06-15 20:39

  本文選題：病理模型 + 低流阻通道　； 參考：《北京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：[目的]經(jīng)脈不通是導(dǎo)致肢體和內(nèi)臟病候的病理機制之一。疏通經(jīng)絡(luò)是針灸最主要的治療作用。本研究通過制造小型豬胃經(jīng)和腎經(jīng)“經(jīng)脈不通”的病理模型,觀察該模型產(chǎn)生的整體病候表現(xiàn)和臟器的病理變化,以發(fā)現(xiàn)阻塞循經(jīng)低流阻通道的相關(guān)病理特征與經(jīng)脈病候之間的關(guān)系,從而建立一套研究“經(jīng)脈不通”病理模型的宏觀定量觀察方法,并與組織學(xué)檢測方法相結(jié)合,為中醫(yī)的實驗研究提供新的思路和方法。[方法]選用同品系小型豬19只,分為胃經(jīng)不通組(胃經(jīng)組)7只、腎經(jīng)不通組(腎經(jīng)組)7只和空白對照組(對照組)5只,每日給予定量的飲用水和飼料。使用凝膠注射法分別堵塞胃經(jīng)組的胃經(jīng)低流阻通道和腎經(jīng)組的腎經(jīng)低流阻通道,對照組只做麻醉處理。觀察造模后取材前7天每日的飲水量、尿量、糞便濕重和烘干后的糞便干重。其中,每組選取1只小型豬(胃經(jīng)豬、腎經(jīng)豬和對照豬)進行造模前后每日飲水量和尿量的連續(xù)觀察。造模當天和取材當天測量小型豬的體重與體尺(胸圍、腰圍、腹圍、體長),抽取耳背靜脈血進行血清尿素氮與肌酐的檢測；取材當天經(jīng)膀胱壁抽取尿液,進行尿液的常規(guī)生化指標檢測。使用游標卡尺測量門齒和犬齒的長度、前臼與臼齒的寬度,使用電子秤稱量各臟器的離體重量,拍照記錄面積測定盤上各臟器的離體面積,根據(jù)照片用數(shù)格法計算各臟器的投影面積。在上述已獲數(shù)據(jù)的基礎(chǔ)上,計算糞便含水量、體軀指數(shù)、臟器重量系數(shù)、臟器面積系數(shù)和腸長度系數(shù)。隨機取心、肝、脾、肺、腎、胃、睪丸、胰腺、膀胱、前列腺、十二指腸、空腸、回腸、盲腸、結(jié)腸和直腸的一塊組織放入固定液中固定,制作并觀察各組織的HE染色切片,測量小腸的絨毛長度和隱窩深度,大腸的黏膜厚度。用免疫組化技術(shù)處理胃的石蠟切片,測定胃泌素的陽性信號面積密度。[結(jié)果]1.宏觀觀察：1.1飲水量及二便量連續(xù)觀察的3只小型豬造模前后的飲水量及尿量比較結(jié)果顯示,胃經(jīng)豬造模后的飲水量比造模前增加49.31%(P0.01),造模后的尿量比造模前增加56.54%(P0.01)。腎經(jīng)豬造模前后飲水量與尿量的變化無統(tǒng)計學(xué)意義(P0.05),且造模后的飲水量和尿量均未增加,反而略有下降。對照豬造模后的飲水量比造模前增加35.00%(P0.01),造模后的尿量比造模前增加37.45%(P0.05)。造模后的飲水量、尿量和糞便含水量比較結(jié)果顯示,胃經(jīng)組的飲水量比腎經(jīng)組高37.52%(P0.01),比對照組高30.62%(P0.05)；腎經(jīng)組與對照組的飲水量相比無統(tǒng)計學(xué)意義(P0.05)。胃經(jīng)組的尿量比腎經(jīng)組高57.40%(P0.01),比對照組高41.24%(P0.05)；腎經(jīng)組與對照組的尿量相比無統(tǒng)計學(xué)意義(P0.05)。胃經(jīng)組的糞便含水量比腎經(jīng)組低35.10%(P0.01)；對照組的糞便含水量分別與胃經(jīng)組和腎經(jīng)組相比均無統(tǒng)計學(xué)意義(P0.05)。1.2體重各組小型豬造模前后的體重差值均無統(tǒng)計學(xué)意義(P0.05)。1.3多臟器剖檢觀察各組肺的顏色、胃經(jīng)組和對照組肺的質(zhì)地和黏膜均見不同程度的異常；胃經(jīng)組心臟的內(nèi)容物和對照組心臟的黏膜見不同程度的異常。對照組肝臟的質(zhì)地、黏膜及腎經(jīng)組肝臟的表面偶見異常。對照組脾的質(zhì)地和黏膜偶見異常。胃經(jīng)組的胰腺顏色偶見異常。腎經(jīng)組膀胱內(nèi)偶見粉末狀白色顆粒。各組小腸與大腸均見不同程度臌氣。1.4牙齒腎經(jīng)組的雙側(cè)第1門齒長度分別大于胃經(jīng)組30.79%(P0.01)和對照組20.62%(P0.01)。1.5體軀指數(shù)胃經(jīng)組的腰圍體軀指數(shù)大于對照組6.78%(P0.05)。1.6臟器重量系數(shù)胃經(jīng)組的腎臟臟器重量系數(shù)高于對照組23.60%(P0.01)；腎經(jīng)組的腎臟臟器重量系數(shù)高于對照組12.82%(P0.05)。腎經(jīng)組心臟臟器重量系數(shù)低于對照組24.14%(P0.05)。腎經(jīng)組的睪丸臟器重量系數(shù)低于胃經(jīng)組22.22%(P=0.054),低于對照組26.32%(P=0.36)。1.7臟器面積系數(shù)腎經(jīng)組的心臟臟器面積系數(shù)小于胃經(jīng)組20.00%(P0.05)。腎經(jīng)組的脾臟器面積系數(shù)小于對照組35.48%(P0.01)。1.8腸長度系數(shù)各組小腸和大腸的長度系數(shù)之間無統(tǒng)計學(xué)意義(P0.05)。2.微觀檢測與觀察：2.1血液指標各組尿素氮造模前后的組間比較均無統(tǒng)計學(xué)意義(P0.05)。胃經(jīng)組與對照組血清肌酐水平造模前均小于參考范圍,各組造模后的血清肌酐水平均比造模前顯著增高。造模后的組間比較結(jié)果顯示,腎經(jīng)組造模后的血清肌酐水平比胃經(jīng)組低13.76%(P0.05),比對照組低14.51%(P0.01)；各組造模后的組間比較均無統(tǒng)計學(xué)意義(P0.05)。2.2尿液指標腎經(jīng)組與對照組的尿葡萄糖均為陽性；腎經(jīng)組的尿比重大于參考范圍；各組隱血、尿蛋白均為陽性；胃經(jīng)組與腎經(jīng)組尿膽紅素、酮體和白細胞均呈陽性。2.3組織學(xué)觀察3組小型豬均出現(xiàn)不同程度的心肌纖維壞死；肝中央靜脈、小葉間靜脈和肝竇可見不同程度的淤血,狄氏隙顯現(xiàn),匯管區(qū)有少量炎性細胞浸潤；肺臟出現(xiàn)肺泡輕度擴張,肺靜脈毛細血管淤血。各組偶見胃黏膜出血、水腫及淤血；腎小管、腎小球病變。腎經(jīng)組4/7例睪丸曲細精管萎縮,其內(nèi)未見(或數(shù)量減少)正常的各級生精細胞,間質(zhì)增寬。腎經(jīng)組與對照組偶見膀胱黏膜輕度充血及水腫,胃經(jīng)組未見明顯異常。各組前列腺均未見明顯異常。小腸絨毛長度結(jié)果顯示,各組十二指腸、空腸與回腸小腸絨毛長度之間均無統(tǒng)計學(xué)意義(P0.05)。各組小腸隱窩深度結(jié)果顯示,胃經(jīng)組的十二指腸隱窩深度高于正常組18.33%(P0.05)；腎經(jīng)組的十二指腸隱窩深度高于正常組20.84%(P0.01)；胃經(jīng)組回腸隱窩深度小于腎經(jīng)組13.60%(P0.01)；各組小腸隱窩深度總平均值之間均無統(tǒng)計學(xué)意義(P0.05)。各組小腸絨毛長度與隱窩深度比值(V/C)的統(tǒng)計結(jié)果顯示,腎經(jīng)組的十二指腸V/C值小于對照組15.74%(P0.05)；胃經(jīng)組的空腸V/C值小于腎經(jīng)組16.44%(P0.05)；胃經(jīng)組回腸V/C值大于腎經(jīng)組25.91%(P0.01)。各組大腸黏膜厚度統(tǒng)計結(jié)果顯示,胃經(jīng)組結(jié)腸黏膜厚度大于對照組53.28%(P0.01)；腎經(jīng)組結(jié)腸黏膜厚度大于對照組68.15%(P0.01)；胃經(jīng)組的大腸黏膜層總厚度大于對照組7.32%(P0.05)。各組胃黏膜胃泌素陽性信號面積密度統(tǒng)計結(jié)果顯示,腎經(jīng)組比胃經(jīng)組高28.65%(P0.05),比對照組高32.83%(P0.05)。[結(jié)論]1.堵塞胃經(jīng)低流阻道小型豬出現(xiàn)了與胃經(jīng)和胃腸特異相關(guān)的病候；堵塞腎經(jīng)低流阻通道小型豬出現(xiàn)了與腎經(jīng)和腎膀胱特異相關(guān)的病候,證明低流阻通道是經(jīng)絡(luò)的解剖結(jié)構(gòu)之一,“經(jīng)脈不通”是導(dǎo)致相關(guān)經(jīng)脈臟腑病變的病理機制之一。2.初步建立了小型豬“經(jīng)脈不通”病理模型的宏觀定量觀察法,使用該方法對經(jīng)脈不通進行研究具有可行性,為經(jīng)絡(luò)研究提供了新的思路和方法。
[Abstract]:In this study , we studied the relationship between the pathological characteristics of small pigs and the pathological changes of the organs , and established a set of macroscopic quantitative observation methods for the pathological models of the stomach meridian and the kidney meridian of the small pigs .
The water content , body index , organ weight coefficient , organ area coefficient and intestinal length coefficient were measured by using vernier caliper . The water content , body index , organ weight coefficient , organ area coefficient and intestinal length coefficient were calculated .
Compared with the control group , there was no significant difference between the two groups ( P0.05 ) . The urine volume of the stomach meridian group was 57.40 % higher than that of the control group ( P0.01 ) , which was 41.24 % higher than that of the control group ( P0.05 ) .
Compared with the control group , there was no significant difference in urine volume between the kidney meridian group and the control group ( P0.05 ) . The stool water content of the stomach meridian group was 35.10 % lower than that of the renal meridian group ( P0.01 ) .
There was no significant difference ( P0.05 ) . 1 . 2 The body weight difference before and after the small - sized pigs in each group had no statistical significance ( P0.05 ) .
In the control group , there was no abnormality in the texture , the mucous membrane and the kidneys of the control group . The texture and the mucous membrane of the liver in the control group were abnormal . The size of the spleen in the group of the control group was more than that of the control group .
There was no significant difference between the two groups ( P = 0 . 05 ) . Compared with the control group , there was no significant difference between the two groups ( P = 0 . 05 ) .
There was no significant difference between the groups after modeling ( P0.05 ) . The urine glucose in the urine index kidney meridian group and the control group was positive ;
The urine specific gravity of the kidney meridian group was larger than that of the reference range ;
All groups of occult blood and urine protein were positive ;
The urine bilirubin , ketone bodies and white blood cells of the stomach meridian group were positive . 2 . 3 histological observation showed that the three groups of small pigs had different degrees of cardiac muscle fiber necrosis ;
The hepatic central vein , interlobular vein and hepatic sinus can be seen with different degrees of stasis , with a small number of inflammatory cell infiltration in the manifold area .
In the lungs , the pulmonary alveolar was slightly dilated and pulmonary venous capillary stasis . Gastric mucosal bleeding , edema and congestion were occasionally seen in each group .
The results showed that there was no statistically significant difference between the two groups ( P0.05 ) . The results showed that the depth of duodenum recess in the stomach meridian group was higher than that in the normal group ( 18.33 % ) ( P0.05 ) .
The depth of duodenum recess in the renal meridian group was higher than that in the normal group ( 20.84 % ) ( P0.01 ) .
The depth of ileum in gastric meridian group was less than 13.60 % ( P0.01 ) .
There was no significant difference ( P0.05 ) between the total mean values of small intestinal villi and the depth of recess depth ( V / C ) in each group . The results showed that the value of duodenum V / C in the renal meridian group was less than 15.74 % in the control group ( P0.05 ) .
The fasting V / C value of the stomach meridian group was lower than that in the kidney meridian group ( 16.44 % ) ( P0.05 ) .
The results showed that the colonic mucosa thickness of the gastric meridian group was greater than that of the control group ( 53.28 % ) ( P0.01 ) .
The thickness of colonic mucosa in renal meridian group was higher than that in control group 68.15 % ( P0.01 ) .
The results showed that the total thickness of gastric mucosa in gastric mucosa was higher than that in the control group ( 7.32 % ) ( P0.05 ) . The results showed that the renal meridian group was 28.65 % higher than that in the control group ( P0.05 ) .
It is proved that the low - flow resistance channel is one of the anatomical structures of the channels and collaterals , which is one of the pathological mechanisms leading to the pathological changes of the related meridians .
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R245

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1 李宏彥;小型豬胃經(jīng)與腎經(jīng)“經(jīng)脈不通”病理模型的比較研究[D];北京中醫(yī)藥大學(xué);2016年

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