【摘要】：目的:(1)動(dòng)物實(shí)驗(yàn)研究肺抑瘤膏對(duì)lewis肺癌小鼠移植瘤的干預(yù)機(jī)制,為肺抑瘤膏治療晚期肺腺癌提供一定的理論依據(jù)。(2)臨床研究74例原發(fā)性支氣管肺癌患者中醫(yī)證型與病理類型的相關(guān)性,為中醫(yī)辨證分型提供客觀化依據(jù)。方法:(1)動(dòng)物實(shí)驗(yàn)建立lewis肺癌小鼠模型,隨機(jī)分為六組,分別為模型對(duì)照組(M組)、肺抑瘤膏低劑量組(ZD組)、肺抑瘤膏中劑量組(ZZ組)、肺抑瘤膏高劑量組(ZG組)、順鉑組(S組)及肺抑瘤膏加順鉑組(SZ組),造模第5天,對(duì)不同組分別予以相應(yīng)的藥物處理,給藥21天結(jié)束后脫頸椎處死小鼠取移植瘤,測(cè)量瘤重,并通過流式細(xì)胞術(shù)Annexin V-FITC/PI法檢測(cè)細(xì)胞凋亡率。(2)臨床研究將74例不同病理類型的肺癌患者辨證分型為氣滯血瘀型、氣虛血瘀型、氣陰兩虛型、陰虛內(nèi)熱型、脾虛痰濕型、熱毒熾盛型,對(duì)中醫(yī)證型與病理類型進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:(1)瘤重、抑瘤率:各實(shí)驗(yàn)組瘤重較M組平均瘤重低,差別具有統(tǒng)計(jì)學(xué)意義(p0.05)。中藥組除ZZ組與ZG組間P0.05,其余中藥組組間比較有統(tǒng)計(jì)學(xué)意義,中藥劑量越高,瘤重越小;SZ組對(duì)腫瘤的抑制作用最佳,其次為S組。(2)細(xì)胞凋亡率:各實(shí)驗(yàn)組凋亡率均高于M組,具有統(tǒng)計(jì)學(xué)意義(P0.05);組間兩兩進(jìn)行對(duì)比,除ZZ組與ZG組比較P0.05外,其余各組組間比較P值均小于0.05,具有統(tǒng)計(jì)學(xué)意義。(3)臨床研究發(fā)現(xiàn)腺癌與鱗癌的中醫(yī)證型分布存在差異(P0.05)。腺癌患者中氣陰兩虛占33.3%,陰虛內(nèi)熱型占30.8%;鱗癌患者中氣滯血瘀型占38.1%,氣虛血瘀型,占28.6%。小細(xì)胞癌、大細(xì)胞癌、及其他類型的肺癌因樣本數(shù)量少,在不同中醫(yī)證型患者中的分布情況無統(tǒng)計(jì)學(xué)意義。結(jié)論:(1)肺抑瘤膏對(duì)lewis肺癌移植瘤生長有抑制作用,肺抑瘤膏中劑量與肺抑瘤膏高劑較低劑量的抑瘤作用明顯。(2)肺抑瘤膏能夠通過促腫瘤細(xì)胞凋亡抑制腫瘤的生長。(3)肺抑瘤膏對(duì)順鉑抑制腫瘤生長有協(xié)同增效作用。(4)肺腺癌以虛證(氣陰兩虛型、陰虛內(nèi)熱型)為主,鱗癌以實(shí)證(氣滯血瘀型、氣虛血瘀型)為主,可作為微觀辨證的一個(gè)指標(biāo)。因小細(xì)胞肺癌、大細(xì)胞癌及其他類型的肺癌樣本數(shù)量少,在不同中醫(yī)證型中的分布無統(tǒng)計(jì)學(xué)意義,有待于進(jìn)一步增加樣本量,以探討其中醫(yī)證型的分布情況。
[Abstract]:Objective: (1) to study the interventional mechanism of Fei Yi Liu Gao (FYO) on transplanted tumor of lewis lung cancer mice. To provide a theoretical basis for the treatment of advanced lung adenocarcinoma. (2) Clinical study of 74 cases of primary bronchial lung cancer patients with traditional Chinese medicine syndrome type and pathological type of correlation, for TCM syndrome differentiation to provide an objective basis. Methods: (1) lewis lung cancer mice were randomly divided into six groups. Model control group (M group), low dose group (ZD group), middle dose group (ZZ group), high dose group (ZG group), cisplatin group (S group) and lung tumor ointment plus cisplatin group (SZ group). After 21 days of administration, the mice with cervical vertebrae were killed to take the transplanted tumor, and the tumor weight was measured. The apoptosis rate was detected by flow cytometry (Annexin V-FITC/PI). (2) 74 cases of lung cancer with different pathological types were classified as qi stagnation and blood stasis type, qi deficiency and blood stasis type, qi and yin deficiency type, yin deficiency internal heat type, spleen deficiency phlegm damp type. The syndrome type and pathological type of TCM were analyzed statistically. Results: (1) tumor weight and tumor inhibition rate: the average tumor weight of each experimental group was lower than that of M group (p0.05). In Chinese medicine group, there was significant difference between ZZ group and ZG group (P0.05). The higher the dosage of traditional Chinese medicine, the smaller the tumor weight, SZ group had the best inhibitory effect on tumor, followed by S group. (2) apoptosis rate: the apoptosis rate of each experimental group was higher than that of M group. There was statistical significance (P0.05); two groups were compared except ZZ group and ZG group P value was less than 0.05 (P < 0.05). (3) Clinical study found that there were differences in the distribution of TCM syndromes between adenocarcinoma and squamous cell carcinoma (P0.05). In adenocarcinoma patients, the deficiency of both qi and yin was 33.33.3, the type of internal heat due to yin deficiency was 30.8; in the patients with squamous cell carcinoma, Qi stagnation and blood stasis accounted for 38.1, and qi deficiency and blood stasis accounted for 28.6. The distribution of small cell carcinoma, large cell carcinoma and other types of lung cancer in different TCM syndromes was not statistically significant because of the small number of samples. Conclusion: (1) FYO can inhibit the growth of transplanted tumor of lewis lung cancer. The middle dose of Feiyao tumour ointment and the low dose of Feiyi tumour ointment had obvious antitumor effect. (2) FYO could inhibit the growth of tumor by promoting apoptosis of tumor cells, (3) FYO had synergistic effect on the inhibition of tumor growth by cisplatin; (4) FYO had a synergistic effect on the inhibition of tumor growth by Cisplatin. Lung adenocarcinoma is characterized by deficiency (deficiency of Qi and Yin). Yin deficiency and internal heat are the main types of squamous cell carcinoma (qi stagnation and blood stasis type, qi deficiency and blood stasis type), which can be used as an index of micro syndrome differentiation. Because of the small number of small cell lung cancer, large cell carcinoma and other types of lung cancer samples, there is no statistical significance in the distribution of different TCM syndromes, so it is necessary to further increase the sample size in order to explore the distribution of TCM syndromes.
【學(xué)位授予單位】：山東中醫(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)】：R273

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