【摘要】：目的:本文擬在通過分析背俞指針療法干預(yù)GERD大鼠任督二脈局部的皮溫治療前后變化特點(diǎn)和探索鈣調(diào)蛋白在胃竇Cajal間質(zhì)細(xì)胞內(nèi)的表達(dá)情況,從中醫(yī)學(xué)和醫(yī)學(xué)分子生物學(xué)角度了解該病的病因病機(jī)及治療機(jī)制,為今后該病的臨床診治提供相應(yīng)的參考。方法:按照完全隨機(jī)法將120只SD大鼠分為空白、模型組、對(duì)照組、治療組進(jìn)行比較,每組30只。采用賁門鋼圈固定法制作GERD大鼠模型,空白組和模型組不實(shí)施干預(yù)治療,治療組連續(xù)14天予以實(shí)施背俞指針治療,對(duì)照組連續(xù)14天予以蘭索拉唑腸溶片聯(lián)合莫沙必利分散片灌胃治療。于治療前及治療結(jié)束后的的第1天、第7天及第14天應(yīng)用紅外熱成像儀檢測(cè)GERD大鼠的任督二脈穴位均溫皮溫變化。實(shí)驗(yàn)結(jié)束后,取胃中部距賁門1/3處的胃竇運(yùn)動(dòng)起搏區(qū)組織,采用逆轉(zhuǎn)錄聚合酶鏈反應(yīng)(RT-PCR)的方法檢測(cè)GERD大鼠胃竇部Cajal間質(zhì)細(xì)胞中CaM基因表達(dá)情況。結(jié)果:1.任督二脈各穴位紅外皮溫檢測(cè)結(jié)果治療第1天,模型組、對(duì)照組、治療組與空白組相比,大椎穴、至陽穴、命門穴、膻中穴皮溫明顯降低(p0.05),中脘穴、關(guān)元穴皮溫明顯升高(p0.05)。治療第7天,模型組與治療組、空白組相比,大椎穴、至陽穴、命門穴、膻中穴、中脘穴、關(guān)元穴皮溫明顯降低(p0.05)。與對(duì)照組相比,大椎穴、至陽穴、膻中穴、中脘穴、關(guān)元穴明顯降低(p0.05),命門穴無明顯降低(p0.05)。治療第14天,模型組與對(duì)照組、治療組相比,大椎穴、至陽穴、命門穴、膻中穴、中脘穴、關(guān)元穴皮溫明顯降低(p0.05)。與空白組相比,命門穴、膻中穴明顯降低(p0.05)。大椎穴、至陽穴、中脘穴、關(guān)元無明顯降低(p0.05)。2.任督二脈紅外熱均溫檢測(cè)結(jié)果治療第1天,模型組、對(duì)照組、治療組較空白組相比,任脈均溫明顯升高(p0.05),督脈均溫明顯下降(p0.05)。治療第7天,模型組與治療組相比,任脈均溫、督脈均溫明顯降低(p0.05),與空白組、對(duì)照組相比,任脈均溫、督脈均溫?zé)o明顯差異(p0.05)。治療第14天,模型組與對(duì)照組、治療組相比,任脈均溫、督脈均溫明顯降低(p0.05),與空白組相比,任脈均溫、督脈均溫?zé)o明顯差異。3.胃竇Cajal間質(zhì)細(xì)胞鈣調(diào)蛋白基因表達(dá)結(jié)果模型組大鼠胃竇Cajal間質(zhì)細(xì)胞的CaM基因表達(dá)下調(diào)(p0.05),使用西藥和背俞指針治療后可使CaM基因表達(dá)上調(diào)(p0.05),且治療組的CaM基因表達(dá)要顯著高于對(duì)照組(p0.05)。結(jié)論:1.任督二脈穴位皮溫的變化與胃食管反流病的發(fā)病相關(guān)。GERD大鼠的任督二脈穴位皮溫較正常大鼠的皮溫低,而使用背俞指針治療后能夠提高任督二脈的皮溫。背俞指針治療胃食管反流病有效機(jī)制可能是通過改善任督二脈經(jīng)氣來實(shí)現(xiàn)。2.GERD大鼠胃竇Cajal間質(zhì)細(xì)胞鈣調(diào)蛋白表達(dá)下降可能是胃食管反流病的發(fā)病機(jī)制之一。3.背俞指針治療對(duì)GERD的治療作用很可能是通過上調(diào)胃竇Cajal間質(zhì)細(xì)胞鈣調(diào)蛋白的基因表達(dá),促進(jìn)胃竇起搏區(qū)運(yùn)動(dòng)來實(shí)現(xiàn)。
[Abstract]:Objective: to explore the changes of calmodulin in the interstitial cells of Cajal in antrum of GERD rats before and after skin temperature therapy. To understand the etiology, pathogenesis and therapeutic mechanism of the disease from the point of view of Chinese medicine and medical molecular biology, and to provide the corresponding reference for the clinical diagnosis and treatment of the disease in the future. Methods: 120 SD rats were randomly divided into blank group, model group, control group and treatment group with 30 rats in each group. The GERD rat model was made by the method of cardia ring fixation. The blank group and the model group were not treated with intervention, and the treatment group was treated with backshu pointer for 14 days. The control group was treated with lansoprazole enteric-coated tablets and mosapride dispersible tablets for 14 days. The changes of mean temperature at the acupoints of Ren du and Ermai of GERD rats were detected by infrared thermography on the 1st day, 7th day and 14th day before and after treatment. At the end of the experiment, the tissue of antral motor pacing region 1 / 3 from the cardia in the middle of the stomach was taken and the expression of CaM gene in the Cajal interstitial cells of the gastric antrum of GERD rats was detected by reverse transcriptase polymerase chain reaction (RT-PCR). The result is 1: 1. On the first day of treatment, model group, control group, treatment group, compared with the blank group, Dazhui point, Zhiyang point, Shengmen point, Shanzhong point skin temperature decreased (p0.05), Zhongwan point, Guanyuan point skin temperature increased significantly (p0.05). On the 7th day, the skin temperature at Dazhui, Zhiyang, Shengzhong, Zhongwan and Guanyuan points in the model group was significantly lower than that in the control group (p0.05). Compared with the control group, Dazhui point, Zhiyang point, Shanzhong point, Zhongwan point and Guanyuan point were significantly decreased (p0.05), but not at Shengmen point (p0.05). On the 14th day, the skin temperature at Dazhui, Zhiyang, Shengzhong, Zhongwan and Guanyuan points in the model group was significantly lower than that in the control group (p0.05). Compared with the blank group, the points of Shengzhong and Shengmen were significantly decreased (p0.05). Dazhui point, Zhiyang point, Zhongwan point, Guan Yuan have no significant decrease (p0.05) .2. On the first day of treatment, the model group, the control group, the treatment group compared with the blank group, the mean temperature of the Ren pulse increased significantly (p0.05), the mean temperature of the du pulse decreased significantly (p0.05). On the 7th day of treatment, the mean temperature of Ren pulse and du pulse in model group was significantly lower than that in treatment group (p0.05), but there was no significant difference between model group and control group (p0.05). On the 14th day, compared with the control group, the model group and the treatment group, the mean temperature of Ren pulse and du vein decreased significantly (p0.05), compared with the blank group, there was no significant difference in the mean temperature of Ren pulse and du pulse. 3. Expression of calmodulin gene in interstitial cells of antral Cajal in rats of model group, the expression of CaM gene was down-regulated (p0.05) in the stromal cells of gastric antrum Cajal. The expression of CaM gene was upregulated (p0.05) after treatment with western medicine and back-shu pointers, and the expression of CaM gene in the treatment group. It was significantly higher than that of the control group (p0.05). Conclusion 1. The change of skin temperature at acupoint of Ren du and Ermai is related to the pathogenesis of gastroesophageal reflux disease. The skin temperature of Ren du and Ermai acupoints in GERD rats is lower than that of normal rats, but the skin temperature of Ren du er vein can be increased after treatment with back Shu pointer. The effective mechanism of the treatment of gastroesophageal reflux disease with back Shu pointers may be that the decrease of calmodulin expression in the interstitial cells of gastric antrum Cajal may be one of the pathogenesis of gastroesophageal reflux disease. The therapeutic effect of back Shu pointer therapy on GERD may be achieved by upregulating the expression of calmodulin gene in stromal cells of gastric antrum Cajal and promoting the movement of gastric antral pacing area.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R245

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 周燕萍;;壯藥穴位貼敷治療中虛氣逆型胃食管反流病30例療效觀察[J];中國(guó)民族民間醫(yī)藥;2016年22期

2 羅蕾;;埃索美拉唑聯(lián)合莫沙必利治療胃食管反流的臨床效果觀察[J];臨床醫(yī)學(xué)研究與實(shí)踐;2016年22期

3 徐亭亭;朱生j;張秀蓮;程艷梅;;疏肝和胃方對(duì)內(nèi)臟高敏感大鼠CaMKⅡ表達(dá)的影響[J];上海中醫(yī)藥雜志;2016年11期

4 魏瑞仙;巴艷東;呂虎軍;;艾灸背俞穴治療圍絕經(jīng)期綜合征療效觀察[J];中國(guó)醫(yī)學(xué)創(chuàng)新;2016年27期

5 王家平;周文濤;顧仁艷;宋國(guó)宏;劉慧敏;;半夏瀉心湯治療胃食管反流病的臨床觀察[J];中國(guó)中醫(yī)急癥;2016年09期

6 廖信茜;朱淑軍;秦榮;;旋覆代赭湯加減聯(lián)合奧美拉唑治療難治性胃食管反流病療效觀察[J];實(shí)用中醫(yī)藥雜志;2016年07期

7 周燕;李保良;姚李吉;薛博瑜;;烏梅丸改善非糜爛性胃食管反流病主要癥狀的臨床觀察[J];中藥材;2016年05期

8 李學(xué)岐;慈麗紋;;觀察龍膽瀉肝湯合溫膽湯加減治療胃食管反流病膽熱犯胃證的臨床療效[J];世界最新醫(yī)學(xué)信息文摘;2016年44期

9 蘇慧芬;王黎明;陳相蕾;蘭春蓉;黃英華;;柴胡香附方治療胃食管反流病36例臨床觀察[J];光明中醫(yī);2016年07期

10 關(guān)錫昊;;大柴胡湯加減治療胃食管反流病的臨床分析[J];世界最新醫(yī)學(xué)信息文摘;2016年27期

相關(guān)會(huì)議論文 前4條

1 蔡洪;劉雪;;幾種質(zhì)子泵抑制劑治療胃食管反流病的臨床觀察[A];中國(guó)中藥雜志2015/專集：基層醫(yī)療機(jī)構(gòu)從業(yè)人員科技論文寫作培訓(xùn)會(huì)議論文集[C];2016年

2 李黎;;基因多態(tài)性與胃食管反流病易感性[A];中華中醫(yī)藥學(xué)會(huì)脾胃病分會(huì)第二十四次全國(guó)脾胃病學(xué)術(shù)交流會(huì)論文匯編[C];2012年

3 王維武;唐旭東;;胃食管反流病中醫(yī)病名探討[A];中華中醫(yī)藥學(xué)會(huì)脾胃病分會(huì)第十九次全國(guó)脾胃病學(xué)術(shù)交流會(huì)論文匯編[C];2007年

4 吳萍;許樹長(zhǎng);陳瑩;方芳;王琛;姚莉雯;;體重指數(shù)與胃食管反流病關(guān)系的研究[A];中國(guó)營(yíng)養(yǎng)學(xué)會(huì)第十次全國(guó)營(yíng)養(yǎng)學(xué)術(shù)會(huì)議暨第七屆會(huì)員代表大會(huì)論文摘要匯編[C];2008年

相關(guān)博士學(xué)位論文 前3條

1 林晗;針灸治療對(duì)難治性胃食管反流病患者食管動(dòng)力的影響[D];上海交通大學(xué);2014年

2 王更如;牙齒侵蝕癥與胃食管反流病的關(guān)系及反流物對(duì)牙本質(zhì)作用機(jī)制的研究[D];山東大學(xué);2011年

3 丁文彥;針刺五臟背俞穴治療慢性疲勞綜合征的臨床研究[D];廣州中醫(yī)藥大學(xué);2011年

相關(guān)碩士學(xué)位論文 前7條

1 胡萬辛;經(jīng)口內(nèi)鏡下肌切開術(shù)（POEM）治療30例賁門失弛緩癥療效觀察及隨訪[D];山東大學(xué);2016年

2 呂建欣;慢性咳嗽為主要癥狀胃食管反流病患者的多因素分析[D];首都醫(yī)科大學(xué);2016年

3 楊浩然;開郁和胃方治療胃食管反流病肝胃郁熱證的初步研究[D];廣州中醫(yī)藥大學(xué);2016年

4 吳齊飛;胃食管反流病患者在督脈背部段的壓痛規(guī)律研究[D];北京中醫(yī)藥大學(xué);2014年

5 宮瑋（王樂）;胃食管反流病之反酸的中醫(yī)古籍文獻(xiàn)研究[D];北京中醫(yī)藥大學(xué);2013年

6 周兵霞;針刺治療胃食管反流病臨床觀察[D];北京中醫(yī)藥大學(xué);2013年

7 關(guān)婧;胃食管反流病的胃鏡表現(xiàn)及病因?qū)W研究[D];南方醫(yī)科大學(xué);2008年

，

本文編號(hào)：2220155