小鼠脾虚便秘模型的建立

目的建立小鼠脾虚便秘模型,研究脾虚便秘的机制。方法应用番泻叶泄泻、饥饱失常、限制饮水等复合因素造模法建立脾虚便秘小鼠动物模型。观察各组小鼠一般情况、体重和大便的改变;用炭末推进实验检测肠道推进功能;采用比色分析法测定各组小鼠血清D-木糖含量。结果模型组小鼠体重和大便数量明显低于正常对照组;与正常对照组比较,模型组小鼠肠道推进率明显降低,血清D-木糖含量显著降低。结论采用番泻叶泄泻、饥饱失常以及限制饮水等复合因素造模方法制作脾虚便秘模型方法稳定且可靠。     

小鼠利血平法脾虚证模型的建立

目的:建立小鼠脾虚证模型,研究小鼠脾虚证的机制。方法:采用利血平单因素造模法建立脾虚证小鼠动物模型,观察各组小鼠一般情况、体重和饮食量的改变,采用比色分析法及ELISA法分别测定各组小鼠血清D-木糖及胃泌素的含量。结果:模型组小鼠体重、饮食量、饮水量均明显低于正常对照组;与正常对照组比较,模型组小鼠血清D-木糖及胃泌素含量显著降低。结论:采用利血平单因素造模方法制作脾虚模型方法成熟可靠。     

四磨汤口服液对脾虚便秘小鼠疗效的实验研究

目的:探讨四磨汤口服液对脾虚便秘小鼠的疗效.方法:将18只脾虚便秘小鼠随机分成模型组、正常组和四磨汤口服液组,每组6只.对模型组和四磨汤口服液组采用灌胃番泻叶水煎液、7d后控制饮食、饥饱失常8d的方法进行脾虚便秘模型制备.造模成功后,模型组和正常组均用无菌水灌胃,四磨汤口服液组予四磨汤口服液灌胃,共7d.观察各组小鼠毛发、活力等一般特征和粪便改善情况及体质量的变化情况.结果:四磨汤口服液组小鼠一般特征及粪便改善程度均优于模型组,接近正常组,体质量变化及体质量变化率四磨汤口服液组与模型组、正常组比较,差异无统计学意义(P＞0.05).结论:四磨汤口服液对脾虚便秘小鼠有明确疗效.     

半夏泻心汤对脾虚便秘小鼠肠道细菌多样性的影响

目的:探讨半夏泻心汤对脾虚便秘小鼠肠道细菌多样性的影响。方法:将24只小鼠随机分成4组,每组各6只。分别为正常组、模型组、枳术汤组和半夏泻心汤组,构建小鼠脾虚便秘模型。造模结束后,半夏泻心汤组、枳术汤组分别采用半夏泻心汤和枳术汤灌胃,模型组和正常组均采用蒸馏水灌胃,共6d。治疗结束后提取肠道微生物总DNA,行16S r DNA V4区测序分析多样性。结果:半夏泻心汤和枳术汤对肠道细菌群落的多样性和丰度均无明显影响。各实验组在群落门水平下比较,差异均无统计学意义(P0.05)。在群落纲水平下Bacilli相对丰度水平上,枳术汤组与正常组比较相对丰度减小(P0.05);在Erysipelotrichi相对丰度水平上,枳术汤组较正常组升高(P0.05);半夏泻心汤组Erysipelotrichi的相对丰度小于枳术汤组(P0.05)。在群落目水平下Lactobacillales水平上,枳术汤组较正常组下降(P0.05);在Erysipelotrichales水平上,枳术汤组较正常组升高(P0.05),半夏泻心汤组Erysipelotrichales的相对丰度小于枳术汤组(P0.05)。在群落科水平下,枳术汤组Lactobacillaceae的相对丰度低于正常组(P0.05);半夏泻心汤组Lachnospiraceae的相对丰度高于正常组和模型组(P0.05);枳术汤组和半夏泻心汤组Ruminococcaceae的相对丰度高于模型组(P0.05);枳术汤组Erysipelotrichaceae的相对丰度高于正常组和半夏泻心汤组(P0.05)。在群落科属水平下,与正常组比较,枳术汤组Lactobacillus的相对丰度下降(P0.05),半夏泻心汤组Lactobacillus的相对丰度升高(P0.05);与模型组比较,枳术汤组Oscillospira的相对丰度增加(P0.05),半夏泻心汤组Lachnospiraceae的相对丰度降低(P0.05)。结论:半夏泻心汤能提高Ruminococcaceae、Lachnospiraceae、Lachnospiracea的相对丰度,使肠道菌群的组成比例比枳术汤更接近正常组,能有效地治疗脾虚便秘。     

小鼠脾虚血瘀动物模型的建立

目的：建立小鼠血瘀证模型。方法：雌性C57BL／6J小鼠100只，随机分为2组，正常对照组以生理盐水、模型组以利血平注射液股四头肌注射，每天1次，连续14天。所有动物于第15天摘眼球取血，检测血液流变学各项指标。结果：模型组的全血高切粘度、低切粘度、血浆粘度等均比对照组明显增高，P〈0．01，P〈0．05。结论：采用利血平可以塑造小鼠脾虚血瘀动物模型。     

超微铁皮石斛对脾虚便秘小鼠影响的实验研究

目的：探讨超微铁皮石斛对脾虚便秘的疗效。方法：将42只实验小鼠随机分为模型组、正常组和治疗组（铁皮石斛传统剂量组、超微全量组、超微50%量组、超微25%量组）,每组7只。对模型组和治疗组大鼠采用灌胃番泻叶水煎液7d后控制饮食、饥饱失常8d的方法制备小鼠脾虚便秘模型。造模结束后,模型组和正常组灌胃无菌水,治疗组分别灌胃给药铁皮石斛传统汤剂、超微全量汤剂、超微50%量汤剂和超微25%量汤剂,共7d。观察小鼠的毛发、活力和粪便等一般特征的变化情况;分别于造模开始前、治疗开始前和治疗完成后称量小鼠体质量,比较各组小鼠经铁皮石斛治疗前后体质量变化及体质量变化率。结果：模型组脾虚便秘症状无显著改善,体质量变化和体质量变化率较正常组低,各治疗组的脾虚便秘症状均有不同程度的改善。结论：铁皮石斛传统汤剂、超微全量汤剂和超微50%量汤剂对脾虚便秘均有很好的疗效。     

半夏泻心汤对脾虚便秘型小鼠血常规影响的实验研究

目的:探讨半夏泻心汤对脾虚便秘小鼠血常规的影响。方法:将24只实验小鼠随机分成正常组、模型组、枳术汤组和半夏泻心汤组,除正常组外,其余各组灌胃番泻叶水煎液,7天后控制饮食,饥饱失常8天,构建小鼠脾虚便秘模型。造模结束后,半夏泻心汤组、枳术汤组分别采用半夏泻心汤和枳术汤灌胃,模型组和正常组均灌胃蒸馏水,共6天,治疗结束后进行血常规指标检测。结果:与正常组比较,模型组白细胞计数(WBC)、中性粒细胞计数(NEUT)显著降低,差异均有统计学意义(P0.01,P0.05)。与模型组比较,半夏泻心汤组血小板计数(BPC)、血小板平均压积(PCT)、红细胞平均血红蛋白含量(MCH)、WBC、NEUT、淋巴细胞计数(LYM)显著升高,红细胞分布宽度(RDW)降低,差异均有统计学意义(P0.05);与枳术汤组比较,半夏泻心汤组BPC、PCT、WBC、NEUT、LYM升高更明显,差异均统计学意义(P0.05)。结论:半夏泻心汤能促进脾虚便秘小鼠血小板计数、血小板平均压积、红细胞平均血红蛋白含量、白细胞计数、中性粒细胞计数和淋巴细胞计数的恢复,有利于血液功能的调节。     

强迫跑步法建立昆明种小鼠心气虚证模型

目的：用强迫跑步、控食及大剂量心得安等复合因素建立昆明种小鼠心气虚证动物模型。方法：造模组实验全过程控食，强迫跑步至力竭。第17天起每日灌服大剂量心得安溶液，连续4天。于实验第21天进行指标测定。结果：望诊动物有气虚证表现。血流动力学显示平均 dP／dtmax、平均Vpm等指标均小于正常组，平均—dP／dtmax等指标均高于正常组，提示心室的收缩舒张功能有所降低。SOD也显著降低，MDA明显升高。IL—4和IL—10均显著高于正常组，TNF-α显著低于正常组，IL—2也有降低的趋势。结论：强迫跑步、控食及大剂量心得安等复合因素可以复制基本符合中医理论的心气虚证动物模型。     

枳术汤对脾虚便秘小鼠通便作用的实验研究

目的：观察枳术汤对脾虚便秘小鼠的通便作用。方法：以饥饱失常、过度疲劳配合禁水不禁食的方法进行脾虚便秘模型的复制，观察大、中、小3个剂量的枳术汤对脾虚便秘小鼠的通便作用，以便秘通为阳性对照药。结果：枳术汤可使正常及脾虚便秘小鼠第1次排黑便的时间缩短、黑便粒数和粪便重量增加，尤以大、中剂量组效果明显，呈现了一定的量效关系。作用优于便秘通。结论：枳术汤对脾虚便秘小鼠有良好的通便作用。     

实验条件对复方地芬诺酯小鼠便秘模型的影响

目的：研究复方地芬诺酯小鼠便秘模型的影响因素，控制试验稳定进行。方法：采用经口灌胃给予复方地芬诺酯建立小鼠便秘模型，观察不同试验条件对模型小鼠排便情况的影响。结果：复方地芬诺酯的剂量、试验过程中动物的禁食等因素均对小鼠便秘模型有明显影响。结论：采用5．0mg/kg、10mg／kg剂量的复方地芬诺酯造模可使动物的首粒排便时间延长，便粒和便量明显减少，在试验测试期间让动物饮水进食可使模型更加灵敏。     

脾虚发热证大鼠模型的研究

目的:复制并评价脾虚发热大鼠模型。方法:大鼠随机分为正常对照组、单纯脾虚组、脾虚发热组。大鼠采用饮食失节+过度疲劳法复制脾虚模型,于造模第22天腹腔注射LPS(80μg/kg)诱导发热,测定各时间点的肛温、体重、外观行为变化积分值、尿D-木糖排泄率和外周血相关指标。结果:①与正常对照组比较,脾虚发热组大鼠体温除在30min有一过性降低外,其余各观察点均呈显著性升高(P0.01,P0.05);单纯脾虚组大鼠体温除在60min时有一过性升高外,其余各点无显著性差异;脾虚发热组与单纯脾虚组大鼠在第1、2、3周末的体重均明显降低;第2、3周末的外观行为变化总积分值呈显著性增加(P0.05,P0.01);第3周末的尿D-木糖排泄率、血GAS、MTLI、L-1β、IL-2、T3、T4、TSH均降低I,L-6和SS升高(P0.05,P0.01);②与单纯脾虚组相比,脾虚发热组大鼠体温在30min时有一过性降低,之后体温一直呈显著性升高(P0.01);外周血T4含量显著性降低(P0.01),其余各指标的差异无显著性。结论:饮食失节+过度疲劳+LPS注射可引起大鼠出现类中医脾虚发热证。     

Observation on effects of moxibustion at abdominal acupoints for slow transit constipation due to yang deficiency of the spleen and kidney

Objective

To observe the clinical effects of moxibustion at abdominal acupoints for slow transit constipation (STC) due to yang deficiency of the spleen and kidney.

Methods

A total of 52 cases with slow transit constipation in conformity with the inclusion criteria were selected and divided into a control group and an observation group according to their visit order and random digital table, 26 cases in each group. Patients in the control group received routine nursing guide. Besides the same routine nursing guide, patients in the observation group received moxibustion at the abdominal acupoints, once every day. The course of the treatment was 4 weeks in the two groups, and the 3-month follow-up was given after the course was finished, for comparing the clinical symptoms, results of colon transit tests, scores of depression/anxiety scale and nursing satisfaction.

Results

The total effective rate was 92.3% in the observation group and 69.2% in the control group, with a significant difference between the two groups. After the treatment and during the follow-up checks, the scores of Chinese medical symptoms in the two groups were remarkably decreased than those before the treatment (all P<0.01); the scores of the observation group were obviously lower than those in the control group (all P<0.01). The discharge rates of the markers in the two groups were remarkably increased than those at the same time period before the treatment; moreover, the discharge rates of the markers at various time periods were remarkably better in the observation group than those in the control group (P<0.01). SDS and SAS scores were remarkably decreased after the treatment in the two groups (P<0.01). In comparison of SDS score between the two groups after the treatment, the difference was statistically significant (P<0.01). In comparison of SAS score between the two groups after the treatment, the difference was statistically significant (P<0.05). The nursing satisfaction was 96.2% in the observation group after the treatment, obviously better than that in the control group (73.1%). The recurrence rate was 8.3% in the observation group, remarkably lower than that in the control group (33.3%).

Conclusion

Moxibustion at the abdominal acupoints plus routine nursing can remarkably improve the colon transit functions and anxious and depressive emotion in patients with STC, and the therapeutic effects are remarkable. Not only the clinical satisfaction is higher, but the recurrence rate is obviously lower than that of routine nursing.

     

枳术汤对脾虚便秘小鼠血浆中P物质和血管活性肽的影响

目的:通过观察脾虚便秘小鼠血浆中P物质(substance P,SP)、血管活性肽(vasoactive intestine peptide,VIP)表达的变化,探讨枳术汤对脾虚便秘小鼠胃肠动力靶向调控的机制.方法:采用脾虚泄泻、饥饱失常以及燥结便秘等复合因素造模方法制作脾虚便秘模型;造模组分别予以枳术汤、便秘通口服液、蒸馏水干预;用放射免疫方法观察SP和VIP表达情况.结果:模型组和蒸馏水组的SP和VIP的表达均较正常对照组减少(P＜0.01),经治疗后,枳术汤大、中剂量组恢复接近至正常水平,与模型组和蒸馏水组比较有显著差异(P＜0.01).结论:枳术汤对脾虚便秘小鼠模型胃肠动力的调控可能与SP和VIP有关.     

从心脾相关论治胸痹脾虚痰湿证的理论探讨

脾虚痰湿证是胸痹较为常见的证型,本文从心脾的生理病理特点出发,对胸痹脾虚痰湿证的病因病机特点、证候特征、治疗法则进行了理论探讨.     

推拿手法治疗失眠心脾两虚证研究进展

失眠是临床常见的疾病,随着生活方式的改变、生活压力的不断增加,越来越多的人出现失眠的症状,且趋势不断增加,寻求绿色、安全、有效的治疗方法显得迫不及待,而推拿手法治疗失眠有其独特效果,且具有患者易于接受、无不良反应等优势特点。本文通过筛选和分析近年来关于研究推拿手法治疗心脾两虚型失眠的相关文献,研究发现推拿治疗心脾两虚型失眠手段包括单纯推拿治疗,推拿结合中药汤剂、针刺、艾灸、耳穴贴压及走罐等多种疗法,本文将拟汇总分析,并总结推拿治疗心脾两虚型失眠的常用穴位如印堂、心俞、脾俞、太阳、百会5穴及所取得的研究成果,以期为临床中运用推拿手法治疗心脾两虚型失眠提供借鉴与参考。     

德尔菲法小儿脾虚泻专家问卷调查分析

目的 对小儿脾虚泻专家问卷调查进行分析.方法 在文献研究及前1轮专家问卷的基础上,编制小儿脾虚泻第2轮专家问卷,发送给北京市35位专家进行问卷调查,对答卷进行回收,并采用德尔菲(Delphi)法进行分析.结果 在构成证候的指标评价中,食后即泻、纳呆、大便清稀或有黏液、面色不华等4项指标满分比＞0.65,变异系数≤0.265;在结局指标的评价中,大便次数5～9次/日、大便次数＞10次/日、尿量明显减少、食欲下降满分比＞0.829,变异系数≤0.27.在治法、方剂等其它评价中,健脾止泻法、参苓白术散满分比＞0.88,变异系数＜0.24.结论 大便次数、尿量、食欲可入选疾病疗效评价指标;食后即泻、纳呆、大便清稀或有黏液、面色不华可入选主要证候指标;参苓白术散、健脾止泻法可入选主要方、法指标.     

Clinical Study on Treatment of Simple Obesity Due to Spleen Deficiency by Acupuncture-moxibustion

目的：探讨针灸治疗脾虚型单纯性肥胖症的临床疗效。方法：将68例脾虚型单纯性肥胖症（包括脾虚湿阻、肺脾气虚、脾肾阳虚3型）随机分成治疗组36例，对照纽32例。治疗组采用温针灸治疗，对照组采用电针治疗，对其疗效及体重指标进行观察。结果：两组的总有效率相比，差异有显著性意义（P〈0．05）；治疗组与对照组体重下降值存在显著性差异（P〈0．01），且治疗组的远期疗效优于对照组。结论：温针灸治疗脾虚型单纯性肥胖症疗效确切且持久，值得推广。     

Therapeutic effect observation on Nie-pinching the spine manipulation for infantile diarrhea due to spleen deficiency

Objective

To observe the influence of Nie-pinching the spine manipulation on the excretory rate of urine D-xylose in the infants with diarrhea due to spleen deficiency, and to assess the clinical effects.

Methods

Sixty infants in conformity with the diagnostic criteria of diarrhea due to spleen deficiency were randomly divided into a treatment group and a control group by the random digital table, 30 cases in each group. The infants in the treatment group were treated by Nie-pinching the spine manipulation and traditional infantile tuina, in addition to the routine basic treatment. The infants in the control group were treated by the same traditional infantile tuina in addition to the routine basic treatment. The infants in the two groups were treated once every day, 4 weeks as a course. Totally, the treatment was given for a course. The symptom integrals of spleen deficiency were used to assess the improvement in the symptoms. The colorimetry was used to determine the excretory rate of urine D-xylose.

Results

In the comparison of the same group before and after the treatment, the differences in the global score of spleen deficiency symptoms and the excretory rate of urine D-xylose in the two groups were statistically significant (all P<0.01). After the treatment, the differences in the global score of spleen deficiency symptoms and the excretory rate of urine D-xylose between the two groups were all statistically significant (both P<0.01).

Conclusion

Chiropractics can reduce the integrals of spleen deficiency symptoms and elevate the excretory rate of urine D-xylose in the infants with diarrhea due to spleen deficiency, so as to enhance the therapeutic effects by alleviating the symptoms of spleen deficiency and the absorptive function of the small intestine.

     

情志刺激致大鼠肝郁脾虚证模型的研究

目的:研究慢性束缚加饮食失节孤养模拟肝郁脾虚病因,创立复合病因大鼠造模方法。方法:将大鼠束缚于网笼中,令其肢体不能自由活动,每日束缚6h,孤养,每周不定时禁食2次,连续3周;另设疏肝健脾方逍遥丸、疏肝泻火方龙胆泻肝丸作对照,正常对照鼠合养,自由活动、饮水,观察一般状况、精神行为、血液免疫器官及脑组织单胺类神经递质变化评价肝郁脾虚证。结果:模型对照组大鼠体质量增长、糖水消耗量、水平和垂直运动、血红蛋白、血小板减少、胸腺和脾指数、5-羟色胺(5-HT)和多巴胺(DA)显著低于空白对照组,水中静止时间显著高于空白对照组(P0.05,P0.01);逍遥丸组与模型对照组比较,其差异也有统计学意义(P0.05,P0.01)。结论:慢性束缚加饮食失节孤养的方法成功创立符合中医证候特征的肝郁脾虚模型。