【作者】 孔乐凯；

【导师】 邵念方；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2004， 博士

【摘要】 本文在导师的指导下，系统总结历代中医对肥胖病和便秘的认识，学习现代医学对肥胖病和便秘的最新研究成果，分析当代肥胖病和便秘流行的原因及其发病特点，旨在探讨当今社会肥胖病和便秘的病因和发病机制，及二者的相同之处，确立治疗原则。对临床效果显著的通尔寿片进行深入的药效学实验研究。 实验结果表明：用高脂高糖饲料喂养大鼠可以造成营养性肥胖模型，符合人类营养性肥胖的发生规律和特点，可用于通尔寿片的药效学研究。通尔寿片能够明显降低肥胖大鼠体重，减少腹腔脂肪含量，降低血清TC、TG、LDL-C的水平，提高HDL-C的量。降低肥胖大鼠血清瘦素、肿瘤坏死因子、MDA的浓度，降低FAI-1的活性，提高SOD的活性。降低全血粘度、血糖、胰岛素的水平，改善胰岛素抵抗状态。下调肥胖大鼠外周血白细胞中iNOS的基因表达，提高血清eNOS的水平。对正常小鼠的排便量、肠运动有促进作用：能改善便秘小鼠的肠运动状态，增加排便量，软化粪便；对肾上腺素、阿托品、吗啡引起的肠运动抑制有拮抗作用。 研究结论：提出饮食不合理、过逸少劳是当今社会肥胖病发生的主要病因，精神压力过大在现代社会便秘发生中占的比例增大。把神经内分泌免疫网络的概念引入肥胖病和便秘的研究中，从中西医两方面对二者进行了深入研究，得出其病因和发病机制多有相同之处。通尔寿片具有可靠的实验药效学指标，是中医药治疗肥胖病和便秘的有效复方。更多还原

【Abstract】 The present study was performed under the instruction of my tutor and based on the summary of the previous understandings and the recent achievement on adiposis and constipation. The purpose of my study was to investigate the reasons and mechanisms that adiposis and constipation become so popular today by analysising the epidemic features of the two diseases, further to find whether there is some relationship between them. So we could find some new therapeutic principle and method. At the same time , we performed an advanced pharmacodynamics research of Tong-Er-Shou Tablet, an clinically-proved effective medcine treating adiposis and constipation .Our results show that alimentary obesity rat model can be induced by high fat and high carbohydrate feeding. The features of the rat models coincide with that of human being and can be used for the pharmacodynamics research of Tong-Er-Shou Tablet. Further reserch shows using Tong-Er-Shou Tablet can lower rat weight, reduce abdominal fat content, decrease the serum levels of triglycerides , totel cholesterol and LDL-C and increase the serum levels of HDL-C . At the same time the levels of leptin, tumor necrosis factor, MDA and the activity of FAI-ldecreased, while the activity of SOD increased. Also, by lowering blood viscosity, serum glucose and insulin level, using Tong-Er-Shou Tablet can ameliorate insulin resistance. We also investigate the effect of Tong’ ersou on NO synthetase, the result shows using Tong-Er-Shou Tablet can down-regulate the gene expression of iNOS in white blood cells and up-regulate the serum level of eNOS. Using Tong-Er-Shou Tabletcan increase defecation of both normal and constipated rats by facilitating intestinal motility , softening feces and can antagonize the inhibition of intestinal motility induced by adrenamine, atropine and morphia.Improper diet and inadequate physical activity are the main causes of adiposis of modern society. While stress plays a key role in the onset of constipation. By introducing the concept of nervous-endocrine-immune net into the reserch of adiposis and constipation, and investigating them at two aspect: western medicine and traditional Chinese medicine, we concluded there are some identity between the two disease. We also proved Tong-Er-Shou Tablet is reliable in pharmacodynamics and is an effective medicine treating adiposis and constipation.更多还原