【摘要】 目的:基于肝郁大鼠模型探讨"知肝传脾,当先实脾"的客观证据及其与血清褪黑素水平变化的关系。方法:慢性束缚法复制中医肝郁模型,通过不同分组给药方式复制"当先实脾"的治疗方案,检测血清肝功能生化指标、进行肝组织病理学观察以评价"肝郁",检测尿液5 h D-木糖排泄率以评价"脾虚",在此基础上检测血清褪黑素水平以探索"知肝传脾,当先实脾"与血清褪黑素水平的关系。结果:肝郁大鼠血清肝功能生化指标均显著升高,肝组织存在炎症、水肿等病理损伤,尿液5 h D-木糖排泄率显著降低,"知肝传脾"客观存在;"疏肝""健脾""疏肝健脾""当先治肝""当先实脾"的干预方式均可不同程度改善肝郁大鼠血清肝功能生化指标、尿液5 h D-木糖排泄率及肝组织病理损伤的异常状态,其中"当先实脾"的干预作用优于其它干预方式,"当先实脾"客观存在;"知肝传脾"——血清褪黑素水平降低,"当先实脾"——血清褪黑素水平升高,血清褪黑素水平变化与"知肝传脾,当先实脾"密切相关。结论:"知肝传脾,当先实脾"客观存在且与血清褪黑素水平密切相关,肝病→褪黑素水平降低→脾病、实脾→褪黑素水平升高→干预肝病,可能为"知肝传脾,当先实脾"的作用机制之一。更多还原

【Abstract】 Objective:This paper discussed the objective existence of "The Liver disease will be transmitted into the Spleen and the Spleen should be firmed first"and it’s relationship with changes of serum melatonin level based on the model of rats with syndrome of Liver depression. Methods:Taked the method of "chronic bondage" with replication the syndrome of Liver depression and taked different intervention modes for different groups to replication the therapeutic schedule of"the Spleen should be firmed first". Detected liver function biochemistry, histopathology observation to evaluate Liver depression and detected 5 h D-xylose excretion rate to evaluate Spleen deficiency. Based on above results,explored the relationship between "The Liver disease will be transmitted into the Spleen and the Spleen should be firmed first" and changes of serum melatonin level by testing serum melatonin level. Results:Liver depression can apparently increase the level of serum ALT、AST、ALP、TBIL、DBIL and remarkably damage liver tissue as well as evidently decrease 5 h D-xylose excretion rate of urine of rats, "The Liver disease will be transmitted into the Spleen" is objective reality. "The Spleen should be firmed first" can apparently decrease the level of serum ALT、AST、ALP、TBIL、DBIL and remarkably improve the damage of liver tissue as well as evidently increase 5 h D-xylose excretion rate of urine of rats with syndrome of Liver depression, "The Spleen should be firmed first" is objective reality."The Liver disease will be transmitted into the Spleen"——decrease the serum melatonin level, "The Spleen should be firmed first"——increse the serum melatonin level, the serum melatonin level is closly related to "The Liver disease will be transmitted into the Spleen and the Spleen should be firmed first".Conclusion:"The Liver disease will be transmitted into the Spleen and the Spleen should be firmed first" are objective reality and closly related to the serum melatonin level. Liver disease→decrease the serum melatonin level→Spleen disease, Firm Spleen→increase serum melatonin level→cure Liver disease, may become one of effective mechanism of "The Spleen should be firmed first."更多还原