乌丹丸改良方对大鼠子宫内膜异位症模型的影响

【作者】 王铁枫；

【导师】 刘雁峰；

【作者基本信息】 北京中医药大学 ， 中医妇科学， 2005， 硕士

【摘要】 近年来,子宫内膜异位症(Endometriosis,EMS)的发病率处于上升趋势,越来越受到医学工作者们的关注。中医药是治疗内异症的主要方法之一,与西医药相比具有毒副作用小、不易复发、可长期服用等优势,而且疗效稳定。乌丹丸是北京中医药大学东方医院自拟方,已在临床应用多年,疗效显著,但因乌丹丸的药物组成达 22 味之多,药方庞大,影响了制剂工艺及质量标准控制的研究,且原乌丹丸为水泛为丸制成,未经过细致的炮制加工,故患者服药量大,不易消化,影响药效的发挥,甚至有的患者在服药后出现了胃痛症状。本课题就针对乌丹丸的这一缺点,对其组成进行改良,简化药方,保留原方中的丹参、赤芍、莪术、肉桂、元胡、水蛭、蜈蚣、制鳖甲、苏木 9 味中药,在简化方应用于临床之前,我们先通过 SD 大鼠子宫内膜异位症模型实验研究,探讨简化方与原方对大鼠异位内膜的作用,为简化方的临床应用奠定实验基础。 通过制作大鼠内异症模型实验,我们得出以下结论:手术方法制作大鼠子宫内膜异位症模型的关键是术者须具有足够的实验动物手术经验,将出血和感染降到最低程度,才可能提高造模的成活率;制作模型时应尽量将子宫组织缝合在靠近大血管处,以利于内膜生长;选取子宫角近端的子宫组织进行移植即可获得较高的模型成功率;将切取的子宫组织块整体移植在腹腔,而无需分离内膜层与肌层,同样可以获得成功的模型,而且简化操作,节省造模时间。 对大鼠内异症模型进行药物治疗后,我们发现:乌丹丸改良方对大鼠内异症模型具有良好的治疗作用,虽然药物较原方减少至 9 味,但在改善内异症大鼠腹腔炎症、缩小异位包块及促进异位内膜变性坏死等方面的治疗作用与乌丹丸原方相近;改良方用至中等剂量即可达到最佳治疗效果。关于乌丹丸改良方的治疗机制和临床应用前景还有待进一步研究和探讨。更多还原

【Abstract】 In recent years, the increasing incidence of endometriosis(EMS) has been attacting more and more attention of medical scholars. Traditional Chinese medicine is one of the main therapy of EMS, and compared with Western medicine, it has advantages of less side-effects, lower relapse rate, permitting longer use and stable curative effect,et al. The WuDan Pill(WDP) is a self-made medicine by the DongFang Hospital of the BeiJing University of TCM. It has been used in clinic for decades and showed prominent effect. But the large prescription of WDP composing 22 spices has limited the preparation technics and quality standard control, and on the other hand, the WDP has not been refined, so it is difficult for patients to digest and even causes stomachache after taking it. Our task is to meliorate the presciption of WDP to 9 spices composing red teony root, red sage root, cassia bark, corydalis tuber, dyied leech, centipede, processing fresh-water turtle shell, sappan caesalpinia, zedoary. We have studied the therapeutic effect of the Predigestion of WDP(PWDP) and WDP on the experimental induction of EMS in SD mouse before the clinic use of PWDP. By imitating an EMS model of SD mouse, we come to the following conclusions: the operators must be experienced enough to lessen the bleeding and infection of mice to the largest extent in order to increase the survival rate; we should sew up the uterus tissue close to the big veins so that the ectopic endometrium can grow well; to transplant the uterus segment close to the uterus corner was good enough to get a high success rate of model; to transplant the whole uterus segment to abdominal cavity rather than to apart the inner layer and the flesh layer of the endometrium may come to a successful model and predigest operation at the same time. After medication to the EMS model of mice, we concluded: the PWDP had favourable effect on the EMS model of mice, and although it had only 9 spices, it showed the same effects as WDP on the aspects of alleviating inflammation of the abdominal cavity, lessening the ectopic focus and accelerating the corrupt of the ectopic endometrium; the middle dose of the PWDP showed the best effects. Next, we will go on to study the curative mechanism and the clinic prospect of the PWDP.更多还原