【作者】 赵想法；

【导师】 王汝俊；

【作者基本信息】 广州中医药大学 ， 中西医结合基础， 2005， 硕士

【摘要】 脾虚证是以消化系统为主的多系统多器官的功能紊乱状态。祖国医学认为“脾主运化”,脾与消化系统的关系最为密切。消化系统形态和功能的异常是脾虚证最基本的病理基础。脾虚患者常见胃肠运动和消化功能异常。胃酸作为一种重要的消化液直接参与机体的消化功能,脾虚时胃酸分泌的异常变化与机体消化功能紊乱密切相关。胃泌酸功能的测定对胃酸相关性疾病的鉴别、诊断及治疗有重要的临床意义。本研究从整体动物、离体胃粘膜、即时分离的胃壁细胞以及胃酸分泌的关键酶(H~+-K~+-ATP酶)四个不同的角度探讨脾虚大鼠的胃酸分泌功能以及补中益气汤对其的调节作用,以期为临床上脾虚证的辨证治疗提供相关的实验依据。 1.活体胃灌流胃酸分泌实验 采用麻醉大鼠活体胃灌流实验模型,用生理盐水作为灌流液进行活体胃灌流,收集给予胃酸分泌刺激剂磷酸组胺前后各1小时的灌流液,用酸碱滴定法滴定灌流液中的胃酸含量。结果显示大黄脾虚模型组大鼠基础胃酸明显低于正常对照组(P<0.01),补中益气汤治疗组基础胃酸介于脾虚模型组和正常对照组之间,与脾虚模型组比较有非常显著性差异(P<0.01)。给予磷酸组胺刺激后,脾虚模型组胃酸分泌的增加幅度明显高于正常对照组(P<0.01),补中益气汤治疗组增加幅度与脾虚模型组比较有非常显著性差异(P<0.01)。大黄脾虚模型大鼠基础状态下胃酸分泌功能低下,但是对刺激剂磷酸组胺的敏感性较强,补中益气汤对脾虚大鼠的胃酸分泌功能有明显的调节作用。 2.离体胃粘膜胃酸分泌实验 采用离体胃粘膜组织泌酸的方法,观察脾虚模型大鼠离体胃粘膜组织在基础状态及组胺刺激下的胃酸分泌情况,以及调理脾胃方药补中益气汤对其的调节作用。脾虚模型组大鼠离体胃粘膜基础胃酸明显低于正常对照组(P<0.05),补中益气汤治疗组的基础胃酸与脾虚模型组比较有显著性差异(P<0.05)。给予磷酸组胺刺激后,脾虚模型组离体胃粘膜胃酸分泌的增加幅度明显高于正常对照组(P<0.01),补中益气汤治疗组增加幅度与脾虚模型组比较有非常显著性差异(P<0.01)。大黄脾虚模型大鼠更多还原

【Abstract】 Spleen-deficiency syndrome is characterized by multisystem and multifunction abnormality, especially in morphological and functional alteration in digestive system. The traditional Chinese medicine believes that the spleen is in charge of transportation and digestion. So the spleen is closely related to the digestive system. The abnormality of morphology and function in digestive system is the elemental pathological base of spleen-deficiency syndrome. The patient of spleen-deficiency frequently appears some abnormality in the gastrointestinal motility and the digestive function. Gastric acid directly participates in the digestive function as an important digestive juice. The abnormal change of gastric acid secretion is tightly connected with the disorder of the digestive function. The measurement of gastric acid secretion shows important clinical referred significance in identification, diagnosis and treatment with regard to the relative diseases of gastric acid. The studies explore the function of gastric acid secretion in spleen-deficiency model rats and the regulating effects of Buzhong Yiqi Decoction from the four different aspects: whole animal, extrasomatic gastric mucosa, immediately isolated gastric parietal cells and the gastric critical enzyme(H+-K+-ATPase). Through the studies, some experimental data are expected to offer for the clinical treatment.1. The experiment of gastric acid secretion by stomach perfusion in vivoUsed the model of stomach perfusion in vivo in anesthetic rats and taken normal saline as perfusate, the experiment respectively collects one-hour perfusate before and after stimulated by Histamine and titrates the perfusate to determine the amount of gastric acid by means of acid-base titration. The result shows that the basic gastric acid of the model group is significantly lower than that of the normal group(P<0.01). In the treating group treated with Buzhong Yiqi Decoction, the basic gastric acid is increased (vs. the model group, P<0. 01). After stimulated by Histamine, the percentage of increased gastric acid of the model group is significantly higher than that of the normal group(P< 0.01), but the percentage of increased of the treating group has significant difference compared with that of the model group(P< 0. 01). The experiment indicates that the secreting function of the basic gastric acid is lower, but the sensitivity to the stimulant is higher in the rats of spleen -deficiency model induced by rhubarb infusion. Buzhong Yiqi Decoction has regulating effects on gastric acid secretion in spleen-deficiency rats.2. The experiment of gastric acid secretion by isolated gastric mucosa tissueAdopted the methods of the isolated gastric mucosa tissue, this experiment observes the gastric acid secretion in spleen-deficiency rats under the basic condition and stimulated by Histamine, and observes the regulating effects of Buzhong Yiqi Decoction. The result shows that the basic gastric acid by isolated gastric mucosa tissue of the model group is significantly lower than that of the normal group(P < 0. 05). The basic gastric acid of the treating group makes significant difference (vs. the model group, P<0. 05). After stimulated by Histamine, the percentage of increased gastric acid secretion of the model group is significantly higher than that of the normal group(P< 0. 01), but the percentage of increased of the treating group has significant difference compared with that of the model group (P < 0. 01). The experiment indicates that the secreting function of the basic gastric acid by isolated gastric mucosa tissue is lower, but the sensitivity to the stimulant is higher in rats of spleen-deficiency model. After treated with Buzhong Yiqi Decoction, the secreting function of the gastric acid gradually recoveres to the normal level. The regulating effects of Buzhong Yiqi Decoction are probably concerned with enhancing the defense function of gastric mucosa.3. The measurement the function of gastric acid secretion of isolated gastric parietal cellsAdopted the two modes of action of Buzhong Yiqi Decoction (taken orally and with the serum containing it in cells), taken faintly alkaline acridine orange (AO) as probe, the function of gastric acid secretion of isolated gastric parietal cells is measured by double wavelength spectrofluorometer. The results are as follows. ? Taken Buzhong Yiqi Decoction orally: The basic gastric acid of isolated gastric parietal cells of the model group is significantly lower than that of the normal group(P < 0. 001). The basic gastric acid of the treating group is significantly higher than that of the model group (P < 0. 01). After stimulated by Histamine, the percentage of increased gastric acid secretion of the model group is significantly higher than that of the normal group (P < 0. 001), but the percentage of increased of the treating group is significantly lower than that of the model group(P < 0. 001), having no statistical significance compared with that of the normal group(P >0. 05). (2) Taken with the serum containing drugs in cells: The amount of gastric acid of the model and the normal groups stimulated by the serum containing drugs is higher than by the normal serum, however having no statistical significance (P > 0. 05, P > 0. 05). But the amount of gastric acid secretion of the model group stimulated by the serum containing drugs is significantly lower than that of the normal group(P< 0. 01). After stimulated by Histamine, the percentage of increased gastric acid secretion of the model group by the serum containing drugs is significantly higher than by the normal serum(P < 0.01). The percentage of increased gastric acid secretion of the normal group by the two types of serum has no significant difference(P > 0.05). Furthermore the percentage of increased gastric acid secretion of the model group by the serum containing drugs is obviously higher than that of the normal group(P<0. 01). But the percentage of increased of the model and normal groups by the normal serum makes no obviously difference(P >0.05), with the model group slightly higher than the normal group. These results manifeste that the secreting function of the basic gastric acid of isolated gastric parietal cells is lower, but the sensitivity to the stimulant is higher in parietal cells of spleen -deficiency model rats. Buzhong Yiqi Decoction has obvious regulating effects on gastric acid secretion of gastric parietal cells in spleen-deficiency rats by taken orally or with the serum containing it in cells.更多还原