【作者】 臧笑薇；

【导师】 孙广仁；

【作者基本信息】 山东中医药大学 ， 中医基础理论， 2005， 硕士

【摘要】 目的:从理论上,对支气管哮喘病寒饮蕴肺证进行系统的阐释与论证,以丰富寒饮蕴肺证理论。在建立支气管哮喘病寒饮蕴肺证大鼠模型的基础上,深入探讨支气管哮喘病寒饮蕴肺证的微观机理以及温阳化饮方（小青龙汤加减）的作用部位和作用机制,从而深化对肺主行水理论的认识。方法:依据“外内合邪”、“形寒饮冷则伤肺”、“劳则气耗”等观点,结合现代医学支气管哮喘致病原理,在冬季寒冷环境中,以冰水及寒性饮食饲养大鼠,配以冰水游泳,卵蛋白致敏的方法,建立支气管哮喘病寒饮蕴肺证大鼠模型。并用温阳化饮方及沙丁胺醇进行干预。观察相关检测指标,如体温、体重、饮水量、血气分析、肺组织病理切片、β肾上腺素受体信使核糖核酸（β-adrenergic receptors messenger ribonucleic acid, β-AR mRNA）的表达等,深入研究支气管哮喘病寒饮蕴肺证的部分微观机制和病理变化,并通过观察温阳化饮方对β受体基因表达的影响,揭示其在分子生物学及基因层次上对治疗支气管哮喘的作用部位和作用机制。结果:实验证明,支气管哮喘病寒饮蕴肺证大鼠模型的建立具有可重复性,造模较为成功。模型组大鼠的一般体征与支气管哮喘病寒饮蕴肺证的临床表现相符,微观指标的变化也与该证相关的支气管哮喘病一致,大鼠体重减轻,体温下降,饮水量减少,动脉血PaO₂、SaO₂、tO₂降低,而PaCO₂升高,病理切片显示肺组织出现炎性损伤,β肾上腺素受体mRNA呈持续性下降,而治疗组的两种药物对上述各项指标都有不同程度的改善,其中温阳化饮方疗效总体最佳。结论:建立的支气管哮喘病寒饮蕴肺证大鼠模型较符合临床表现及病理变化,模型的建立具有可重复性。支气管哮喘病寒饮蕴肺证的形成与β-AR有着密切的关系,温阳化饮方对支气管哮喘病寒饮蕴肺证确有较好的治疗效果,其疗效机制可能在于调控肺组织β-AR的基因表达,使肺组织β-AR水平保持相对稳定,调节气道舒缩,改善肺通气。说明温阳化饮方的温补肺阳,蠲化寒饮及改善肺通气的作用,与其调控肺组织中β-AR的基因表达有关,这也可能是肺气行水的部分微观机制。更多还原

【Abstract】 Objective: This thesis expounds systematically the theoretic problems about the syndrome of accumulation of cold fluid in the lung in asthma to enrich the theory of the syndrome. Based on the.pathologic rat models with the syndrome of accumulation of cold fluid in the lung in asthma, the thesis discuss deeply the microcosmic mechanism of syndrome of accumulation of cold fluid in the lung in asthma and the target curative location and the functional mechanism of "Yang-Warming and Fluid-Dispersing Formula" to understand further of the theory of the lung’s promoting water metabolism. Methods: This research based on the viewpoints of three theories, namely, the combination of exopathogens and inpathogens, coldness of body and drinking cold tends to impair lung, and overstrain leading to consumption of qi, combining with asthmatic nosogenesis of modern medicine. Pathologic rat models with the syndrome of accumulation of cold fluid in the lung in asthma were set up with the methods of feeding with ice water and food with cold property and swimming in the ice water, while ovalbumin was used to induce rat asthma in the cold environment. The models were treated with "Yang-Warming and Fluid-Dispersing Formula" and Salbutamol. Then observe the relevant indexes including body temperature, avoirdupois, the drink capaticy, arterial blood gas, and expression of β -ARmRNA in lung tissues, etc. Results: The results of the experiment showed that the development of pathologic rat models with the syndrome of accumulation of cold fluid in the lung in asthma which proved to be repetitive is comparatively successful and reliable. General syndromes of the rats in the model group were in accordance with clinical symptoms of patients of the syndrome of accumulation of cold fluid in the lung in asthma. The changes of microcosmic indexes coincided with those of asthma related to the syndrome. For example, the expressive indexes of avoirdupois, body temperature, the drink capacity were alleviated, P_aO₂ 、 S_aO₂ 、 tO₂ decreased while P_aCO₂ increased in更多还原