【作者】 张莹；

【导师】 朱耀环；

【作者基本信息】 大连医科大学 ， 中西医结合临床内科， 2010， 硕士

【摘要】 研究背景及目的：慢性萎缩性胃炎(CAG)是消化系统的一种多发病、常见病,是指胃粘膜已发生了萎缩性改变的慢性胃炎,常伴有肠上皮化生,属于中医学的“胃脘痛”、“痞满”等范畴,以病程长、病情复杂、反复发作为特点。其主要的病理改变是胃粘膜变薄,腺体萎缩,易形成肠化生和息肉,被认为是胃癌癌前病变之一。积极的治疗CAG也是预防癌变,降低胃癌发病率的有效手段。多年来,慢性萎缩性胃炎的治疗一直是消化领域研究的热点。现代医学对CAG的病因尚未完全阐明,且治疗也仅局限于Hp感染和消化不良的对症治疗,缺乏特异有效的治疗方法。近年来,中医治疗慢性萎缩性胃炎积累了不少经验。采用中医药治疗本病,以中医传统理论为指导,结合中医的辨证论治,研制出许多治疗CAG的专方(包括成药和汤剂)。它们作用专一、效果明显。对CAG的临床症状、胃镜及病理组织学改变均有较好的疗效,且服用方便,容易推广。本课题组正是秉承中医治疗CAG的理念,在老中医朱耀环教授的指导下,采用综合造模法复制大鼠慢性萎缩性胃炎模型,以正常大鼠及CAG大鼠为研究对象,将用于临床近20年的丁香胃灵合剂进行了较为系统的研究。通过观察丁香胃灵合剂对CAG大鼠的一般状态、胃粘膜病理、胃液PH值、血管内皮生长因子(VEGF)、丙二醛(MDA)的影响,探讨该方治疗CAG的作用原理。为进一步推广和应用提供依据。材料和方法：将60只成年健康、雌雄各半Wistar大鼠随机分为5组：正常对照组、模型对照组、丁香胃灵合剂低剂量组、丁香胃灵合剂中剂量组、丁香胃灵合剂高剂量组,每组12只。除正常对照组外,其他大鼠制成慢性萎缩性胃炎模型：2%水杨酸钠按大鼠10ml／kg灌胃,并自由饮用0.05%氨水二个月。造模成功后,除模型对照组和空白对照组外,其余各组给予相应剂量的丁香胃灵合剂灌胃治疗6周。采用摘取眼球法取血,分离出血清,使用MDA试剂盒进行生化检测。剖胃取材,用PH试纸测定胃液PH值,观察胃粘膜组织学改变,并用免疫组化方法检测大鼠胃粘膜VEGF的表达,对其结果进行分析。结果：模型组与正常对照组比较,胃液PH值显著增加(P<0.01),MDA水平显著增高(P<0.01),VEGF阳性表达显著升高(P<0.01),胃粘膜组织病变明显。丁香胃灵合剂各治疗组胃液PH值,MDA含量,VEGF阳性表达指数明显下降,与模型对照组有非常显著的差异(P<0.01)。治疗组之间指标也有明显差异(P<0.01或P<0.05)。结论：丁香胃灵合剂对CAG大鼠有一定的治疗作用。在病理形态学上,能增加胃粘膜厚度,消除胃粘膜炎症,改善甚至逆转胃粘膜萎缩、肠上皮化生及不典型增生等病理学改变。在生化指标上,丁香胃灵合剂可以降低胃液PH值,减少脂质过氧化代谢产物MDA的含量,抑制VEGF的表达。可能是通过消除氧自由基、减轻或阻断组织的脂质过氧化反应,抑制大鼠胃粘膜的过度增殖等作用而达到治疗的目的。更多还原

【Abstract】 Study Backgroud and Objective:Chronic atrophic Gastritis (CAG) is a frequently-occurring disease of digestive system, common diseases。It is the gastric mucosal changes have occurred in chronic atrophic gastritis, often accompanied by intestinal metaplasia, in Chinese medicine, "stoma-chache" "fullness" and other areas to long course of disease, disease complex, has repeatedly made as a feature. The main pathological changes of gastric mucosa is thin, glandular atrophy, intestinal metaplasia and polyps easy to form, is considered one of gastric precancerous lesions. CAG is also aggressive treatment to prevent cancer, reduce the incidence of gastric cancer effective means. Over the years, has been digested in the field of research.At present, the cause of modern medicine on the CAG not yet been fully clarified, and treatment is also limited to Hp infection and dyspeptic symptomatic treatment, the lack of specific and effective treatment. In recent years, Chinese medicine treatment of chronic atrophic gastritis and accumulated much experience. Use of Chinese medicine treatment of this disease, traditional Chinese medicine theory as a guide, combined with TCM syndrome differentiation, flexible addition and subtraction drug toxicity, has more advantages.This study to detect effect of Clove wei ling mixture on the quantity of MDA and expression of VEGF in rats model of Chronic atrophic gastritis.Material and Method:Sixty Wistar rats were randomly divided into five groups:normal control group, model control group, Clore wei ling mixture low—dose group, Clore wei ling mixture middle—dose group and Clore wei ling mixture high—dose group. Except normal control group rats, CAG model was established in other rats by synthetical method:sodium salicylic was given once a day, and ammonia was drink freely etal, all the factors were given for two monthes. When the model was established successfully, Except normal control group rats and model control group, others rats were treated with different dose medicines, after six weeks, all the rats were sacrificed. Their gastric juice was collect to detect PH, their blood serum was collect to detect MDA by chemic method, their stomaches were collect to detect VEGF by immunohistochemistry methods and detect the histologic mucosa changes by microscopy.Results:Model group and normal control group, a significant increase in gastric PH value (P<0.01), MDA levels were significantly higher (P< 0.01), VEGF expression was significantly higher (P< 0.01), Gastric mucosa lesions significantly. Clore wei ling mixture in the PH value of the treatment group, MDA levels, VEGF expression index decreased, and the model control group there was a significant difference (P< 0.01)。Indicators between treatment groups were significantly different(P<0.01或P<0.05)。Conclusion:The Clore wei ling mixture on the CAG have a therapeutic effect in rats. Pathological morphology, can increase the gastric mucosal thickness, eliminating gastric inflammation, improve or even reverse gastric atrophy, intestinal metaplasia and atypical hyperplasia pathology. In the biochemical indicators, clove mixture in gastric juice can reduce the PH value, reduce lipid peroxidation metabolites MDA, inhibition of VEGF expression. May be by eliminating the oxygen free radicals, reduce or block the organization of lipid peroxidation, inhibits the proliferation of such over-the role of gastric mucosa to achieve the purpose of treatment.更多还原