【作者】 张莉；

【导师】 吕霞；

【作者基本信息】 山东中医药大学 ， 中西医结合临床， 2015， 硕士

【摘要】 目的:以本院自制剂九华膏作为中药涂擦疗法治疗痔的代表药物,观察中药涂擦疗法治疗痔病的临床疗效,从病理组织学角度探讨痔发病机制,并从细胞学角度探讨中药涂擦疗法对成纤维细胞功能及活性影响机制的大致趋势,为临床治疗提供客观的理论依据。方法:临床试验观察选择30例混合痔Ⅱ期内痔患者,使用九华膏治疗前后分别观察痔核大小、出血、糜烂及脱出情况并记录,进行统计分析。病理组织学观察病例则根据31例患者的主要症状分为脱出组、便血组及脱出+便血组,将手术切取的标本31例,经固定、脱水、石蜡包埋、HE染色制片后观察统计间质、血管的病理变化。另外应用透射电镜对比观察1例术前使用中药九华膏治疗的痔患者和2例术前未使用中药九华膏治疗的痔患者切除的组织中成纤维细胞的超微形态结构。结果:经过临床试验对比,使用九华膏治疗前后痔核脱出次数、痔核大小、痔黏膜情况三者差值的t值分别为15.425、11.195、10.033,P<0.05,即治疗前后存在显著性差异。在病理组织学观察方面,三组痔组织胶原纤维排列情况的积分P<0.05,即三组在胶原纤维排列情况存在显著统计学差异;在成纤维细胞数目、结缔组织水肿程度、炎细胞浸润程度、窦状血管扩张程度及血管内皮增生程度各项目中P>0.05,即三组在以上几方面不存在显著统计学差异。通过透射电镜对痔组织的超微结构观察,发现使用九华膏治疗后的痔组织中成纤维细胞活性高于未治疗者,胶原纤维排列也较未治疗者规则。结论:以九华膏为代表的中药涂擦疗法可有效改善痔的症状及体征,可提高成纤维细胞活性,使其合成分泌作用具有增强的趋势,从而改善胶原纤维、弹性纤维排列疏松、紊乱、断裂等病理形态学改变。更多还原

【Abstract】 Objective:The aim of this study is to investigate the clinical application of tradition Chinese medicine in hemorrhoidal disease. The jiuhuagao was selected and applied by inunction treatment.The morphology of hemorrhoid and function and viability of fibroblasts cells were observed after the application of jiuhuagao. Our research provides the principal mechanism to the clinics.Methods:30 patients of hemorrhoid at the secondary stage were selected and jiuhuagao was applied as the only medicine in the process. The size of hemorrhoid, volume of blooding, anabrosis and prolapse were recorded and statistically analyzed. 31 patients were divided into three groups according to the pathological features and samples were taken during the surgery. Samples were then fixed by paraffin for histology observation. The change of the vessels and tissues were recorded after HE staining. In addition, TEM was applied to observe 1 sample of the hemorrhoid tissues after jiuhuagao application and 2 untreated samples.Results: According to the clinical experiments, jiuhuagao is useful to hemorrhoid. The values for the number of the prolapse of hemorrhoid, the size of hemorrhoid and the anabrosis of mucosa were 15.425, 11.195, and 10.033 before and after the treatment(P<0.05), respectively, indicating the significant differences for the treatment. While, no statistical significance were uncovered for the number of fibroblast cell, connective tissue、the degree of inflammatory cell infiltration、sinus veins dilation and vascular enendothelial proliferation(P>0.05). The survival rates of fibroblasts cells and arrangement of collagen fiber were all become normal after the application of jiuhuagao according to the optical microscope and TEM observation.Conclusion: The tradition Chinese medicine, jiuhuagao, is useful in hemorrhoid treatment. It can elevate the viability of the fibroblasts cells, which further influence the pathology morphology of collagen fibers, the arrangement of the collagen fiber and elastic fiber.更多还原