【作者】 朱萍萍；

【导师】 陈力；

【作者基本信息】 南京中医药大学 ， 中医外科学， 2012， 硕士

【摘要】 目的：痤疮是一种青春期常见的毛囊皮脂腺的慢性炎症性疾病,表现为粉刺、丘疹、脓疱、结节和瘢痕等,好发于面背胸等富含皮脂腺的部位,但以颜面部居多,给患者的工作生活带来了不良影响,并危害患者的身心健康。本实验以金黄地鼠侧腹部皮脂腺斑为实验对象,以中医药理论为指导,通过测量皮脂腺斑的大小,观察皮脂腺斑的显微结构,阐明中药复方痤疮灵颗粒组方的合理性,找出复方中有效药味,为其在治疗痤疮中对性激素影响的物质基础及其作用机理研究做好更进一步基础工作。方法：雄性金黄地鼠62只,重120～150g。正常饲养一周后,随机分为六组,空白组12只,全方组、拆方1组、拆方2组、拆方3组、阳性对照组各10只。实验开始时先用电动剃须刀剃尽金黄地鼠双侧背部毛,充分暴露皮脂腺斑,在强光照射下,用游标卡尺测量双侧斑块的最大横径(DT)和最大纵径(DL)。灌胃时,各组金黄地鼠均按人的10倍剂量给药。全方组按金黄地鼠11g/kg生药的剂量给药,拆方1组、拆方2组、拆方3组分别按金黄地鼠6g/kg、2g/kg、3g/kg生药的剂量给药；阳性对照组按10mg/kg剂量给药；空白组灌服等量(1ml/100g)生理盐水。每日一次,连续灌胃4周。实验结束时再次用电动剃须刀剃尽金黄地鼠背部毛,充分暴露双侧皮脂腺斑,在强光照射下,用游标卡尺测量双侧斑块的最大横径和最大纵径。处死动物后取下金黄地鼠侧背部皮脂腺斑组织,切取约1.5cm*1.5cm组织块,放入10%甲醛固定液小瓶中固定,常规石蜡包埋、切片、HE染色,于光镜下观察皮脂腺斑的组织学变化。解剖各组金黄地鼠并称取其睾丸重量,计算睾丸系数。结果：1.皮脂腺斑大小：痤疮灵全方组、拆方1组、拆方2组、拆方3组及阳性对照组皮脂腺斑较治疗前缩小,具有非常显著性差异或显著性差异(p<0.01或0.05),空白组皮脂腺斑与治疗前比较无显著性差异(p>0.05)；治疗后全方组、拆方1组、拆方2组及阳性对照组左侧皮脂腺斑面积较空白组明显缩小,具有非常显著性差异(p<0.01),拆方3组与空白组比较有显著性差异(p<0.05)；全方组、拆方1组、拆方2组右侧皮脂腺斑面积较空白组明显缩小,具有非常显著性差异(p<0.01),阳性对照组、拆方3组与空白组比较有显著性差异(p<0.05)。痤疮灵全方组、拆方1组、拆方2组、拆方3组皮脂腺斑大小与阳性对照组比较无显著性差异(p>0.05)；全方组、拆方1组、拆方2组、拆方3组皮脂腺斑大小组间比较无显著性差异(p>0.05)。2.皮脂腺斑组织学结构：痤疮灵全方组、拆方1组、拆方2组、拆方3组及阳性对照组均较空白组皮脂腺松散,厚度变薄,皮脂腺腺叶变小；其中全方组、拆方2组较明显。皮脂腺厚度的比较：痤疮灵全方组皮脂腺厚度较空白组明显变薄,具有非常显著性差异(P<0.01)；拆方2组较空白组变薄,具有显著性差异(P<0.05)；拆方1组、拆方3组、阳性对照组与空白组比较,无显著性差异(P>0.05)。与阳性对照组比较,全方组、拆方1组、拆方2组、拆方3组均无显著性差异(P>0.05)。全方组、拆方1组、拆方2组及拆方3组皮脂腺厚度组间比较无显著性差异(P>0.05)。皮脂腺松散程度的比较：与空白组比较,痤疮灵全方组、拆方1组、拆方2组及阳性对照组均有非常显著性差异(P<0.01)；拆方3组具有显著性差异(P<0.05)。与阳性对照组比较,全方组、拆方1组、拆方2组、拆方3组无显著性差异(P>0.05)。全方组、拆方1组、拆方2组及拆方3组皮脂腺松散度组间比较无显著性差异(P>0.05)。3.睾丸系数：全方组、拆方1组、拆方2组、拆方3组、阳性组睾丸系数与空白组比较无显著性差异(P>0.05)。结论1.痤疮灵全方及其各拆方组、阳性对照组(安体舒通)均能使皮脂腺斑面积缩小。2.痤疮灵全方组、拆方2组均能使皮脂腺斑萎缩、变薄、腺叶松散。拆方1组、拆方3组及阳性组能够使皮脂腺腺叶松散,而腺叶变薄不明显。3.痤疮灵与安体舒通疗效相当,整方疗效大于拆方各组；拆方各组中,抑制皮脂腺斑增生的疗效可能依次为：拆方2组>拆方1组疗>拆方3组。4.痤疮灵全方及其拆方各组、阳性组均没有导致金黄地鼠睾丸萎缩的副作用。由此可见,痤疮灵能够通过调节性激素水平抑制皮脂腺细胞的增生和分泌功能,影响皮脂腺斑的增生,有效缩小金黄地鼠侧腹部皮脂腺斑。其中起主要作用的药味是丹参、制大黄,其次为蒲公英、蛇舌草、葛根。更多还原

【Abstract】 Objective:Acne vulgaris is a chronic imflammatory disorder of the pilosebaceous unit that occurs most commonly during adolescence,characterised by areas of skin with seborrheal,comedones(blackheads and whiteheads),papules, pustules, nodules and possible scarring. Acne affects mostly skin with the densest population of sebaceous follicles,these area include the face,the upper part of the chest and the back.Aside from scarring,acne negatively affects psychological health and psychosocial functioning,and even quality of life.Using the lateral abdominal sebaceous glands of a golden hamster as the experimental model,traditional Chinese medicine theory as a guide, by measuring the size and observing the microscopic structure of the sebaceous glands,the objective of the experiment is to expound the formula rationality of the traditional Chinese medicine(TCM) compound "Cuo Chuang Ling"pellet, and to find out effective drugs in the compound group,in order to further the research of its hormone influencing and mechanism in acne treating.Methods:62male golden hamsters,weighing120-150g,giving normal breeding, randomly divided into six groups after a week:non-treatment control group has12golden hamsters,each of the whole prescriptions group, disassembled prescriptions group1,2, and3, positive control group has10golden hamsters.At the beginning, the bilateral abdominal feather of the golden hamsters were completely cut with an electric shaver fully to expose the bilateral sebaceous glands. The maximum diameter (DT) and maximum longitudinal diameter (DL)of bilateral plaques were measured with caliper under the strong light. The each group of hamsters was fed the drug which was10times of human dosage.Animals of the whole prescriptions group were fed with11g/kg crude drug. Disassembled prescriptions group1,2, and3were given6g/kg,2g/kg,3g/kg crude drug separately.And the positive control group were10mg/kg dosage. Non-treatment control group was given an amount (1ml/100g) normal saline. Each group of golden hamsters wes fed once daily for4weeks. At the end of the experiment, the bilateral back hair of the golden hamsters were shaved again with an electric shaver, fully revealing the bilateral sebaceous glands.DT and DL of bilateral sebaceous glands were measured with caliper under the strong light.The tissue on the sebaceous glands approximately1.5cm*1.5cm were cut off after the hamsters were executed and were put in small bottles filled with10%formaldehyde liquid. Then the sebaceous glands were paraffined, sectioned, HE dyed,and the microstructual changes was being strutinized under a light-microscope. After the golden hamsters were dissected,their testicles were weighed and the testicular coefficient was calculated.Results1. The size of sebaceous glands:The size of the sebaceous glands of the whole prescriptions group, disassembled prescriptions group1,2, and3, and positive control group is smaller compared with the sebaceous glands before treating,which has a very significant difference or significant difference (p<0.01or0.05)than before.However, the non-treatment control group has no significant difference (p>0.05). The size of the left sebaceous glands of whole prescriptions group, disassembled prescriptions group1,2and positive control group is much smaller compared with the non-treatment control group,which has a very significant difference (p<0.01),and disassembled prescriptions group3with a significant difference (p<0.05). The size of the right sebaceous glands of the whole prescriptions group, disassembled prescriptions group1,2become much smaller compared with the non-treatment control group which has a very significant difference (p<0.01),while disassembled prescriptions group3and positive control group with significant differences (p<0.05). The size of the sebaceous glands of the whole prescriptions group, disassembled prescriptions group1,2and3has no significant difference compared with the positive control group (p>0.05). The size of the sebaceous glands of the whole prescriptions group and its disassembled prescriptions groups has no significant difference compared with each other(p>0.05).2. Micro structural analysis of the sebaceous glands:The microstructure of the sebaceous glands of the whole prescriptions group, disassembled prescriptions group1,2, and3, and positive control group loosen,becomes thinner, and the gland leaves are much smaller compared with the Blank group.Of them, whole prescriptions group, disassembled prescriptions2are obvious. Comparison of the thickness of the sebaceous glands:Thickness of the sebaceous glands of whole prescriptions group is much thinner than the non-treatment control group group.which has a very significant difference (p<0.01). Thickness of the sebaceous glands of disassembled prescriptions group2is thiner than the non-treatment control group which has a significant difference (P<0.05). Thickness of the sebaceous glands of disassembled prescriptions group1,3and the positive control group has no significant differences(P>0.05) compared with the non-treatment control group.Thickness of the sebaceous glands of the whole prescriptions group, disassembled prescriptions group1,2and3has no significant differences(p>0.05) compared with the positive control group.Thickness of the sebaceous glands of the whole prescriptions group and its disassembled prescriptions groups has no significant difference compared with each other(p>0.05).Comparison of the loose degree of the sebaceous glands:The loose degree of the sebaceous glands of whole prescriptions group and disassembled prescriptions group1,2and positive control group is much looser compared with the non-treatment control group,which has a very significant difference(p<0.01), while disassembled prescriptions group3with a significant difference (P<0.05).The loose degree of the sebaceous glands of the whole prescriptions group, disassembled prescriptions group1,2and3has no significant difference (p>0.05) compared with the positive control group. The loose degree of the sebaceous glands of the whole prescriptions group and its disassembled prescriptions groups has no significant difference compared with each other(p>0.05).3. Testicular coefficient:The testicular coefficient of whole prescriptions group and its disassembled prescriptions groups, positive control group has no significant difference compared with the non-treatment control group (p>0.05).Conclusion1. The size of the sebaceous glands of the whole prescriptions group and its disassembled prescriptions groups,positive (spironolactone) control group becomes smaller.2. The microstructure of sebaceous glands of whole prescriptions group,disassembled prescriptions group2becomes atrophy, thinner, and the gland leaves loosen. The gland leaves of disassembled prescriptions group1,3and the positive control group loosen, while the gland leaves not become thinner obviously.3. The whole prescriptions group of "Cuochuang ling" has equivalent effect with spironolactone in inhibiting hyperplasia of the sebaceous glands. The whole prescriptions group is more effective than its disassembled prescriptions groups. And the effect of inhibiting the hyperplasia of the sebaceous glands of the disassembled ones, disassembled prescriptions2group is best.next is the disassembled prescriptions group1,and the disassembled prescriptions group3is the last.4. None of the whole prescriptions group, disassembled prescriptions group1,2, and3, and positive control group has side effects of inducing atrophy to the testicular of hamsters.This shows proliferation and secrete function of the sebaceous glands can be inhibited,the sebaceous glands hyperplasia are influenced, and the golden hamsrer sebaceous glands are narrowed effectively by "Cuo Chuang Ling" through adjusting the sex hormone levels.Of the prescription,Danshen,processed Dahuang may play the main effct, followed by Pugongying,Baihuasheshecao and Gegen.更多还原