【作者】 詹新林；

【导师】 刘淑余；

【作者基本信息】 湖南中医学院 ， 中西医结合临床妇产科学， 2002， 硕士

【摘要】 本项目研究目的是探讨以益气化瘀立法的黄芪、丹参复方成分提高胎盘血供的可能机制。提取黄芪、丹参有效成分制成注射液(以下称芪丹注射液)，于妊娠第10天用一氧化氮合酶(NOS)阻滞剂亚硝基左旋精氨酸甲酯(L-NANE)建立妊娠高血压综合征(PIH)动物模型，分别以硝酸甘油、芪丹注射液进行孕期同步干预，结果显示： 1．通过抑制一氧化氮(NO)合成，可使孕鼠出现高血压、蛋白尿等PIH相关症状，胎儿发育不良或胎死宫内发生率明显增加。 2．益气化瘀法能够改善胎儿的各项发育参数，胎死宫内、胎儿宫内发育迟缓(IUGR)的发生明显减少。 3．益气化瘀法能够降低模型孕鼠尿蛋白、血压水平。 4．益气化瘀法能够调整内皮细胞分泌NO功能，以改善子宫胎盘循环。 5．益气化瘀法能降低细胞毒性因子肿瘤坏死因子(TNFα)水平，以减轻对血管内皮细胞的损害。 6．益气化瘀法能够减轻子宫胎盘充血及炎性反应，防止血管内皮细胞损伤，促进子宫胎盘床血管的修复。 上述实验结果表明：NO合成不足或障碍是PIH发病的重要因素或环节。以益气化瘀立法的芪丹注射液通过影响NO、TNFα水平，促进滋养细胞的生长发育及胎盘血管重铸过程，从而达到改善子宫胎盘循环的目的。说明本法对抑制NO合成所致PIH具有良好的疗效。更多还原

【Abstract】 Objective: To investigate the potential curative mechanism of increasing the placental blood of the components in HuangQiDanShen compound prescription based on Qi-tonifying and bloodstasis-resolving therapy (YiQiHuaYu) in TCM.Methods: Effective components of astragalus root and red sage root were abstracted and made into injection(named "QIDAN injection").NOS blocker L-NANE was used to make PIH animal model on the 10th pregnant day, and nitroglycerin and the QIDAN injection were administered synchronously.Results: By inhibiting the synthesis of NO hypertension, albuminuria and some other PIH-related symptoms occurred in the pregnant rats ,and the rats of intrauterine growth retardation(IUGR) and fetal death in the uterus increased obviously. YiQiHuaYu therapy improved all measured growth parameters of fetus. The incidence of IUGR and fetal death in uterus decreased remarkably in the treatment group. YiQiHuaYu therapy decreased the levels of urine protein and blood pressure in pregnant model rats. YiQiHuaYu therapy improved uterine and placental circulation by regulating the endothelial cells function of secreting NO. YiQiHuaYu therapy protected the vascular endothelial cells by decreasing the level of cytotoxin TNFa. YiQiHuaYu therapy alleviated the congestion and inflammation of the uterus and placenta, protected the vascular endothelial cells from injury and facilitatethe restoring of the uterine and placental vessels.Conclusion: The results show that NO synthetical deficiency is an important factor or process in the pathogenesis of PIH. QIDAN injection based on the YiQiHuaYu therapy can improve the uterine and placental circulation by effecting the levels of NO and TNF, promoting the trophoblastic cell’s growth and development and accelerating the process of placental revascularization. In a word, the results suggest that this prescription has a satisfactory curative effect on the placental blood deficiency induced by inhibiting NO synthesis.更多还原