四逆散促胃肠动力作用及其作用机制的实验研究

【作者】 牛潞芳；

【导师】 邱明义；

【作者基本信息】 湖北中医学院 ， 中医临床基础， 2003， 硕士

【摘要】 目的 功能性消化不良(Functional Dyspepsis, FD)，是由非器质性病变引起的一组消化不良症候群。FD的发病机制至今尚未完全明了，现代医学主要采用促胃肠动力药予以治疗，虽有一定的疗效，但同时也有不同程度的副作用。FD属于祖国医学“胃痛”、“痞证”、“纳呆”、“嘈杂”、“胃缓”、“呕吐”、“呃逆”等证的范畴，近些年来，应用中医药治疗FD取得了显著的疗效。FD以肝郁气滞，脾运失职，胃失通降为其基本病机，因此，本课题采用疏肝理气的代表方四逆散，从胃排空、小肠推进、神经元、神经递质的角度，来探讨其促胃肠动力的作用及作用机制。 本课题通过对正常小鼠胃内葡聚糖蓝-2000残留量、小肠内葡聚糖蓝-2000推进率，来研究四逆散对小鼠胃排空、小肠推进的影响；通过采用正常大鼠肠道气囊法，记录正常大鼠用药后肠收缩幅度和频率的变化；采用医学彩色图象全自动分析系统，分析用药后正常大鼠胃窦组织中NOS(Nitric xidesynthase)阳性神经元分布面积和酶活性的变化；采用硝酸酶还原法和比色法，检测用药后正常大鼠胃窦组织中NO(Nitric Oxide)和TchE(True choline esterase)的含量变化，通过以上几个方面，研究四逆散的促胃肠动力作用及其作用机制。 方法 取30只健康的昆明种小白鼠，体重20±2g，雌雄各半；30只健康的SD系大白鼠，体重200±20g，雌雄各半。随机分为四逆散组、莫沙比利组和生理盐水组三组，每组10只。分别观察四逆散，莫沙比利和生理盐水对小鼠胃排空、小肠推进的影响，对大鼠肠收缩幅度和频率的影响，对大鼠胃窦组织中NOS阳性神经元分布面积和酶活性的影响，以及对大鼠胃组织中NO、TchE含量的影响。各组数据均采用均数±标准差((?)±s)表示，用SPSS统计软件进行数据处理，单因素方差分析，均采用组间两两比较。 结果 1．对小鼠胃内色素残留量的影响中，四逆散组与莫沙比利组比较无显著性差异(p＞0.05)，与生理盐水组比较有非常显著性差异(P＜0.01)；莫沙比利组与生理盐水组比较有非常显著性差异(P＜0.01)。 2．对小鼠小肠色素推进率的影响中，四逆散组与莫沙比利组比较无显著性差异(P＞0.05)，而与生理盐水组比较有显著性差异(P＜0.05)；莫沙比利组与生理盐水组比较有非常显著性差异(P＜0.01)。 3．对大鼠肠收缩幅度和频率的影响中，四逆散组与生理盐水组比较有非常显著性差异(P＜0.01)，与莫沙比利组比较无显著性差异四逆散促胃肠动力一作用及其作用机制的实验研究硕士论文(P>0.仍);莫沙比利组与生理盐水组比较也有非常显著性差异(P<0 .01)。 4.对大鼠胃窦组织中NOS阳性神经元分布面积和酶活性的影响中，四逆散组与莫沙比利组比较无显著性差异(P>0.05)，而与生理盐水组比较有非常显著性差异(P<0.01);莫沙比利组与生理盐水组比较也有非常显著性差异(P<0.01)。 5.对大鼠胃窦组织NO，TchE含量的影响中，四逆散组与莫沙比利几组比较有非常显著性差异(P<。.01)，与生理盐水组比较无显著性差异(P>0.05);莫沙比利组与生理盐水组比较有非常显著性差异(P<仪01)。结论 四逆散可促进胃排空、小肠推进，从而促进胃肠动力。 四逆散的促胃肠动力作用机制可能是: (1)加快肠收缩频率并升高其收缩幅度，从而推进肠蠕动，防止肠动力障碍，协调胃十二指肠运动。 (2)使胃窦壁NOS阳性神经元分布面积减少，活性降低，从而减少非肾上腺素非胆碱能神经元(non一adrennergie non一eholinergie NANc)抑制性神经递质NO的生成，从而增强胃肠道平滑肌的兴奋性，促进胃排空。 (3)增加胃组织中兴奋性神经递质Aoh的水解酶T比E含量的同时降低胃组织中抑制性神经递质NO的含量，促进胃收缩.更多还原

【Abstract】 Object:Dysfunctional Dyspepsia is a group of dyspepsia symptoms caused by nonorgan pathological changs.The cause of it does not definite.So far,we have beening lakeing effective remedies for curing it. There is no name about the illness in the TCM,but according its clinical symptom, it belong to the syndrome of the stomachache, the stuffiness in the stomach,the scarcity desire of the dining, the gastric upset, the frequent vomiting, the spewing, the hiccup and so on.The fundamental pathogenesis of it is the liver-qi stagnation the spleen-qi deficiency and the stomache-qi ascending adversely. During this years, TCM has a prominent effect on Dysfunctional Dyspepsia,so we study the effect of SiNiSan of soup on the Dysfunctional Dyspepsia sharply from the ability of stomach emptying and the ability of intestines pussing on the normal Kunming rats by the coloring matter,and the chang of the nerve fiber, nerve qualitative, on the stomach organize of normal SD ratsMethods:In the experiment, the thirty Kunming rats, whose avoirdupois are about twenty grammes,and thirty S. D rats, whose avoirdupois are about two hundred grammes,were randomly divided into three groups, 0. 9yS group, SiNiSan of soup group and Mosapride Citrate group. Every gro-up had ten rats and was dealed with water, SiNiSan of soup and Mosa-pride Citrate. At last,we study the effect of the ability of stomach emptying and the ability of intestines pussing on the Kunming rats.An-d we study the chang of the intestines constract scope and frequency of the norml SD rats, the chang of the nerve fiber, the nerve qualitative, on the stomach organize of the normal SD rats The statistical method are F test and Q test.Result:The experiment of gastric emptying rate on mouse has showed thatSiNiSan of soup could promote he gastric mptying ate,there was very remarkable differentce between the SiNiSan of soup group and the normal group (p<0.01),and there was not significant difference between the SiNiSan of soup group and the Mosapride Citrate group (p>0. 05). And there was very remarkable differencebetween the Mosap-ride Citrate group and the normal group(p<0. 01).The experiment of intestines pussing rate on rat has showed that SiNiSan ofsoup could promote the intestines pussing rate, there was remarkable difference between the SiNiSan of soup group and the norma 1 group(p<0. 05),and there was not significant difference between the SiNiSan of soup group and the Mosapride Citrate group(p>0.05).And there was very remarkable difference between the Mosapride Citrate group and the normal group(p<0. 01).The experiment of the intestines constract scope and frequenc has showed that SiNiSan ofsoup could promote the intestines constract scope and frequenc, there was very remarkable difference between the SiNiSan of soup group and the normal group(p<0. 01),and there was not significant difference between the SiNiSan of soup group and the Mosapride Citrate group(p>0. 05).And there was very remarkable difference between the Mosapride Citrate group and the normal group (p<0. 01).The experiment of the NOS masculine nerve fiber distributing area and enzyme active that SiNiSan ofsoup could reduce the NOS masculine nerve fiber distributing area and enzyme active there was very remarkable difference between the SiNiSan of soup group and the normal group (p<0. 01), and there was not significant difference between the SiNiSan of soup group and the Mosapride Citrate group(p>0,05).And there was very remarkable difference between the Mosapride Citrate group and the normal group(p<0. 01).The experiment of the stomach organize NO, TchE content has showedthat SiNiSan ofsoup could reduce NO content and promote tHe TchE content there was very remarkable difference between the SiNiSan of soup group and the normal group (p<0. 01), and there was not significant difference between the SiNiSan of soup group and the Mosapride Citrate group(p>0. 05). And there was very remarkable difference between the Mosapride Citrate group and the normal group (p<0. 01).Conclusion:更多还原