肺热证与阳明热证的相关性研究

【作者】 于河；

【导师】 谷晓红；

【作者基本信息】 北京中医药大学 ， 中医临床基础， 2006， 硕士

【摘要】 肺与胃肠是人体重要的相关脏腑,它们在生理病理上联系紧密。笔者通过总结谷晓红教授对于诊治热证中手太阴与阳明同病的经验,认为阳明有热是肺热证发生发展的重要影响因素,即肺热证与阳明的功能状态有密切联系。【目的】以谷晓红教授经验方银莱汤治疗肺胃积热证为切入点,探讨手太阴肺热证与阳明热证的相关性,以揭示肺与胃肠生理病理联系,提出治疗肺热证重视阳明的治疗思路。【方法】本文分为理论研究、实验研究和临床研究。理论研究分为三个部分:一、建立肺胃相关理论数据库,追本溯源,从中医学角度阐述其生理病理联系,及肺与阳明同病之热证的辨治思路和处方用药规律;二、以肺热证与阳明的相关性为依据,开展银莱汤治疗肺胃积热证的理论研究,阐释肺胃积热证的病因病机,分析银莱汤的组方原理和适应证候;三、开展肺与胃肠西医学相关性理论研究,以西医学中有关肺与胃肠生理联系的物质基础为依托,阐释肺系疾病与胃肠疾病在发病机制、症状中的联系,探讨中医肺胃同病的西医学物质基础。实验研究:通过喂饲高蛋白、高热量饮食,制作阳明积热证小鼠模型,描记阳明积热证小鼠胃电图,观察分析小鼠胃电图参数改变及规律;流感病毒经鼻感染阳明积热证小鼠以制作肺胃积热证病因模型,观察银莱汤对肺胃积热证小鼠肺脏病理以及血清IL-2、TNF-α的影响,探讨银莱汤对肺胃积热证的防治作用机理。以证明阳明有热对肺热证发生发展的重要影响,及治疗肺热证重视阳明的有效性。临床研究:建立谷晓红教授临床诊治肺与阳明同病证病例数据库,验证临床经验方银莱汤的治疗效果,归纳肺与阳明同病之热证的临床常见症状和疾病。【结果】1理论研究:肺胃在五行属金土相生,为母子关系;肺与大肠互为表里,荣则共荣,损则俱损。它们在生理上联系紧密:经络相通,次第流注;为人体纳化之源,共成后天之本,化生气血,共成津液,洒陈脏腑,濡养周身,共司卫外,同候脉气;调畅气机,运行气血;呼吸摄纳,推陈出新。阳明有热对肺热证发生发展起着重要作用;现代西医研究证实肺与胃肠生理病理存在密切联系,肺与胃肠在激素水平互相调节、互相影响;在细菌和病毒等病原微生物所致的感染性疾病中,呼吸系统与消化系统症状体征具有相关性;非感染性疾病中,某些胃肠疾病有呼吸系统的特殊表现,有的关系甚为密切,某些呼吸系统疾病也同时存在消化道症状。2实验研究2.1实验一:与正常组比较,阳明积热模型组胃电图呈高频、高幅。造模3天组与正常组胃电图振幅差异显著(p<0.05)。造模3天组与正常组胃电图频率差异极显著(p<0.01),造模5天组与正常组差异显著(p<0.05)。主频变异系数正常组为0.1799,造模3天组为0.3973,造模5天组为0.2672,均高于正常组。造模3天组和造模5天组之间胃电图频率、更多还原

【Abstract】 The author presumes that Yangming meridians pyretic syndrome is relative to Hand-TaiYin pyretic pulmonary syndrome , by summarying professor GuXiaohong’s experience cureing the patients who got pyretic comorbidity of Hand-TaiYin and Yangming meridians.Therefore,there is close relationship between pyretic pulmonary syndrome and the functional condition of Yangming meridians.【AIM】Discusing the relationship of Hand-TaiYin pyretic pulmonary syndromes and Yangming meridians by analysing Professor GuXiaohong’s empirical formula“Yinlai Decoction”,and paying more attention to Yangming meridians syndromes when the patients are caught Hand-TaiYin pyretic pulmonary syndromes.【Method】Theory study,laboratory study and clinical study are involved. Theory study:first,creating a database composed of theories about lung、stomach and large intestine,to investigate their relationships of physiology and pathology in Chinese medicine,and the conception of treatment and prescription of pyretic syndrome of lung and stomach.Second,carrying out the theory study of FEIWEIJIRE syndrome,in order to explain the cause and onset of the disease,principle of prescription,and indication.Third,studying the correlation between lung、stomuch and intestine according to the conception of these organs in western medicine.Based on the study of the physiological connection of lung、stomach and intestine,to further inverstigate the relationship between lung diseases and gastroenteropath of their pathogenesis and symptoms.And discuss the material foundation of the theory--“the syndromes of the lung and stomach occurring simultaneously”in traditional Chinese medicine.Laboratory study:creating the mice model of YANGMINGJIRE syndrome by feeding high calorie and high protein diet,and recording the EGG of the mice,in order to observe the change and law of parameter of EGG.Creating the mice model of FEIWEIJIRE syndrome by feeding high calorie and high protein diet and infecting FM1 Influenza virus via nose,in order to investigate the influence of Yinlai Decoction on lung injury,IL-2 and TNF-αlevels in serum by Yinlai Decoction.And to indicate the role of pyretic Yangming meridians syndrome during pyretic pulmonary syndrome course.Clinical study:building up the database of clinical cases which suffer from the syndromes of the lung and yangming meridians,in order to demonstrate the efficacy of Yinlai Decoction,and summarize the usual symptom and common diseases which is characteristic of the same pathogenesis--“the syndromes of the lung and Yangming meridians”.【REAULT】1. Theory study:lung and stomach complement each other,they are mother and son.The lung更多还原