基于望诊的急性胃肠道辐射伤大鼠模型中医证候演变规律

Evolution Rule of Chinese Medicine Syndromes in Acute Gastrointestinal Radiation Injury Rat Model Based on Inspection

目的通过观察实验动物活体、器官和组织动态变化,总结急性胃肠道辐射伤的中医证候学特点及演变规律。方法将90只SD雄性大鼠随机分为模型组80只和对照组10只。模型组采用60Co-γ射线单次全身照射,对照组不予照射,观察大鼠全身状况,并分别于照射后第1、4、7、10、14天肉眼及显微镜观察胃肠道及组织形态变化。结果照射后初期(0~2天),模型组出现躁动、多饮、目赤等现象,小肠黏膜轻度充血水肿;早期(3~6天),体质量下降,水样便,小肠黏膜充血水肿明显、多发出血灶及糜烂坏死;中期(7~12天),经过短暂恢复后体质量继续下降、拒食、大量死亡,胃肠腔内淤积紫黑色黏液,黏膜下层微血管闭塞;后期或恢复初期(13天后),蜷缩少动、毛发干枯、爪甲苍白,肠组织固有层间质纤维增加。对照组活体、胃肠及黏膜组织观察均无异常。结论急性胃肠道辐射损伤,初期属热毒内盛、气血两燔证,早期为热灼血肉、元气耗伤、脾阳不振证,中期为元气虚损、真阴耗伤、瘀毒互结证,后期为肝肾亏耗、气血两虚、血络瘀阻证。

Objective To summarize the characteristics of Chinese medicine syndromes and evolution rule of acute gastrointestinal radiation injury by observing the dynamic changes of living animals,organs and tissues in experimental animals. Methods Ninety SD male rats were randomly divided into model group（n = 80） and control group（n = 10）. The model group was irradiated with a single dose of60 Co-γ radiation and the control group was not irradiated. The general condition of the rats was observed. The changes of gastrointestinal tract and histomorphology were observed with the naked eye and the microscope at 1,4,7,10,and 14 days after irradiation. Results In the initial post-irradiation period（0 to 2 days）,the model group showed signs of restlessness,excessive drinking,and red eyes. The small intestine mucosa was slightly congested and with edema. In the early stage（3 to 6 days）,body weight decreased with watery stools,and small intestine mucosal was with obvious congestion and edema,as well as multiple bleeding,erosion and necrosis. In the middle stage（7 to 12 days）,after a brief recovery,body weight continued to decline,and unwilling to eat,with massive death. Purple-black mucus was deposited in the gastrointestinal cavity,and submucosal microvascular was occluded. In late or early recovery stage（13 days later）,the rats were cowered with less activity,dry hair,pale paws,and increased interstitial fibers in the intestine. The control group had no abnormalities in living body,gastrointestinal and mucosal tissues. Conclusion Acute radiation damage of gastrointestinal tract is internal exuberance of heat toxin,blazing of both Qi and blood syndrome in the initial stage;heat burning flesh and blood,Yuan Qi consumption and damage,and devitalization of spleen Yang syndrome in the early stage; Yuan Qi deficiency and damage,true Yin consumption and damage,binding of blood stasis and toxin syndrome in the middle stage; and the liver and kidney depletion and consumption,Qi and blood deficiency,blood stasis and collateral obstruction syndrome in the late stage.