代谢性疾病病证结合动物模型的探讨与思考

Animal models combining disease and syndromes related to metabolic diseases

目的为选择合理、可靠的动物种类、造模方式、评价体系的病证结合动物模型提供参考,为中医药辨证论治提供可靠的病证结合动物模型。方法系统检索30年来糖尿病、肥胖症、高脂血症、高血压、高尿酸血症与痛风六大疾病相关病证结合动物模型的文献,收集和整理相关文献报道,归纳、总结动物相关参数、造模方式、证型及评价体系。结果收集到代谢性疾病病证结合动物模型的文献243篇,其中132篇涉及糖尿病(气阴两虚、湿热困脾、阴虚内热、内热偏盛型);3篇涉及肥胖症(脾虚湿阻型);9篇涉及高脂血症(痰浊阻滞、气滞血瘀、气郁血瘀型);7篇涉及高尿酸血症及痛风(脾虚痰湿、瘀血、湿热蕴结型);92篇涉及高血压(痰湿壅盛、肝阳上亢、肝火亢盛型)。实验动物以雄性大鼠应用最广泛(高尿酸血症及痛风多使用鹌鹑);造模方式有单因素、双因素及混合因素复制病证结合动物模型;评价体系分别从病理指标(糖、脂代谢、血清生化、肝肾功能等)和一般状态(精神状态、活动量、二便、舌色等)进行判定。结论目前代谢性疾病相关的病证结合动物模型的造模方式及评价体系仍需进一步完善,为中医药辨证论治提供可靠的病证结合动物模型,以期为深入研究中医药辨证论治创造条件。

Objective This article provides a reference for choosing a reasonable,reliable animal species,modeling method and evaluation index system,and provides a reliable animal model combining disease and syndrome for Chinese medicine syndrome differentiation.Methods We systematically searched the last 30 years for literature on animal models that combine a disease and a syndrome for six diseases related to diabetes mellitus,obesity,hyperlipoidemia,hypertension,hyperuricemia,and gout.Then we collected and organized the relevant literature,and summarized animal-related parameters,modeling method,evidence types and evaluation systems.Results Among the 243 literatures retrieved,132 literatures involved diabetes.The syndromes include deficiency of both qi and yin,damp heat trapped spleen type,internal heat due to yin deficiency,excessive internal heat;3 literatures involved obesity.The syndromes include Spleen deficiency dampness resistance type;9 literatures involved hyperlipidemia.The syndromes include Phlegm turbidity blocking type,qi stagnation and blood stasis type;7 literatures involved hyperuricemia and gout.The syndromes include spleen deficiency phlegm dampness type,blood stasis type and damp heat accumulation type;92 literatures involved hypertension.The syndromes include phlegm dampness essential,hyperactivity of the liver yang and vigorous liver fire type.Male rats(SD rat,Wistar rat)are involved in the most widely used experimental animals,quail is also applied to hyperuricemia and gout.The modeling method involved are mainly single-factor,dual-factor and hybrid-factor.The main evaluation method of creditial card combining disease and syndrome is to judge and characterize animal model by macroscopic symptoms,signs(behavior experiments,mental status,livestock manure,tongue images,ect)and pathological indicators(glucolipid metabolism,serum biochemistry,liver and kidney function,ect).Conclusions The current modeling method and the main evaluation method of animal models that that combine a disease and a syndrome need to be improved to provide a reliable animal model combining diseases and syndromes for Chinese medicine syndrome differentiation and to establish conditions to study Chinese medicine syndrome differentiation.