Clinical Nursing Intervention of Moxibustion on Abdominal Distension Symptoms in Heart Failure (Heart and Kidney Yang Deficiency and Blood Stasis Blocking Collaterals Syndrome)

Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.

Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Objective:To investigate the molecular mechanism underlying the development of diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen and kidney yang deficiency (SKYD) using a proteomics approach.Methods:Male Sprague-Dawley rats (n =22) were divided into IBS-D (n =12) and normal control (n =10) groups.SKYD was then modeled in IBS-D rats by a combination of acetic acid enema,bondage,rectal dilation,tail stimulation,and Senna gavage.Colon tissue samples were subsequently collected and examined by Q Exactive mass spectrometry to identify differentially expressed proteins between the two groups.Results:The occurrence of SKYD/IBS-D was associated with ribosomal protein S23 (Rps23),protein phosphatase 2 catalytic subunit alpha (Pp2a),and growth factor receptor-bound protein 2 (Grb2),which are involved in the ribosome,neurotrophin signaling,and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathways.Conclusion:These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation,cell growth,apoptosis,stress granule formation,immune activation,loss of epithelial cell integrity,and visceral hypersensitivity.

Transcriptomic and metabolomic analysis of the effects of Zhenwu decoction on kidney yang deficiency pattern in chronic kidney disease

Objective:To explore the kidney yang deficiency pattern(KYDP)in a chronic kidney disease(CKD)rat model and the mechanisms underlying the effects of Zhenwu decoction(ZWD)by conducting tran-scriptomic and metabolomic analyses.Methods:Adriamycin(ADR)combined with hydrocortisone(HC)was used to induce CKD with KYDP in rats.ADR was injected into the tail vein twice.HC was injected intramuscularly for 8 weeks.ZWD was administered by gavage for 8 weeks.The general condition was observed,24-h urine protein was detected,serum corticosterone,triiodothyronine,thyroxine,TSH,testosterone,cAMP,and cGMP levels were determined,and pathological analysis was conducted.Transcriptomic and metabolomic analyses were conducted to screen differentially expressed genes(DEGs),differentially expressed metabolites(DEMs),and differentially expressed pathways(DEPs).The core DEMs and DEGs were input to Metab-oanalyst 5.0 to identify the pathways affected by ZWD.Results:In the HC group,KYDP symptoms were observed.Compared with control group,the levels of 24-h urine protein,TSH,and cGMP significantly increased(all P<0.01),and corticosterone,triiodothyronine,thyroxine,and cAMP significantly decreased(all P<0.01)in the HC group.After ZWD intervention,the levels of above-mentioned indicators could be reversed to some extent.Pathological analysis in the HC group revealed kidney lesions.DEGs in the ZWD group were mainly associated with pathways such as nucleotide synthesis and endocrine pathways.In the ZWD group,differences in biosynthesis of unsat-urated fatty acids and butanoate metabolism were observed.The following pathways were significantly affected by ZWD:arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.Conclusion:ZWD can be used to treat KYDP in CKD through regulating arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.

Clinical observation on efficacy of compound of warming yang, descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with Yin-Yang deficiency and blood stasis syndrome

Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.

Warm needling moxibustion versus electroacupuncture for simple obesity due to yang deficiency of the spleen and kidney: a controlled clinical trial

Objective: To compare the therapeutic efficacy between warm needling moxibustion and electroacupuncture (EA) in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Methods: Seventy patients with simple obesity due to yang deficiency of the spleen and kidney were randomly divided into a warm needling moxibustion group and an EA group, with 35 subjects in each group. Same major acupoints were selected for the two groups, including Shuifen (CV 9), Guanyuan (CV 4), Daheng (SP 15), Shuidao (ST 28), Shousanli (LI 10), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The warm needling moxibustion group received warm needling moxibustion, while the EA group received EA treatment. The interventions were performed once every other day, with 15 treatments as one course. The therapeutic efficacy, body weight and body mass index (BMI) were then observed and compared. Results: The total effective rate in the warm needling moxibustion group was 85.7% versus 77.1% in the EA group, and the between-group difference was statistically significant (P<0.05). The warm needling moxibustion was remarkably superior to the EA in weight loss and lowering BMI, both with statistical significance (P<0.05, P<0.01). At the three-month follow-up, the body weight and BMI further decreased in the warm needling moxibustion group (both P<0.05), and the levels were lower than those in the EA group (P<0.05, P<0.01). Conclusion: Warm needling moxibustion can produce reliable and consistent efficacy in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Compared with EA, warm needling moxibustion shows advantage in both short-term and long-term efficacies, and thus is worth promotion in clinical practice.

Regulatory mechanism of hormones of the pituitary-target gland axes in kidney-Yang deficiency based on a support vector machine model

OBJECTIVE:To study the development mechanism of kidney-Yang deficiency through the establishment of support vector machine models of relevant hormones of the pituitary-target gland axes in rats with kidney-Yang deficiency syndrome.METHODS:The kidney-Yang deficiency rat model was created by intramuscular injection of hydrocortisone,and contents of the hormones of the pituita- ry-thyroid axis:thyroid stimulating hormone(TSH),3,3',5-triiodothyronine(T_3) and thyroxine(T_4);hormones of the pituitary-adrenal gland axis:adrenocorticotropic hormone(ACTH) and Cortisol(CORT);and hormones of the pituitary-gonadal axis:luteinizing hormone(LH),follicle-stimulating hormone(FSH),and testosterone(T),were determined in the early,middle,and advanced stages.Ten support vector regression(SVR) models of the hormones were established to analyze the mutual relationships among the hormones of the three axes.RESULTS:The feedback control action of the pituitary-adrenal axis began to lose efficacy from the middle stage of kidney-Kong deficiency.The contents all hormones of the three pituitary-target gland axes decreased in the advanced stage.Relative errors of the jackknife test of the SVR models all were less than 10%.CONCLUSION:Imbalances in mutual regulation among the hormones of the pituitary-target gland axes,especially loss of effectiveness of the pituitary-adrenal axis,is one pathogenesis of kidney-Yang deficiency.The SVR model can accurately reflect the complicated non-linear relationships among pituitary-target gland axes in rats with of kidney-Yang deficiency.

The Effect of Hormones of the Hypothalamic-pituitary-target Gland Axes in a Kidney-Yang Deficiency Syndrome Model

Kidney-yang deficiency syndrome(KYDS)is a diagnostic pattern in the traditional Chinese medicine.Studies have shown that KYDS is related to the functional disorder of hormones of the hypothalamic-pituitary-target gland axes.The standard procedure used to mimic KYDS is the injection of a high dose of exogenous glucocorticoid(hydrocortisone and corticosterone).Such a model showed symptoms such as exhaustion,body twists,cold limbs,lying crowded together,decreased rectal temperature,sexual dysfunction,decreased reaction speed,reduced spontaneous activity,hair loss,loss of appetite,and weight loss.Moreover,the model manifested an imbalance in mutual control among the hormones of the pituitary-target gland axes,including adrenocorticotrophic hormone,CORT,CRH,thyroid-stimulating hormone,triiodothyronine,thyroxine,T,E2,follicle-stimulating hormone,luteinizing hormone,and 17-OHCS.

消水圣愈汤治疗老年肺源性心脏病临床观察

目的探讨消水圣愈汤对老年慢性肺源性心脏病(CPHD)患者血栓前状态指标及血清白细胞介素-8(IL-8)和肽素(Copeptin)水平的影响。方法将117例老年CPHD患者随机分为对照组(58例)和试验组(59例)。对照组予常规对症治疗,试验组在对照组的基础上予消水圣愈汤治疗,两组均治疗4周。比较两组临床疗效、血栓前状态指标及血清IL-8、Copeptin水平。结果治疗后,试验组总有效率为94.92%(56/59),高于对照组的79.31%(46/58)(P<0.05)。与对照组比较,试验组治疗后血浆黏度、血浆纤维蛋白原(FIB)水平、血清D-二聚体(D-D)、血管性假血友病因子(vWF)、内皮素(ET-1)水平较低,血清IL-8、Copeptin水平较低(P<0.05)。结论消水圣愈汤能明显改善老年CPHD患者血栓前状态,减轻炎症反应,促进心功能恢复,临床疗效显著。

温阳理气宣肺汤治疗感染后咳嗽肺脾阳虚型

目的观察温阳理气宣肺汤治疗感染后咳嗽肺脾阳虚型的临床疗效。方法选取72例肺脾阳虚型感染后咳嗽患者。采用随机抽取的方式分对照组与治疗组,各36例。治疗组采用温阳理气宣肺汤治疗,对照组给予复方甲氧那明胶囊治疗。2组均治疗10 d。对比2组治疗效果,2组中医证候评分、简易咳嗽程度评分表(CET)积分、莱彻斯特咳嗽问卷(LCQ)积分、复发率及不良反应发生情况。结果治疗组临床疗效结果总有效率(94.44%,34/36)高于对照组(83.33%,30/36)(P<0.05)。治疗后,2组中医证候评分、CET积分、LCQ积分均明显降低,且治疗组低于对照组(P<0.05)。治疗组复发率低于对照组(P<0.05)。2组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论温阳理气宣肺汤治疗感染后咳嗽肺脾阳虚型,可显著改善患者咳嗽症状,改善生活质量,促进患者康复,提高临床疗效,减少复发率,且安全性良好。

浅议肺饮病之论治

肺饮病病位在肺,涉及脾、肾、心等脏,病性为本虚标实之证,病机以肺阳亏虚为本,气、血、水紊乱为标,西医中的肺水肿即属于肺饮病范畴。肺水肿是指肺内组织液的生成和回流平衡失调,大量肺毛细血管内的组织液经过外渗,积聚在肺泡、肺间质和细支气管内,使肺血管外液量增多,从而造成肺的通气与换气功能严重障碍的病理状态。中医在治疗上需要分清标本虚实,注重肺与其他脏腑联系,急性期以温阳利水、化痰理气为主,缓解期以温肺助阳、健脾益肾为主,突出“以温药和之”的治疗原则,用药应标本兼顾、补虚泄实,使得复杂病症得以合理有效的治疗。

IgA肾病中医证候与尿蛋白电泳、尿视黄醇结合蛋白、尿免疫球蛋白G相关性研究

目的:探讨IgA肾病中医证候与尿蛋白电泳、尿视黄醇结合蛋白(urine-retinolbinding protein, U-RBP)、尿免疫球蛋白G(urine-immunoglobulin G,U-IgG)的相关性。方法:选取2021年4月至2022年5月于九江市中医医院肾内科住院的IgA肾病患者120例,根据其症状表现确定证候类型,收集各证型患者一般资料、检测各证型患者血肌酐(serum creatinine, Scr)水平,于肾穿刺活检前采集患者新鲜晨尿,测定尿蛋白检出率、U-RBP及U-IgG水平,分析IgA肾病患者中医证候分型与上述各指标的关系。结果:120例IgA肾病患者中,气阴两虚证占比最高,为28.33%,其次为肝肾阴虚证、脾肾气虚证、肺肾气虚证、脾肾阳虚证,占比分别为24.17%、18.33%、15.83%和13.33%。不同证候分型IgA肾病患者病程比较,差异有统计学意义(P<0.05)。120例IgA肾病患者的尿液经SDS-AGE电泳分析后共检出93例尿蛋白阳性,其中气阴两虚证和肝肾阴虚证检出肾小球性尿蛋白的概率高于其他证型,脾肾阳虚证检出混合性尿蛋白的概率高于肺肾气虚证和脾肾气虚证(P<0.05)。不同证候分型IgA肾病患者Scr、U-RBP、U-IgG水平比较,差异具有统计学意义(P<0.05),其中脾肾气虚证或肺肾气虚证患者血清Scr、U-RBP、U-IgG水平明显低于其他3个证候分型(P<0.05)。LEE分级中,肺肾气虚证Ⅰ级占比高于肝肾阴虚证和脾肾阳虚证,Ⅳ级占比低于肝肾阴虚证;脾肾气虚证LEE分级中Ⅰ级占比高于肝肾阴虚证和脾肾阳虚证,Ⅳ级占比低于气阴两虚证和肝肾阴虚证,差异均有统计学意义(P<0.05)。结论:IgA肾病患者肾小球性、混合性尿蛋白检出率及U-RBP、U-IgG水平与中医证候有一定相关性,综合分析其相关性,可一定程度上为IgA肾病的中医辨证分型提供参考。

肺积阳虚证古籍文献整理与研究

肺积乃“五积”之一,病名最早见于《难经》。肺积的发生多与阴气内积、外感寒邪、正气虚弱有关,情志、起居、饮食等因素也会影响其预后和发展。阳虚证是肺积的重要证型,肺积阳虚证的发展特点可总结为起于寒,伴随于寒,又不止于寒。本研究以古籍文献为基础,通过对肺积阳虚证病名内涵、病因病机和治疗特点进行归纳、分析、总结,探究古人对肺积阳虚证的认识,以期为临床治疗肺积阳虚证提供参考。

基于“肺阳虚”探析支气管哮喘的发病机制

支气管哮喘是目前最常见的慢性呼吸道疾病。中医认为哮喘的主要病理因素便是痰,痰凝聚伏藏于肺,则成为发病的潜在“夙根”。形成原因是素体肺气不足,津液不能正常宣散敷布,不能通调水道,易酿湿成痰,痰饮内伏。《素问·阴阳应象大论》中提到“阳化气,阴化形”,提示肺气的不足其根源便是肺阳的不足。以“肺阳虚”为基础,发现肺阳虚无力温化寒痰,哮喘之“夙根”由此产生;肺阳虚导致肺卫不固,无法抵御外邪入侵肺腑,诱发哮喘发作;肺阳虚无以化气,无法正常宣发肃降、通调水道,累及脾肾,形成哮喘缓解期的本虚标实之证。由此进一步探讨“肺阳虚”与哮喘的发病认识。

右归饮合增损启膈散辅助TP方案治疗晚期非小细胞肺癌肾阳亏虚证患者疗效观察

目的:探讨右归饮合增损启膈散辅助紫杉醇与顺铂(taxol cisplatin,TP)方案治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)肾阳亏虚证患者的临床疗效。方法:选择晚期NSCLC肾阳亏虚证患者80例,根据随机数字表法分为对照组与观察组,每组40例。对照组行TP方案化疗,21天为1个周期,连用2个周期;观察组在此基础上内服右归饮合增损启膈散,每日1剂,化疗第1天开始,水煎分2次温服,连服6周;比较两组临床疗效、肾阳亏虚证单项症状评分、毒副反应发生情况。结果:观察组总有效率[52.50%(21/40)]高于对照组[27.50%(11/40)](P<0.05);治疗6周后,肾阳亏虚证单项症状评分对照组明显增加(P<0.05),观察组明显降低(P<0.05),两组比较差异有统计学意义(P<0.05);白细胞及胃肠道反应发生率观察组低于对照组(P<0.05)。结论:在常规TP化疗基础上,使用右归饮合增损启膈散干预晚期NSCLC肾阳亏虚证患者,疗效确切,有利于减轻肾阳亏虚证单项症状,减轻毒副反应。

补肺温肾汤联合穴位埋针治疗阳虚水泛证肺胀临床研究

目的:观察补肺温肾汤联合穴位埋针治疗阳虚水泛证肺胀的临床效果。方法:选择96例阳虚水泛证肺胀患者作为研究对象,随机分为联合组和对照组各48例。对照组给予常规西医治疗,联合组在常规西医治疗基础上给予补肺温肾汤内服联合穴位埋针治疗。连续治疗2周后,比较2组临床疗效、中医证候评分、呼吸困难程度[改良版英国医学研究委员会呼吸困难量表(mMRC)评分]、生活质量[慢阻肺自我评估问卷(CAT)评分]、肺功能[用力肺活量(FVC)、第1秒用力呼气量(FEV_(1))、FEV_(1)/FVC]、心功能[左心室射血分数(LVEF)]和不良反应发生率。结果:治疗后,联合组总有效率为93.75%,对照组为79.17%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候评分、mMRC评分、CAT评分均较治疗前降低(P<0.05),且联合组中医证候、mMRC、CAT评分均低于对照组(P<0.05)。治疗后,2组FVC、FEV_(1)、FEV_(1)/FVC水平均较治疗前升高(P<0.05),且联合组3项肺功能指标均高于对照组(P<0.05)。治疗后,2组LVEF水平较治疗前升高(P<0.05),且联合组LVEF水平高于对照组(P<0.05)。联合组不良反应发生率为8.33%,对照组为6.25%,2组比较,差异无统计学意义(P>0.05)。结论:补肺温肾汤联合穴位埋针治疗阳虚水泛证肺胀可进一步减轻临床症状,改善心肺功能,提高生活质量,且安全性良好。

自拟补肺抗痨方合地黄饮子加减联合隔蒜灸及标准抗结核方案治疗耐多药肺结核阴阳两虚证的临床研究

目的:探讨自拟补肺抗痨方合地黄饮子加减联合隔蒜灸及标准抗结核方案治疗耐多药肺结核(MDR-PTB)阴阳两虚证的临床疗效。方法:选择我院2021年1月~2023年1月收治的124例MDR-PTB阴阳两虚证患者作为研究对象,按随机数字表法分为观察组和对照组各62例。对照组采用标准抗结核方案[6Lfx(Mfx)-Bdq(Lzd)-Cfz-Cs-Z(E,Pto)/12~14Lfx(Mfx)-Cfz-Cs-Z(E,Pto);Lfx:左氧氟沙星,Mfx:莫西沙星,Bdq:贝达喹啉,Lzd:利奈唑胺,Cfz:氯法齐明,Cs:环丝氨酸,Z:吡嗪酰胺,E:乙胺丁醇,Pto:丙硫异烟胺]治疗,观察组在对照组基础上联合采用自拟补肺抗痨方合地黄饮子加减及隔蒜灸治疗,连续治疗12周后对两组疗效进行评价。比较两组治疗前后中医证候积分以及治疗后痰菌转阴率、病灶吸收率、空洞缩小率。治疗前后检测患者血清炎症标志物[可溶性髓系细胞触发受体~1(sTREM-1)、基质金属蛋白酶-9(MMP-9)、白细胞介素-18(IL-18)]和外周血细胞免疫功能指标[CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞百分比以及CD4^(+)/CD8^(+)比值]。统计两组不良反应情况。结果:观察组总有效率为93.55%,与对照组的75.81%相比显著升高(P<0.05)。治疗后,两组形寒肢冷、盗汗、自汗、潮热、面浮肢肿、咳逆喘促少气积分均较治疗前显著降低(P<0.05),均以观察组为著(P<0.05)。治疗12周后,观察组痰菌转阴率、病灶吸收率、空洞缩小率分别为53.23%、64.52%、59.68%,较对照组(35.48%、45.16%、40.32%)均有明显升高(P<0.05)。治疗后,观察组血清sTREM-1、MMP-9、IL-18水平和外周血CD8^(+)水平均显著低于对照组(P<0.05),外周血CD3^(+)、CD4^(+)水平和CD4^(+)/CD8^(+)比值均显著高于对照组(P<0.05)。观察组不良反应发生率(33.87%)显著低于对照组(58.06%,P<0.05)。结论:自拟补肺抗痨方合地黄饮子加减联合隔蒜灸及标准抗结核方案治疗MDR-PTB阴阳两虚证能有效减轻患者机体内炎症反应,改善细胞免疫功能,促进痰菌转阴和病灶吸收,提高临床疗效。

四君子汤合四逆汤联合化疗治疗脾肾阳虚型肺癌效果观察

目的:分析四君子汤合四逆汤联合化疗治疗脾肾阳虚型肺癌的临床效果。方法:选取2021年3月—2023年10月汕尾逸挥基金医院收治的60例脾肾阳虚型肺癌患者为研究对象,随机分为中药联合组和常规化疗组,各30例。常规化疗组应用化疗方案干预,中药联合组在常规化疗组基础上联合四君子汤合四逆汤干预。对比两组中医证候评分,瘤体体积变化,贫血、骨髓抑制情况以及生活质量。结果:治疗后,中药联合组中医证候评分低于治疗前,且低于常规化疗组(P<0.05)。中药联合组贫血、骨髓抑制发生率均低于常规化疗组(P<0.05);两组瘤体体积减小幅度对比,差异无统计学意义(P>0.05)。治疗后,两组精神健康、生理功能、社会功能、情感功能评分均升高,中药联合组高于常规化疗组(P<0.05)。结论:四君子汤合四逆汤联合化疗治疗脾肾阳虚型肺癌的效果较好,有利于缓解患者不适症状,减少贫血、骨髓抑制发生,提高生活质量。

温补肾阳法对肾阳虚肺纤维化大鼠肺内CTGF表达的影响

目的探讨温补肾阳法治疗肾阳虚肺纤维化(PF)的作用及机制。方法 60只雄性6周龄Wistar大鼠采用随机数字表法分为正常组、模型组和干预组,采用一次性博来霉素A5气管插管给药加腺嘌呤连续灌胃28 d复制肾阳虚PF大鼠模型。正常组大鼠气管插管给予生理盐水加等渗生理盐水灌胃作为对照,模型组大鼠造模后生理盐水灌胃14 d,干预组大鼠造模后加味参附汤灌胃14 d,每组于实验第42天处死大鼠,留24 h尿液检测17-羟皮质类固醇(17-OH-CS)含量,同时,HE和MASSON染色观察肺纤维化程度,免疫组化法和Western印迹测定大鼠肺内结缔组织生长因子(CTGF)蛋白的表达,RT-PCR检测肺组织CTGF mRNA的表达。结果与正常组比较,肾阳虚肺纤维化模型大鼠尿17-OH-CS明显下降,模型大鼠肺组织内可见肺泡结构大量破坏,大量胶原沉积,干预组大鼠肺泡结构也基本消失,可见较多的胶原沉积,病理组织学表现明显轻于模型组。与正常组比较,模型组肺组织CTGF在肺内的表达水平明显升高(P<0.05);与模型组比较,干预组大鼠肺内CTGF的表达降低(P<0.05)。结论肾阳虚PF大鼠肾阳虚症状明显,肺内纤维化表现明显,造模成功,加味参附汤可以改善大鼠肾阳虚症状,可能通过抑制CTGF蛋白表达而缓解肺内胶原的进一步沉积减缓肺纤维化的发展。

多因素复合造模法致肺阳虚大鼠模型的研究

[目的]探讨肺阳虚大鼠病理模型方法。[方法]采用烟熏(外邪犯肺)、冰水游泳(形寒劳倦)、常温游泳(劳倦)、服用他吧唑冰水溶液(免疫抑制、内饮生冷)多因素复合造模法来制备肺阳虚证大鼠模型。观测大鼠体征,测定血液流变学指标。[结果]造模后期,大鼠出现喘鸣、呼吸急促、畏寒少动、精神萎靡、毛发凌乱无光泽、饮水量下降等症状;模型大鼠体重、背部温度、肛温、抓力呈显著性下降(P<0.05);低切变率下的全血粘度、全血还原粘度、红细胞刚性指数、电泳指数均显著性升高(P<0.05)。[结论]该造模方法能较好的与肺阳虚之临床症状相吻合,表明该方法是可行的。