摘要
目的基于肝硬化中医基本证候病机的认识及中医“以方测证”的思维方法,探讨下瘀血汤、茵陈蒿汤、一贯煎、黄芪汤对CCl4大鼠肝硬化成型阶段的干预作用及方证病理基础。方法首次以CCl43ml/kg皮下注射,以后以50%CCl4橄榄油溶液2ml/kg皮下注射,每周2次;第9周开始随机分为模型对照组及下瘀血汤、茵陈蒿汤、一贯煎、黄芪汤与小柴胡汤等5个干预治疗组;干预治疗的同时继续造模至12周末取材。观测肝功能、肝组织病理学、肝组织羟脯氨酸(Hyp)含量变化。结果(1)模型大鼠8周时呈典型的慢性肝损伤肝纤维化的病理改变,12周时已形成肝硬化。(2)与模型对照组大鼠比较,下瘀血汤组和一贯煎组肝组织病理改变明显减轻,肝组织Hyp含量显著下降,肝功能显著改善,其中尤以下瘀血汤的改善作用为著;一贯煎的特点是提高血清白蛋白(Alb)含量。结论CCl4大鼠肝硬化成型阶段病理变化的主要矛盾———肝内纤维结缔组织的快速增生以及由此引起的组织结构改建是下瘀血汤发挥作用、血瘀阻络方证病机的病理基础;而此阶段的肝实质严重受损,是一贯煎发挥效应、肝阴虚损方证病机的又一病态表现。
Objective To investigate the recipe-based pathogenesis and effects of Xiayuxue Decoction （XD）, Yinchenhao Decoction （YcD）, Yiguanjian Decoction （YgD） and Huangqi Decoction （HD） on carbon tetrachloride （CCl4） induced liver cirrhosis formation in rats on the basis of the recognition of basic pathogenesis of liver cirrhosis in TCM and train of thoughts of detecting the TCM syndrome by recipe. Methods Model rats of liver cirrhosis were established by subcutaneous injecting of 100 % CCl4 3ml/kg followed by 50 % CCl4 olive solution 2ml/kg, twice a week for 12 weeks. They were randomly divided into the model group, the XD treated group, the YcD treated group, the YgD treated group and the HD treated group. Rats in the three treated group received the treatment starting from the 9th week of modeling with the corresponding decoctions. All animals were sacrificed by the end of the 12th week, and their hepatic function, liver pathological changes and hydroxyproline （Hyp） content of hepatic tissue were detected. Results （1） Typical chronic liver injury and fibrosis became evident in the model rat at the 8th week and cirrhosis came into being at the 12th week. （2） Compared with the rats in the model group, hepatic pathological changes were alleviated significantly, content of Hyp in hepatic tissue was decreased markedly and hepatic function improved remarkably in the XD group and YgD group. The improvement in the XD group was superior to that in the YgD group, while the serum albumin level elevated more significant in the YgD group. Conclusion The main pathological changes during CCl4 induced liver cirrhosis formation in rats is the rapid hyperplasia of hepatic fibrous connective tissue and obstruction of collaterals by blood stasis, thus induced reconstruction of the tissue structure, which could be treated with XD effectively, while the severe injury of liver parenchyma in this phase is another pathological change of Gan-yin deficiency syndrome, which could be effectively treated with YgD by its Yin-nourishing action.
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2006年第4期344-347,共4页
Chinese Journal of Integrated Traditional and Western Medicine
基金
国家自然科学基金重大研究计划重点项目(No.90409020)
上海市自然科学基金重点项目(No.02JC14024)
上海市教育委员会E研究院建设计划项目(No.E03008)
上海市重点学科建设项目(No.Y0302)
关键词
肝硬化
中医方剂
中医病机
liver cirrhosis
TCM recipe
TCM pathogenesis
作者简介
通讯作者：刘平，Tel：021-51322002，E-mail：liuping@shutcm.com
