活络效灵丹加味治疗肢体缺血再灌注损伤的临床与实验研究-中医骨伤科学专业论文.docxVIP

提要本课题是在祖国传统医学和现代医学理论的指导下，对中医药预防治疗肢体缺血 提要 本课题是在祖国传统医学和现代医学理论的指导下，对中医药预防治疗肢体缺血 再灌注损伤研究的一次新的尝试。其内容分临床观察和实验研究两部分。临床观察病 人59例，治疗组3l例，对照组28例；经方活络效灵丹加味治疗，结果治疗组显效 23例．显效率74．2％，总有效率96．t1％；实验部分应用止血带环扎兔后肢方法造模， 建立兔肢体缺血再灌注模型32只，随机分为活络效灵丹加昧预防治疗组、活络效灵 丹加味治疗组、甘露醇治疗组、模型对照组共四组，每组8只，进行血清学检查和骨 骼肌组织形态学观察，结果显示活络效灵丹加味对肢体缺血再灌注后的骨骼肌有保护 作用，能够减轻肢体缺血再灌注带来的损伤。分析活络效灵丹加味的作用机制，我们 认为与中药本身具有的清除自由基、抗氧化、改善微循环等作用有关。另外，作为研 究的一部分，本文就近年来肢体缺血再灌注损伤作用机制的研究等方面作了理论上的 概括，并对其国内外治疗进展状况进行了阐述。 关键词肢体缺血再灌注损伤；活络效灵丹加味／中医药疗法；临床观察；实验 研究 CLINICAL CLINICAL AND EXPERIMENT STUDY ON ISCHEMIA．REPERFUSION INJURY OF EXTREMITY Speciality：Osteotraumata，Orthopaedics andTraumatology of TCM Author：Sun Deshun Tutor：professor Zhang Shihua ABSTRACT Under the guidence of Traditional Chinese Medicine theories and Modem Medicine theories，we made the study,which is a new attempt of research about the therapy of Ischemia—reperfusion(I／R)Injury of Extremity using medical herbs．The paper consists of two parts：Clinical Observation and Experimental Study．Altogether 59 patients were randomly divided into therapeutic group(3 1)and control group(28)．The therapeutic group was observed in the former being treated with Huoluoxiaolingdan Jiawei(HXLDJ)，23 of them were cured，the cure rate was 74．2％，and the total effective rate was 96．8％；In the experiment，32 healthy adult rabbits were randomly divided into 4 groups(each of 8 rabbits)．The I／R models were produced in all the rabbits hind limbs．Group 1 was fed on HXLDJ for prevention and therapy；group 2 was fed on HXLDJ for therapy；group 3 was given intra—veuous injection of 20％mannitol for therapy and contrast；group 4 was fed on distilled water for contrast．The serum were examined and skeletal muscle samples were obtained for light microcopy．The result showed that HXLDJ has protective effect on I／R injury of skeletal muscle and can alleviate the I／R injury．Analyzing the mechanism of medical herbs external application，we think it due to its clearing away oxygen free—radicals and aineliorating the microcircul