黄芪桂枝五物汤预防椎板切除后硬膜外瘢痕粘连实验研究-中西医结合临床专业毕业论文.docxVIP

— — PAGE 1— 摘 要 黄芪桂枝五物汤预防椎板切除后硬膜外 瘢痕粘连实验研究 摘 要 目的：观察和评价内服黄芪桂枝五物汤对椎板切除模型动物硬膜外瘢痕粘连的 干预作用效果，并探讨其作用机制。方法：36 只成年雄性 SD 大鼠随机分为三组：A 生理盐水组为实验条件对照组、B 双氯芬酸钠组为阳性对照组和 C 黄芪桂枝五物汤 组为实验组，行 L1 椎板切除术，造成 0.3cm×0.8cm 大小缺损，术后 A 组、B 组和 C 组分别连续灌服生理盐水、双氯芬酸钠混悬液和黄芪桂枝五物汤 4 周后停药。分别 于术后第 4 周和第 8 周分两批处死动物，每组每批随机抽取 5 只取术段脊椎进行大 体观察评估瘢痕粘连韧度、HE 染色光学切片组织学观察及测定瘢痕组织中羟脯氨酸 （HOP）含量。结果：术后 4 周，A 组大体及组织学观察结果评分差于 B 组和 C 组， 有统计学意义（P0.05），A 组和 B 组羟脯氨酸含量高于 C 组，有统计学意义（P0.05）。 术后 8 周，A 组和 B 组大体观察、组织学观察结果和羟脯氨酸含量与 C 组比较均有 统计学意义（P0.05），A 组、B 组和 C 组三组间羟脯氨酸含量比较均有统计学意义 （P0.05）。结论：黄芪桂枝五物汤可以减少大鼠椎板切除后硬膜外瘢痕组织中胶原 含量，阻止硬膜外瘢痕粘连形成。其有效性可能是通过加速局部血肿及炎性物质的 清除，抑制炎性细胞、成纤维细胞的增殖和增加椎板切除区椎体的稳定性等作用来 实现。黄芪桂枝五物汤早期有预防大鼠椎板切除后硬膜外瘢痕粘连的作用。 关键词：椎板切除；瘢痕；粘连；黄芪桂枝五物汤 新疆医科大学医学硕士学位论文 The experimental methods of Huangqi Guizhi Wuwu Decoction in preventing post-laminectomy fibrosis and adhesion Abstract Objective：To study the effectiveness of Huangqi Guizhi Wuwu Decoction on preventing post-laminectomy fibrosis and adhesion. Methods：36 adult rats were divided randomly into three groups: Group Nacl (Group A), Group Diclofenac Sodium Enteric-coated Tablets (Group B), and Group Huangqi Guizhi Wuwu Decoction (Group C). All the rats were established as the experimental models undergoing L1 laminectomy with 0.3cm×0.8cm dura mater exposed. All laminectomy levels were treated with relative medicine for four weeks: At the 4th and 8th weeks after laminectomy, the samples were obtained for gross observation, histological examinations and to detecting the contents of hydroxyprdine. Results ： At the 4th week, the gross observation and histological examinations in Group A were significantly higher than those in Group B and Group C(P0.05), the contents of hydroxyprdine of Group A and Group B were significantly different than those of Group C(P0.05). At the 8th week, all the indexes of Group A and Group B were significantly higher than those of Group C(P0.05), the contents of hydroxyprdine of Group A , Group B and Group C were significantly different (P