大半夏汤在治疗化疗所致呕吐作用中对CAJAL间质细胞影响的电镜及临床观察-中医内科学专业论文.docx

中文摘要 目的:通过对胃起搏区 ICC 电镜下超微结构的观察来探讨大半夏汤对抗化疗所 致恶心呕吐的作用机制，从而寻求中药止呕和化疗药致呕之间是否可通过中药对 ICC 的调控来解释。临床观察大半夏汤用于治疗化疗所致呕吐的疗效，为中医药 治疗呕吐提供了一定的临床依据。 方法: 1.采用家鸽腹腔注射顺铂造模，将受试家鸽随机分为空白对照组、DDP 组、 阳性胃复安对照组、高剂量组、中剂量组、低剂量组，造模成功后连续给药 7 天， 给药期间详细观察记录每只家鸽的一般情况，给药第七天后禁饮禁食 24h，按预 定方法取得电镜标本，观察 ICC 的镜下超微结构的变化。2. 临床观察 30 例化疗 致呕患者，化疗起开始用大半夏汤汤剂治疗，连续用药 14 天后，通过对治疗前 后患者的恶心、呕吐分级及身体一般状况 Karuafsky 积分统计分析，总结评定疗 效。 结果：1.高、中、低剂量组与 DDP 组相比，电镜下 ICC 的形态方面均有变化， 且与剂量呈正相关。2.治疗前后患者恶心、呕吐症状比较均有统计学意义；大半 夏汤改善患者身体一般状况有效率为 83.3%恶心呕吐症状完全缓解 3 例，部分缓 解 20 例，总有效率为 73.3%。 关键词 化疗呕吐 ICC 大半夏汤 电镜 临床观察 ABSTRACT Objective: District of gastric pacing ICC ultrastructure observation under electron microscope to investigate the Decoction against chemotherapy-induced nausea and vomiting mechanism in order to find traditional Chinese medicine and chemotherapy antiemetic drug-induced vomit can be between the traditional Chinese medicine for ICC to explain the regulation and control. Decoction large clinical observation for the treatment of chemotherapy-induced vomiting, the efficacy of traditional Chinese medicine for the treatment of vomiting provides a clinical basis. Methods：1. The use of pigeons by intraperitoneal injection of cisplatin model, the pigeon subjects were randomly divided into blank control group, DDP group, metoclopramide positive control group, high-dose group, middle dose group, low-dose group, after the successful model continuous administration for 7 days, detailed observations recorded during the administration of each pigeon in general, administration of the fourteenth day of fasting drink ban 24h, according to electron microscope specimen method, the endoscopic observation of the ultrastructure of ICC change. 2. Clinical observation of 30 cases of patients with chemotherapy-induced vomit, chemotherapy started large Decoction Decoction treatment, medication for 14 days, before and after treatment by patients with nausea, vomiting grade and general condition of the body points Karuafsky statistical analysis,