【摘要】：目的:探討不同中醫(yī)證候狀態(tài)下,心與小腸功能變化和相互關(guān)聯(lián)。方法:將40只家兔隨機(jī)分正常組、心火亢盛證組、腎實(shí)熱證組、小腸實(shí)熱證組,每組10只。家兔耳緣靜脈注射強(qiáng)毒力的大腸桿菌建立心火亢盛證模型;家兔耳緣靜脈注射小牛血清建立腎實(shí)熱證模型;經(jīng)口腔灌飼辣椒汁、白酒混合液建立小腸實(shí)熱證模型。觀察各組家兔心臟超聲實(shí)時(shí)影像、血清心肌酶譜、血清尿素氮與肌酐、酚紅排泄率、小腸吸收能力、空腸平滑肌張力與收縮頻率。結(jié)果:各組家兔心功能比較:除舒張末期左室后壁厚度各組比較,無(wú)顯著性差異外,心火亢盛證組與小腸實(shí)熱證組其余各指標(biāo)如心率、左室舒張末期內(nèi)徑、左室收縮末期內(nèi)徑、左室射血分?jǐn)?shù)、左室短軸縮短率,血清磷酸肌酸激酶(creatine phosphokinase,CK)、肌酸激酶同工酶、乳酸脫氫酶比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);而與腎實(shí)熱證組無(wú)顯著差異(P0.05);與小腸實(shí)熱證組相比,腎實(shí)熱證組各指標(biāo)存在顯著差異性(P0.05)。各組家兔腎功能比較:心火亢盛證組血清尿素氮、肌酐與小腸實(shí)熱證組比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),而與腎實(shí)熱證組無(wú)顯著差異(P0.05);與小腸實(shí)熱證組相比,腎實(shí)熱證組各指標(biāo)差異顯著(P0.05);酚紅排泄實(shí)驗(yàn)顯示,與正常組比較,3個(gè)時(shí)間段各模型組家兔酚紅排泄率均下降;心火亢盛證組與小腸實(shí)熱證組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),而與腎實(shí)熱證組無(wú)顯著差異(P0.05);與小腸實(shí)熱證組比較,腎實(shí)熱證組各指標(biāo)差異顯著(P0.05)。小腸功能觀察,灌胃后血中葡萄糖濃度心火亢盛組、腎實(shí)熱組之間差異亦不顯著(P0.05),二者與小腸實(shí)熱證組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);3個(gè)模型組空腸離體平滑肌張力和肌收縮頻率也均較正常組增高,心火亢盛證組與小腸實(shí)熱證組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),而與腎實(shí)熱證組無(wú)顯著差異(P0.05),與小腸實(shí)熱證組相比,腎實(shí)熱證組各指標(biāo)存在顯著差異性(P0.05)。結(jié)論:在中醫(yī)相關(guān)證候狀態(tài)下,心與腎功能變化及其聯(lián)系,較之小腸似乎更為緊密,"心與小腸相表里"之實(shí)質(zhì)大致應(yīng)該更多的從現(xiàn)代解剖學(xué)心與腎之間的關(guān)聯(lián)去探討。
[Abstract]:Objective: to investigate the changes and correlation between heart and small intestine function under different TCM syndromes. Methods: forty rabbits were randomly divided into normal group, heart fire hyperactivity syndrome group, kidney excess heat syndrome group and small intestine heat syndrome group with 10 rabbits in each group. The model of hyperactivity of heart fire was established by intravenous injection of Escherichia coli at the ear edge of rabbits, the model of kidney excess heat syndrome was established by intravenous injection of calf serum into the ear edge of rabbits, and the model of small intestine heat syndrome was established by oral administration of chili juice and liquor mixture. The real-time ultrasound images, serum myocardial zymogram, serum urea nitrogen and creatine excretion rate, phenol red excretion rate, intestinal absorption capacity, tension and contraction frequency of Jejunum smooth muscle were observed. Results: comparison of cardiac function in each group: except for the thickness of left ventricular posterior wall at the end of diastolic stage, there was no significant difference between the hyperactivity syndrome group and the small intestine heat syndrome group, such as heart rate, left ventricular end-diastolic diameter and left ventricular end-systolic diameter. Left ventricular ejection fraction, left ventricular short axis shortening rate, serum creatine kinase (creatine phosphokinase,CK), creatine kinase isoenzyme and lactic dehydrogenase were significantly different (P 0.05). There was no significant difference between the kidney excess heat syndrome group and the kidney excess heat syndrome group (P 0.05), and there was significant difference in each index between the kidney excess heat syndrome group and the small intestine excess heat syndrome group (P 0.05). Comparison of renal function in each group: there was significant difference in serum urea nitrogen and creatinine between Xinhuo Sheng syndrome group and small intestine heat syndrome group (P 0.05), but there was no significant difference between Xinhuo Sheng syndrome group and kidney excess heat syndrome group (P 0.05), but there was no significant difference between Xinhuo Sheng syndrome group and small intestine heat syndrome group (P 0.05). Compared with the small intestine heat syndrome group, the indexes of the kidney excess heat syndrome group were significantly different (P 0.05), and the phenol red excretion test showed that compared with the normal group, the phenol red excretion rate of rabbits in each model group decreased in three time periods. There was significant difference between the heart fire hyperactivity syndrome group and the small intestine excess heat syndrome group (P 0.05), but there was no significant difference between the heart fire hyperactivity syndrome group and the small intestine excess heat syndrome group (P 0.05), but there was no significant difference between the heart fire hyperactivity syndrome group and the small intestine excess heat syndrome group (P 0.05), but there was no significant difference with the kidney excess heat syndrome group (P 0.05). The observation of small intestinal function, the concentration of glucose in blood after gastric perfusion was not significantly different between Xinhuo hyperactivity group and renal hyperpyretic group (P 0.05), and there was significant difference between the two groups (P 0.05). The tension and muscle contraction frequency of isolated Jejunum smooth muscle in the three model groups were also higher than those in the normal group. There was significant difference between the heart fire hyperactivity syndrome group and the small intestine heat syndrome group (P 0.05), but there was no significant difference between the heart fire hyperactivity syndrome group and the kidney excess heat syndrome group (P 0.05). Compared with the small intestine heat syndrome group, there was significant difference in each index in the kidney excess heat syndrome group (P 0.05). Conclusion: under the condition of TCM related syndromes, the changes of heart and kidney function and their relationship seem to be closer than those of small intestine. The essence of "heart and small intestine phase table" should be discussed more from the relationship between heart and kidney in modern anatomy.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京中醫(yī)醫(yī)院;
【基金】：國(guó)家自然科學(xué)基金項(xiàng)目(81273614) 北京市自然科學(xué)基金項(xiàng)目(7152070)
【分類號(hào)】：R228

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