放射性肺损伤中医证候学特点及其演变规律的研究  

Experimental study on TCM symptomatological and developmental characteristics of rats with radiation-induced lung injury

作　　者：窦永起[1] 杨明会[1] 林明雄[1] 刘毅[1] 臧倩[1] 

机构地区：[1]解放军总医院中医科全军中医研究所,北京100853

出　　处：《中华中医药杂志》2009年第6期706-708,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金资助项目(No.30371826);军队"十一五"课题基金资助项目(No.06MA251)

摘　　要：目的:探索动物实验作为新手段研究放射性肺损伤病因病机与证候演变的可能性,并为制定中医药早期防治方法提供理论和实验依据。方法:Wistar雌性大鼠80只,随机分为造模组和对照组各40只,每次麻醉定位后,造模组用6mVX线照射右肺2cm×3cm,3Gy×2次/w,最多10次/5w;分别在第3、5、8、12、26w末,从两组各随机抽取8只处死;运用中医诊断学方法,通过对大鼠活体状况、肺脏大体标本和肺组织切片进行动态观察和比较,分析在照射过程中放射性肺损伤中医证候学特点及其演变规律。结果:造模组大鼠在照射初期即出现鼻周及眼周红赤、有黄色分泌物,呼吸急促、大便干硬、精神萎靡、反应迟钝、活动减少等症状,符合热毒内盛、元气耗伤证;放射早期大鼠肺脏肿胀,表面鲜红,并有鲜红色斑片状出血,镜下示肺间质充血、出血、水肿明显,属热伤血络、血溢脉外证;后期肺脏外观颜色晦暗、有明显紫黑色瘀斑、质硬而弹性差,镜下见陈旧性出血灶、肺内毛细血管瘀滞、闭锁,局灶性纤维化团块等,与瘀血阻络证相吻合。对照组无异常变化。结论:通过动物实验,可以利用现代病理学方法作为中医证候学研究的手段,从活体、肺脏大体标本及肺组织微观层面揭示"放射性肺损伤热毒致病,早期属热伤肺络证、晚期属瘀阻肺络证"的证候特点和演变规律。Objectives： To explore the possibility of using experimental animal models as a new means for studying the pathogenesis and symptomatologic development of radiation-induced lung injury, and provide theoretical and experimental evidences for early prevention and treatment with the traditional Chinese medicine. Methods： 80 female Wistar rats were divided randomly into the model group and control group with 40 rats in each group respectively. The rats in model group were anesthetized and fixed, and a 2cm×3cm area of the right lungs received 6mV X-ray radiation at 3Gy×2/w and a maximal 10/5w. Eight rats randomly selected from each group were sacrificed at the end of weeks of 3, 5, 8, 12 and 26.Diagnostic techniques of TCM were employed to analyze symptomatological and developmental characteristics of TCM in radiation-induced lung injury during exposure by dynamic examination and comparison of living rats, gross lung samples and tissue sections. Results： Signs and symptoms including redness around nose and eyes, yellowish secretion, tachypnea, dry stool, lethargy, sluggishness, inactiveness were observed in model group in early stage of radiation exposure, which consistent with dominant heat in the interior and primordial qi exhaustion syndrome. Swollen lungs, bright redness on surface and red bleeding patches were observed in early stage of radiation; microscopic examination showed interstitial tissues, and readily visible congestion, hemorrhage and edema of pulmonary interstitial tissues, consistent with damaged blood collaterals by heat and blood escaping circulation syndrome. In the later stage of radiation exposure, the lungs showed dark appearance, apparent purple petechia, hard texture and poor elasticity. Microscopic examination showed remote hemorrhage foci, pulmonary capillary stasis or closure, and focal fibrotic clumps, consistent with obstruction of collaterals by blood stasis syndrome. No abnormal changes were observed in the control group. Conclusions： Animal experiments can redeem the clinica

关 键 词：放射性肺损伤 证候学 实验研究 

分 类 号：R273[医药卫生—中西医结合]