基于中西医病证特点的泻剂结肠动物模型的临床吻合度分析  

Fitting Degrees of Cathartic Colon Animal Models with Disease Characteristics of Western Medicine and Syndrome Characteristics of Traditional Chinese Medicine

作　　者：何友成 蒋风茹 周盐 钱佳南 刘君 杭露 周淳宇 李思汉 黄铭涵[3] 袁建业 HE Youcheng;JIANG Fengru;ZHOU Yan;QIAN Jianan;LIU Jun;HANG Lu;ZHOU Chunyu;LI Sihan;HUANG Minghan;YUAN Jianye(Institute of Digestive Diseases,Longhua Hospital,Shanghai University of Traditional Chinese Medicine(TCM),Shanghai 200032,China;Johns Hopkins University,Baltimore 21218,USA;The Second People's Hospital Affiliated to Fujian University of TCM,Fuzhou 350003,China)

机构地区：[1]上海中医药大学附属龙华医院/脾胃病研究所,上海200032 [2]约翰斯·霍普金斯大学,马里兰州巴尔的摩21218 [3]福建中医药大学附属第二人民医院,福州350003

出　　处：《中国实验方剂学杂志》2023年第22期146-154,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：上海市2021年度“科技创新行动计划”医学创新研究专项项目(21Y11922600)。

摘　　要：泻剂结肠(CC)是消化内科临床常见病、难治病,其病理机制尚未被完全阐明,除泻药对症和手术治疗外,尚缺乏行之有效的治疗方式,建立符合中西医病证特点的CC动物模型是推动该病研究的重要环节。临床吻合度是一种基于中西医临床病证特点,以现有最新的中西医诊断标准为参考依据,评估动物模型对中西医病证模拟效果的指标。通过梳理文献发现,各文献报道所选用的造模动物、药物及其剂型、剂量、给药方式、造模周期等各有不同,现有CC动物模型的临床吻合度水平参差不齐。大鼠是CC模型的首选动物,大黄类制剂是最常用的模型诱导药物,但造模后期可出现水电解质紊乱、免疫力下降,甚至出现模型动物死亡的情况。造模方法是在起始剂量基础上逐步递增,但起始剂量、递增剂量不尽相同;以半数动物出现稀便为维持剂量,多以80%动物稀便消失,为单个循环结束标准;造模周期2~3个循环,约2~4个月。其中,应用大黄中药颗粒和大黄酸所复制的CC模型均具备较高的中西医临床吻合度。此外,CC中医证候模型尚处于探索阶段,证候模型种类少,仅肝郁脾虚、气阴两虚、气滞血瘀、脾肾两虚4种,仍需进一步补充和完善,以期建立符合中西医病证特点且临床吻合度高的动物模型,为CC机制研究和新药研发提供帮助。Cathartic colon(CC)is a common and refractory digestive system disease,with the pathogenesis not fully clarified.The effective therapies other than laxatives and surgery remain to be developed for CC.Therefore,establishing the CC animal models that fit the disease characteristics of western medicine and syndrome characteristics of traditional Chinese medicine(TCM)is an important link to promote the research on this disease.The fitting degree of animal models with the latest Chinese and western medical diagnostic criteria is an indicator to assess the effectiveness of the animal models in simulating the disease characteristics of western medicine and syndrome characteristics of TCM.The literature review showed that the model animals,drugs and their dosage forms,doses,administration methods,and modeling period of CC varied in different studies,and the available CC animal models presented different fitting degrees with the disease characteristics of western medicine and syndrome characteristics of TCM.Rats were the preferred animals for the modeling of CC.Rhei Radix et Rhizoma preparations were commonly used for model inducing,which,however,may cause water electrolyte disorders,decreased immunity,and even death of animals at the late stage of modeling.The animals were modeled by gradually increasing the starting dose,while the starting dose and increasing dose varied.The maintenance dose was determined based on 50%of the animals having loose stools,and the end for a cycle was determined as the time when loose stools disappeared in 80%of animals.The modeling always lasted for 2-3 cycles,approximately 2-4 months.The CC models established with Rhei Radix et Rhizoma granules and rhein had high fitting degrees with the disease and syndrome characteristics.In addition,the CC animal models of TCM syndromes were still in the exploration stage.There were only the animal models of four TCM syndromes:liver depression and spleen deficiency,both Qi and Yin deficiency,Qi stagnation and blood stasis,and spleen and kidney deficienc

关 键 词：泻剂结肠 泻药依赖性便秘 动物模型 临床吻合度 中西医病证特点 

分 类 号：R284[医药卫生—中药学] R285[医药卫生—中医学] R289R287R22R2-031R33R24