病证结合胃食管反流病动物模型的临床吻合度分析  

Analysis of Animal Model of Gastroesophageal Reflux Disease Based on the Combination of Disease and Syndrome

作　　者：周立捷 王彦刚 王晨[1] 徐楚楚 赵婷婷 ZHOU Lijie;WANG Yangang;WANG Chen;XU Chuhcu;ZHAO Tingting(Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China;Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]河北省中医院,石家庄050011

出　　处：《世界科学技术-中医药现代化》2024年第10期2638-2647,共10页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：北京市自然科学基金委员会面上项目(7232281):Lnc517368调控胃癌前病变线粒体自噬介导凋亡机制及化浊解毒方的干预研究,负责人:王彦刚;河北省自然科学基金委员会面上项目(H2020423207):基于Hippo信号通路探讨化浊解毒方干预胃癌前病变胃黏膜上皮细胞自噬的作用机制,负责人:王彦刚;北京中医药大学第三附属医院科技处面上项目(BZYSY-2022-PYMS-14):lnc 517368/miRNA-203b-3p/SMAD2调控胃癌前病变细胞内质网应激介导凋亡机制及化浊解毒方干预研究,负责人:王彦刚。

摘　　要：目的胃食管反流病(Gastroesophageal reflux disease,GERD)是指胃内容物突破抗反流屏障从胃逆流到食管乃至口腔、咽喉及气道引起的症状或并发症,是上消化道最常见的难治病之一,严重影响患者生活质量。中医药治疗GERD效果明显且接受度较高,构建病证结合的动物模型是开展相关研究的基础和前提。方法检索相关数据库,以GERD中西医临床诊断标准为依据,将现有病证结合的GERD动物模型的造模方法、成模表现、模型特点进行总结,对具体造模方式和评价指标的选择原因进行探讨,并根据中西医临床病证特点进行吻合度评价。结果GERD病证结合模型在手术或药物刺激基础上,如食管灌注外源性酸、手术干预改变大鼠胃肠道生理结构造成胃反流或混合反流,施加中医干预因素,肝郁型动物模型以慢性不可预见性刺激,气郁痰阻型以夹尾刺激法,瘀血阻络型以慢性应激刺激联合高脂饮食,脾虚湿热证以内外因湿热干预法为主。结论目前GERD动物模型具有相对较高的西医病证特点吻合度,但中医吻合度较低,因此根据中医证型病机的不同提出相应改进和观察方法,以及目前研究的不足之处,以期为GERD模型建立提供参考,建立符合中西医病证特点且临床吻合度高的动物模型,为GERD机制和药物研究奠定基础。Objective Gastroesophageal reflux disease(GERD)is a condition in which the contents of the stomach break through the anti-reflux barrier and reflux from the stomach into the esophagus and even into the mouth,throat,and airway,causing symptoms or complications,and it is one of the most common intractable diseases of the upper gastrointestinal tract,which seriously affects the quality of life of patients.Traditional Chinese medicine(TCM)is effective and highly accepted in the treatment of GERD,and an animal model that combines disease and syndrome is the basis and prerequisite for conducting relevant research.Methods Relevant databases were searched,and based on the clinical diagnostic criteria of GERD in Chinese and Western medicine,the modeling methods,modeling performance,and modeling characteristics of the existing animal models of GERD combined with disease and syndrome were summarized,and the reasons for the selection of the specific modeling methods and evaluation indexes were explored,and the degree of match was evaluated based on the characteristics of the clinical disease and syndrome in Chinese and Western medicine.Results The combination model of GERD was based on surgical or pharmacological stimulation,such as esophageal instillation of exogenous acid,surgical intervention to change the physiological structure of the gastrointestinal tract of the rat causing gastric reflux or mixed reflux,and imposition of TCM interventions,with chronic unpredictable stimulation for the liver qi depression syndrome type of animal model,with pinch-tail stimulation for the qi-stagnation and phlegm-obstruction type,with chronic stress stimulation in conjunction with a high-fat diet for the blood stasis blocking collaterals type,with internal and external causes of dampness-heat for the splenic-deficiency damp heat syndrome.The intervention method was mainly used.Conclusion The current animal model of GERD has a high degree of consistency with the characteristics of Western medicine,but a lower degree of consistency with C

关 键 词：胃食管反流病 非糜烂性胃食管反流 动物模型 病证结合 模型评价 

分 类 号：R-332[医药卫生]