【作者】 周永坤；

【导师】 宋爱莉；

【作者基本信息】 山东中医药大学 ， 中医外科学， 2007， 博士

【摘要】 目的:通过观察中药清肠合剂对急性化脓性腹膜炎(AP)病人的治疗效果,及对大鼠模型血清肿瘤坏死因子-a(TNF- a)和白介素-6(IL-6)等的调控作用,从炎症介质和细胞因子的角度,探讨通里攻下法治疗AP的作用机制,丰富治疗手段及实验基础。方法:40例急性化脓性腹膜炎病人在常规治疗的基础上应用清肠合剂治疗,与对照组对比,观察术后体温、WBC、肠功能恢复时间等情况。动物实验部分选取Wistar大鼠60只,随机分为空白对照组、模型组、清肠合剂大剂量组、清肠合剂小剂量组,通过腹腔注射大肠杆菌法制作动物模型,用不同剂量清肠合剂灌胃,观察TNF- a、IL-6、WBC的变化及脏器的病理改变。结果:临床研究证实,清肠合剂具有退热、促进胃肠功能恢复、改善全身状况的作用,总有效率达87.50%,优于常规治疗对照组。动物实验提示清肠合剂有降低TNF- a、IL-6的表达,降低WBC计数,减轻脏器病理损害的作用。结论:肺、腹膜、肠管的病理损害与TNF- a、IL-6的过度表达有相关性;清肠合剂有促进胃肠功能恢复、减轻过度的炎症反应及保护重要脏器功能的作用,其作用机制是通过降低TNF- a、IL-6的表达而产生的。更多还原

【Abstract】 Object :To explore the mechanism of clearing away pathogenic toxic material and purgation in treating acute peritonitis, through observing the effect of patients and the change of TNF-a, IL-6 and account of WBC using Qingchang Mixture in acute peritonitis (AP) rats. Method: 40 patients with acute peritonitis were treated by Qingchang Mixture, while 36 cases treated by rutine methods,. Observing the change of temperature, WBC, and the time of recovery of gastrointestinal function. 60 Wistar rats were divided into four groups by injecting bacillus coli into abdominal ca vity of rats to make AP animal model, using Qingchang Mixture as treatment group, to observe the general condition, TNF-a, IL-6, account of WBC were detected after 24 hours and 72 hours. After 72 hours, all the rats were put to execution, the peritonaeum, intestines, liver, lungs, kidneys were gotten to have a pathological cut sections for microscopic examination. Results: The result showed much effective in Qingchang Mixture group TNF-a, IL-6 and leukocyte count in model group were higher than in the black group at 24 hours, and much lower at 72 hours in Qingchang Mixture groups than in model groups. And pathological change was obvious in model groups than in Qingchang Mixture groups. Conclusion: The excessive expression of TNF-a, IL-6 is has siginificant relations with pathological injugery of lung, small intestines and peritoneum; Qingchang Mixture is effective in anti-inflammation, regulating excessive expression of inflammation factors, reducing the pathological injury of important organs, and protecting important organ functions. Qingchang Mixture plays very importment role in treating acute peritonitis by regulating the express of TNF-a and IL-6.更多还原