【作者】 李卉；

【导师】 彭兆麟；

【作者基本信息】 湖北中医学院 ， 中西医结合临床儿科， 2004， 硕士

【摘要】 目的 溃疡性结肠炎是引起儿童慢性腹泻的一种疾病，以腹痛，腹泻，黏液脓血便及里急后重为主要临床表现。中医文献虽无UC之名，但结合本病临床表现，应归属“肠风”，“肠辟”，“滞下”，“泄泻”范畴。健脾化食口服液是经临床应用疗效肯定的一个自拟方剂。本课题研究的主要目的是：1 建立幼年大鼠的脾虚模型及脾虚型溃疡性结肠炎模型；2 观察健脾化食口服液对UC模型大鼠损伤结肠黏膜的修复效果及结肠组织SOD，MDA，NO，NOS含量的影响；3 探讨健脾化食口服液对UC的治疗机理，为新药的开发提供实验依据。 方法 取健康刚断奶的SD幼年大鼠60只，分成5组，3组采用番泻叶浸剂灌胃的方法建立脾虚证大鼠模型，然后将包括这3组在内的共4组用乙酸灌肠的方法制成溃疡性结肠炎模型，造模成功后，将5组大鼠分成正常对照组，单纯溃疡性结肠炎组，脾虚溃疡性结肠炎组，脾虚溃结健脾化食口服液治疗组，脾虚溃结柳氮磺吡啶治疗组，分别给予生理盐水，健脾化食口服液，柳氮磺吡啶混悬液灌胃，每日一次，连续治疗14天后，颈椎脱臼处死大鼠，取大鼠结肠黏膜，HE染色制片，采用组织病理学进行损伤指数评分，组织离心取上清液，生化法测定SOD，MDA，NO，NOS含量。 结果 1 病理学改变：正常对照组(A组)未见明显病理学变化；单纯溃结组(B组)，脾虚溃结组(C组)黏膜及黏膜下层明显充血，水肿，炎细胞浸润，腺体杯状细胞减少，有糜烂及溃疡形成；JPHS治疗组(D组)，SASP治疗组(E组)溃疡基本愈合，残存溃疡有明显修复性改变，如黏膜上皮修复，肉芽组织增生等。B，C模型组的损伤指数显著高于A，D，E正常对照组和治疗组(P＜0.01)，B，C单纯和脾虚模型组间的损伤指数也有差异(P＜0.05)，D，E中西药治疗组间的损伤指数无显著性差异(P＞0.05)。 2 B，C模型组与A，D，E正常对照组，治疗组相比，结肠黏膜NOS的活性及NO的水平明显升高，统计学分析差异显著(P＜0.01)，而B，C组比较无显著性差异(P＞0.05)，A，D，E正常组和治疗组组间上述指标差异无显著性(P＞0.05)。 3 B，C模型组的MDA均显著高于A，D，E正常对照组，治疗组(P＜0.01)，B，C模型组的SOD均显著低于A，D，E正常对照组，治疗组(P＜0.01)，B，C组比较有差异(P＜0.05)，A正常组与D，E治疗组间的上述指标无显著性差异(P＞0.05)。 结论 1 健脾化食口服液能有效修复UC模型大鼠损伤的结肠黏膜。 2 本课题的研究表明，UC模型大鼠的MDA，NO，NOS含量明显升高，SOD含量降低，经治疗后可恢复正常，推测氧自由基和NO可能是UC结肠黏膜损伤的原因。 3 脾虚证溃结大鼠结肠组织与单纯溃结组比较MDA含量升高，SOD含量降低，推测脾虚因素也会引起氧自由基代谢的变化，加重结肠黏膜的损伤程度。湖北中医学院中西医结合专业硕士学位论文 4健脾化食口服液能提高Uc大鼠降低的s0D含量，清除氧自由墓，降低异常升高的NO，Nos，MDA含量，从而保护结肠钻膜。更多还原

【Abstract】 ObjectiveTo establish rat ulcerative colitis of spleen deficiency model and observe abnormal NO, NOS, SOD, MDA in colon constitutionMethods60 SD rats were divided into 5 groups: normal control (group A), experiment (ulcerative colitis (group B) and ulcerative colitis of spleen deficiency type (group C)), treatment (JPHS (group D) and SASP (group E)), sienna leaf oral liquid was administered in group C, D, E to establish model of spleen deficiency. The group B, C, D, E were respectively received saline enemas, JPHS, SASP enemas 1 ml daily after distal colitis was included by 5% acetic enemas was study by pathology and biochemistry, respectively.Results1 In rats of group B, C, obvious hyperemia, edema in colon mucous and sub mucous were found, and obvious infiltration cells, decrease of glandular goblet cells and formation of typical ulcer could be seen while in grounded, there were few ulcers, and the remaining ulcers presented obvious recovering changes, such as recovery of mucous, hyperplasic of granulation and cicatrisation. The damage score in experiment group was notably higher than that in treatment group (P<0.01). There were also significant difference between treatment group and control group (P<0.01).2 The levels of No and activities of NOS in colon mucous of the rats in experiment group were significantly higher than those in control group and treatment group (PO.01), But there was no significant difference between control group and treatment group (P>0.05)3 MDA in experiment group was significantly increased than that in control group and treatment group (P<0.01), but SOD in experiment group was significantly lower than that in control group and treatment group (P<0.01). There was no significant difference between control group and treatment group (P>0.05)ConclusionJianpihuashi decoction has better effects in treatment of ulcerative colitis in consideration of the aspects of clinical overall effect, manifestation, intestinoscopy mucous change and mucous pathological histological research. To reduce free radical which involved in the pathological process of the disease can provide a new pathway for ulcerative colitis.更多还原