CAJ | 학술논문

结肠上皮黏膜细胞屏障损伤是发生细菌移位的最根本原因.结肠黏膜上皮细胞间的紧密连接,是机体防止肠道内细菌发生移位的机械屏障的最重要组成部分.结肠上皮黏膜细胞旁间隙是由蛋白复合体封闭,蛋白复合体被认为可以调节细胞之间的通透性,在众多蛋白复合体中,ZO-1、Claudin-1和Occludin最具代表性,已经成为实验判断结肠上皮黏膜细胞屏障损伤程度的重要指标.内毒索是细菌释放产物,抗内毒索是保护结肠黏膜屏障、预防和治疗细菌移位的方法之一.抗内毒素药物众多,但至今还没有一种能被临床广泛认同的药物.清胰汤和柴芩承气汤等我国传统中药具有保护肠黏膜屏障,抑制肠道细菌移位的作用.氧化苦参碱具有抗菌、抗炎、免疫调节等多种药理作用,在重症感染时对肠黏膜具有保护作用,但其作用机制目前还不完全清楚,有待深入研究.我国传统中药在重症感染时结肠上皮黏膜细胞屏障损伤导致细菌移位的防治临床应用中前景广阔.
결장상피점막세포병장손상시발생세균이위적최근본원인.결장점막상피세포간적긴밀련접,시궤체방지장도내세균발생이위적궤계병장적최중요조성부분.결장상피점막세포방간극시유단백복합체봉폐,단백복합체피인위가이조절세포지간적통투성,재음다단백복합체중,ZO-1、Claudin-1화Occludin최구대표성,이경성위실험판단결장상피점막세포병장손상정도적중요지표.내독색시세균석방산물,항내독색시보호결장점막병장、예방화치료세균이위적방법지일.항내독소약물음다,단지금환몰유일충능피림상엄범인동적약물.청이탕화시금승기탕등아국전통중약구유보호장점막병장,억제장도세균이위적작용.양화고삼감구유항균、항염、면역조절등다충약리작용,재중증감염시대장점막구유보호작용,단기작용궤제목전환불완전청초,유대심입연구.아국전통중약재중증감염시결장상피점막세포병장손상도치세균이위적방치림상응용중전경엄활.
The damage to the barrier of colonic mucosal epithelial cells is the fundamental cause of bacterial translocation.The tight junction among epithelial cells forms the most important constituent part of the mechanical barrier of the organism to prevent bacterial translocation from happening in the intestinal canal.The para-colonic-mucosal-epithelial-cell space is closed by protein complexes which are considered to be used for regulating the permeability between cells.ZO-1,Claudin-1 and Occludin are the most representative among the numerous protein complexes.They have become the important index to judge the damage degree of the barrier of colonic mucosal epithelial cells in test.The endotoxin is the product released by bacteria.Anti-endotoxin is one of the methods to protect the colonic mucosal barrier,to prevent and treat bacterial translocation.There are anti-endotoxin drugs.However,there has not been any drug widely recognized clinically up to now.Qingyi Decoction and Chaiqin Chengqi Decoction are the traditional Chinese medicine with the function of protecting the intestinal mucosal barrier and suppressing the transloeation of enteric bacteria.Oxymatrine has many pharmacological effects such as anti-bacterial,anti-inflammatory and immunoragulation.The recent animal experiments showed that oxymatrine has protective effect on the intestinal mucosa during severe infection.However,the mechanism of the drug action has not been completely known and needs to be studied in depth.Our traditional Chinese medicine applies extensively in clinical application of the prevention of the damage to the colonic mucosal epithelial cells during severe infection.