中华消化病与影像杂志(电子版)
中華消化病與影像雜誌(電子版)
중화소화병여영상잡지(전자판)
2015年
4期
26-30
,共5页
直肠炎%思密达%美沙拉嗪%治疗结果
直腸炎%思密達%美沙拉嗪%治療結果
직장염%사밀체%미사랍진%치료결과
Proctitis%Smecta%Mesalazine%Treatment outcome
目的:研究思密达灌肠联合美沙拉嗪喂服治疗大鼠溃疡性直肠炎的疗效。方法成年Wistar大鼠120只,以二硝基氯苯和乙酸复合法构建溃疡性直肠炎动物模型。建模成功后1周随机分为3组,每组40只。思密达灌肠治疗组大鼠以天然蒙脱石0.6 g·d-1·kg-1灌肠,1次/d,共8周;美沙拉嗪治疗组大鼠喂服美沙拉嗪0.2 g·d-1·kg-1,共8周;思密达灌肠联合美沙拉嗪治疗组大鼠喂服美沙拉嗪0.2 g·d-1·kg-1,天然蒙脱石0.6 g·d-1·kg-1灌肠共8周。分别于治疗前和治疗后记录各组大鼠腹泻症状变化;测定各组大鼠肠道黏膜通透性(尿中乳果糖与甘露醇的比率);光镜下观察各组大鼠结肠组织学变化;电镜下观察肠黏膜超微结构包括组织紧密连接、上皮细胞间隙、肠基底膜细胞核分裂相和细胞凋亡情况。思密达灌肠联合美沙拉嗪治疗组与思密达灌肠治疗组、美沙拉嗪治疗组大鼠腹泻症状恢复正常时间、黏液脓血便消失时间、尿中乳果糖与甘露醇的比率、超微结构恢复正常时间差异采用t检验比较;思密达灌肠联合美沙拉嗪治疗组与思密达灌肠治疗组、美沙拉嗪治疗组大鼠组织学缓解情况差异采用秩和检验比较。结果思密达灌肠联合美沙拉嗪治疗组大鼠腹泻症状恢复正常时间为(8.7±4.6)d,短于思密达灌肠治疗组、美沙拉嗪治疗组大鼠腹泻症状恢复正常时间(13.8±4.1)d、(15.6±3.3)d,且差异均有统计学意义(t=5.235、7.709,均P<0.05)。思密达灌肠联合美沙拉嗪治疗组大鼠黏液脓血便消失时间为(10.2±3.9)d,短于思密达灌肠治疗组、美沙拉嗪治疗组大鼠黏液脓血便消失时间(15.9±4.1)d、(16.8±3.9)d,且差异均有统计学意义(t=6.369、7.568,均P<0.05)。思密达灌肠联合美沙拉嗪治疗组大鼠尿中乳果糖与甘露醇的比率为(26.2±4.7)%,小于思密达灌肠治疗组、美沙拉嗪治疗组大鼠尿中乳果糖与甘露醇的比率(34.8±4.9)%、(35.6±4.7)%,且差异均有统计学意义(t=8.01、8.094,均P<0.05)。思密达灌肠联合美沙拉嗪治疗组大鼠组织学缓解情况优于思密达灌肠治疗组、美沙拉嗪治疗组大鼠组织学缓解情况,且差异均有统计学意义(t=2.018、2.16,均P<0.05)。思密达灌肠联合美沙拉嗪治疗组大鼠超微结构(包括DIS、TJs及肠基底膜细胞核分裂像和细胞凋亡情况)恢复正常时间为(33.7±6.5)d,短于思密达灌肠治疗组、美沙拉嗪治疗组大鼠超微结构恢复正常时间(50.2±8.1)d、(52.4±8.5) d,且差异均有统计学意义(t=10.06、10.15,均P<0.05)。结论利思密达灌肠联合美沙拉嗪治疗大鼠溃疡性直肠炎在腹泻症状、肠黏膜通透性及肠黏膜组织学改善等方面优于单独应用美沙拉嗪喂服或者单独应用思密达灌肠。
目的:研究思密達灌腸聯閤美沙拉嗪餵服治療大鼠潰瘍性直腸炎的療效。方法成年Wistar大鼠120隻,以二硝基氯苯和乙痠複閤法構建潰瘍性直腸炎動物模型。建模成功後1週隨機分為3組,每組40隻。思密達灌腸治療組大鼠以天然矇脫石0.6 g·d-1·kg-1灌腸,1次/d,共8週;美沙拉嗪治療組大鼠餵服美沙拉嗪0.2 g·d-1·kg-1,共8週;思密達灌腸聯閤美沙拉嗪治療組大鼠餵服美沙拉嗪0.2 g·d-1·kg-1,天然矇脫石0.6 g·d-1·kg-1灌腸共8週。分彆于治療前和治療後記錄各組大鼠腹瀉癥狀變化;測定各組大鼠腸道黏膜通透性(尿中乳果糖與甘露醇的比率);光鏡下觀察各組大鼠結腸組織學變化;電鏡下觀察腸黏膜超微結構包括組織緊密連接、上皮細胞間隙、腸基底膜細胞覈分裂相和細胞凋亡情況。思密達灌腸聯閤美沙拉嗪治療組與思密達灌腸治療組、美沙拉嗪治療組大鼠腹瀉癥狀恢複正常時間、黏液膿血便消失時間、尿中乳果糖與甘露醇的比率、超微結構恢複正常時間差異採用t檢驗比較;思密達灌腸聯閤美沙拉嗪治療組與思密達灌腸治療組、美沙拉嗪治療組大鼠組織學緩解情況差異採用秩和檢驗比較。結果思密達灌腸聯閤美沙拉嗪治療組大鼠腹瀉癥狀恢複正常時間為(8.7±4.6)d,短于思密達灌腸治療組、美沙拉嗪治療組大鼠腹瀉癥狀恢複正常時間(13.8±4.1)d、(15.6±3.3)d,且差異均有統計學意義(t=5.235、7.709,均P<0.05)。思密達灌腸聯閤美沙拉嗪治療組大鼠黏液膿血便消失時間為(10.2±3.9)d,短于思密達灌腸治療組、美沙拉嗪治療組大鼠黏液膿血便消失時間(15.9±4.1)d、(16.8±3.9)d,且差異均有統計學意義(t=6.369、7.568,均P<0.05)。思密達灌腸聯閤美沙拉嗪治療組大鼠尿中乳果糖與甘露醇的比率為(26.2±4.7)%,小于思密達灌腸治療組、美沙拉嗪治療組大鼠尿中乳果糖與甘露醇的比率(34.8±4.9)%、(35.6±4.7)%,且差異均有統計學意義(t=8.01、8.094,均P<0.05)。思密達灌腸聯閤美沙拉嗪治療組大鼠組織學緩解情況優于思密達灌腸治療組、美沙拉嗪治療組大鼠組織學緩解情況,且差異均有統計學意義(t=2.018、2.16,均P<0.05)。思密達灌腸聯閤美沙拉嗪治療組大鼠超微結構(包括DIS、TJs及腸基底膜細胞覈分裂像和細胞凋亡情況)恢複正常時間為(33.7±6.5)d,短于思密達灌腸治療組、美沙拉嗪治療組大鼠超微結構恢複正常時間(50.2±8.1)d、(52.4±8.5) d,且差異均有統計學意義(t=10.06、10.15,均P<0.05)。結論利思密達灌腸聯閤美沙拉嗪治療大鼠潰瘍性直腸炎在腹瀉癥狀、腸黏膜通透性及腸黏膜組織學改善等方麵優于單獨應用美沙拉嗪餵服或者單獨應用思密達灌腸。
목적:연구사밀체관장연합미사랍진위복치료대서궤양성직장염적료효。방법성년Wistar대서120지,이이초기록분화을산복합법구건궤양성직장염동물모형。건모성공후1주수궤분위3조,매조40지。사밀체관장치료조대서이천연몽탈석0.6 g·d-1·kg-1관장,1차/d,공8주;미사랍진치료조대서위복미사랍진0.2 g·d-1·kg-1,공8주;사밀체관장연합미사랍진치료조대서위복미사랍진0.2 g·d-1·kg-1,천연몽탈석0.6 g·d-1·kg-1관장공8주。분별우치료전화치료후기록각조대서복사증상변화;측정각조대서장도점막통투성(뇨중유과당여감로순적비솔);광경하관찰각조대서결장조직학변화;전경하관찰장점막초미결구포괄조직긴밀련접、상피세포간극、장기저막세포핵분렬상화세포조망정황。사밀체관장연합미사랍진치료조여사밀체관장치료조、미사랍진치료조대서복사증상회복정상시간、점액농혈편소실시간、뇨중유과당여감로순적비솔、초미결구회복정상시간차이채용t검험비교;사밀체관장연합미사랍진치료조여사밀체관장치료조、미사랍진치료조대서조직학완해정황차이채용질화검험비교。결과사밀체관장연합미사랍진치료조대서복사증상회복정상시간위(8.7±4.6)d,단우사밀체관장치료조、미사랍진치료조대서복사증상회복정상시간(13.8±4.1)d、(15.6±3.3)d,차차이균유통계학의의(t=5.235、7.709,균P<0.05)。사밀체관장연합미사랍진치료조대서점액농혈편소실시간위(10.2±3.9)d,단우사밀체관장치료조、미사랍진치료조대서점액농혈편소실시간(15.9±4.1)d、(16.8±3.9)d,차차이균유통계학의의(t=6.369、7.568,균P<0.05)。사밀체관장연합미사랍진치료조대서뇨중유과당여감로순적비솔위(26.2±4.7)%,소우사밀체관장치료조、미사랍진치료조대서뇨중유과당여감로순적비솔(34.8±4.9)%、(35.6±4.7)%,차차이균유통계학의의(t=8.01、8.094,균P<0.05)。사밀체관장연합미사랍진치료조대서조직학완해정황우우사밀체관장치료조、미사랍진치료조대서조직학완해정황,차차이균유통계학의의(t=2.018、2.16,균P<0.05)。사밀체관장연합미사랍진치료조대서초미결구(포괄DIS、TJs급장기저막세포핵분렬상화세포조망정황)회복정상시간위(33.7±6.5)d,단우사밀체관장치료조、미사랍진치료조대서초미결구회복정상시간(50.2±8.1)d、(52.4±8.5) d,차차이균유통계학의의(t=10.06、10.15,균P<0.05)。결론리사밀체관장연합미사랍진치료대서궤양성직장염재복사증상、장점막통투성급장점막조직학개선등방면우우단독응용미사랍진위복혹자단독응용사밀체관장。
Objective To study the therapeutic effects of smecta enema combined with mesalazine in treating Wistar rats with ulcerative proctitis.Methods One hundred and twenty adult Wistar rats were divided randomly into 3 groups (40 each)1 week later after the model had been established by dinitrochlorobenzol (DNCB) combined with acetic acid (AA).Group A:smecta enema (0.6 g·d-1 ·kg-1 for 8 weeks.Group B:mesalazine (0.2 g·d-1 ·kg-1 )for 8 weeks.Group C:smecta enema (0.6 g·d-1 ·kg-1 )combined with mesalazine (0.2 g·d-1 ·kg-1 )for 8 weeks.The variance of diarrhoea symptom was recorded prior and post treatment.The entero-membrane permeability (the ratio of lactulose and mannitol in urine)was measured.Then histological change was observed by light microscope,entero-mucosa ultrastructure was observed by electron microscope,including zonula occludens,dilated intercellular spaces,intestines basal lamina karyomitosis phasing and apoptosis status.The differences of the recovery time of diarrhea,extinction time of bloody mucopurulent stool,the ratio of lactulose and mannitol in urine,the recovery time of ultrastructure among the three groups were analyzed by t-test.The difference of the histologic remission among the three groups was analyzed by rank-sum test.Results Compared with group A and group B, group C had an obviously shorter diarrhea recovery time [(8.7 ±4.6)d vs (13.8 ±4.1)d,(15.6 ±3.3)d;t=5.235,P<0.05;t=7.709,P<0.05],a shorter extinction time of bloody mucopurulent stool [(10.2 ± 3.9)d vs (15.9 ±4.1)d,(16.8 ±3.9)d;t=6.369,P<0.05;t=7.568,P<0.05],an obviously lower entero-membrane permeability [(26.2 ±4.7)%vs (34.8 ±4.9)%,(35.6 ±4.7)%;t=8.01,P<0.05;t=8.094,P<0.05 ],an better histological remission (t=2.018,P<0.05;t=2.16,P<0.05 ),an obviously shorter ultramicrostructure recovery time [(33.7 ±6.5)d vs (50.2 ±8.1)d,(52.4 ±8.5)d,t=10.06,P<0.05;t=10.15,P<0.05].Conclusion The therapeutic effects (improvement of diarrhea, entero-membrane permeability and histological changes ) of smecta enema combined with mesalazine in treating ulcerative proctitis is superior than that of smecta enema or mesalazine.