| Adhesive intestinal obstruction(AIO) is a kind of clinical disease caused by adhesive intesinal which leads to transmission disorder of intestinal content.It is one of most clinical frequent acute abdomen disease.It may cause many kinds of severe complication for threating to life such as multiple system organ failure(MSOF).It is a common and intractable problem.It means a lot of pain and cost that patient should suffer from. Although many medicines can play some roles,there is still one recognized method is available for prevention of adhesion in abdominal cavity.It is one of the most important tasks in the medical field to actively search for how to prevent and cure AIO.The following two aspects are concerned in this dissertation to discuss AIO systematically in the field of acupuncture and moxibustion of traditional Chinese medicine.1.Literature researchOn reviewing the knowledge of AIO,animal model of AIO in western medicine.The authors pointed out that there was closely related between AIO and intestinal epithelial cell.Small intestine is the critical organ which maintain nonnal function of human body,and take on digestion,digestion,externalization,excretion and immunifaction.Disruption of gastroin-testinal epithelial barrier integrity may induce increasing of permeability of gastrointestinal wall, bacterial and endotoxin translocation,releasing inflammatory mediators,and lead to lethal sepsis and distant organ injury,finally result in multiple system organ failure.The original sign of impairment of mucosal is increasing of permeability.Before the marked change of morphology of mucosal,increasing of permeability of intestinal tract has happened.So increasing of permeability of mucosal can reflect injury of intestinal barrier earlier. Increasing of permeability of mucosal may provide a chance for absorption of toxin in enteric cavity,which is the pathological foundation of bacterial translocation.As far as its treatment was concerned,at present,it still stayed at operation and infusing into abdominal cavity with some special medicine such as sodium hyaluronate,urokinase and intralipid et al. On reviewing the etiology and pathogenesis,treatment selection on syndrome differentiation of AIO in TCM,the author pointed out that the history of the cognition of physiology and pathology for the coeliac disease in TCM is very long.Not a few literatures are relative to AIO,while none of them is specialized in AIO.The symptoms are included in the following chapters,such as "bellyache","accumulation "," intense carotid and radial pulsation ",etc.Acu-bustion has many kinds of therapeutic methods including acupunture, moxibustion,tuina,decoction edema,etc.It has desirable effect on AIO.In addition,my director has got a great experience on research of AIO.On reviewing the cognition of AIO in both Traditional Chinese Medicine and modern medical science,the author pointed out that there is stable and forceful theoretic foundation and significant clinical meaning to probing into the protective effect of acupuncture in points for the treatment of AIO.2.Experimental researchPurpose:To probe the protective effect of acupuncture for the treatment of AIO from the angle of animal experiment.Methods:75 SD rats were randomly divided into groups:normal group, sham-operation group,model group,Dachengqi decoction enema group,acupuncture group. Acupuncture group was treated by electro-Acupuncture 30 min every day.Acupoints chosen in acupuncture group were as follows:Zusanli(ST36),Tianshu(ST25),Shangiuxu (ST37).Enema group was given enema with Dachengqi decoction 5ml/kg once everyday while sham-operation group and model group with physiological saline at same dose.All of the experimental animals were averagely put to death on the 14th day after operation,and collected serum and samples,measured and observed the following indexes:(1) The chiu score and W/D ratio of intestinal epithelial cell,The Phyllips score of adhesive intestinum.(2) The pathomorphological change of intestinal epithelial cell in adhesive intestinal obstruction injury rat models with light-microscope.(3) The ultrastructure change of intestinal epithelial cell in adhesive intestinal obstruction injury rat models with electon-microscope,including the amounts of bacterium cytoryctes cell and rough endoplasmic reticulum rough endoplasmic reticulum cav.(4) The content of Ca2+ in intestinal epithelial cell(5) The changes of chondriosome's function in intestinal epithelial cell(6) The activity of diamine oxidase(DAO) of intestinal epithelial cell.(7) The content of oxygen free radical in intestinal epithelial cell.Results: (1) Edema of intestine in model group was serious.The W/D ratio in three operation group was significantly higher(p＜0.05) than that in the sham-operation group at all time points,but it was obviously reduced by the acupuncture treament at 14,28 days after operation.Adhesive intestinum in model group was compacted and twisted lumping,proximate intestinal of some stage became distention,other distal end intestinal was coarctation and thin than normal group.The Phyllips score and chiu score of adhesive intestinum was significantly higher(P＜0.01) than that in the sham-operation group and normal group at all time points,but it was obviously reduced by acupuncture or enema treament at 14,28 days after operation(P＜0.05).(2) The intestinal mucosa injury of model group in light-microscope was worse than other groups.There was great amount of degen-akaryocyte and amotio epithelium mucosae endothelial cell,villi was getting confused,atrophy and shorter.Intestinal villi edema, capillary congestion,polymophonuclear infiltration in enteric cavity was noted in the model group after intestinal operation,pathomorphological change of the enema group and acupuncture group in light-microscope was better than model group.(3) The amounts of bacterium cytoryctes cell and rough endoplasmic reticulum rough endoplasmic reticulum cav in model group after 14 days were highest.And then it was obviously reduced by acupuncture than that in enema group.The amounts of microvilli, mitochondria and rough surface endoplasmic reticulum(RSER) were all decreased, infiltration of inflammatory cells were increased under the electromicroscope.Acupuncture can improve the ultrastructure injury of the obstructive intestinal tissues,promote the recovery of both the function and morphology of the mitochondria and RSER.(4)The content of Ca2+ in model group was significantly higher than that in the sham-operation group at all time points(P＜0.05),especially after 14days.The content of Ca2+ was obviously reduced by the acupuncture treament at 14 days after operation (p＜0.01),and the same between normal group and sham-operation group(P＞0.05).(5)The ST4 and PCR of chondriosome on IEC in model group was significantly reduced than that in the sham-operation group,and The ST3 of chondriosome on IEC was higher inversely(P＜0.01).But the ST4 and PCR of chondriosome in acupunture group was obviously increased by the acupuncture treament after operation,The ST3 of chondriosome was decreased.There was significantly higher between model group.(P＜0.01),but no as to normal group.(6) The DAO of intestinal mucosa in model group was significantly reduced than that in the sham-operation group,and the DAO in plasma was higher inversely(P＜0.01).But the DAO of intestinal mucosal in acupunture group was obviously increased by the acupuncture treament after operation,DAO in plasma was decreased at all time points. There was no significantly higher between normal group and sham- operation group. (P＞0.05)(7) The level of SOD was higher obviously in acupuncture group than that in model group,and the content of NO,MDA in acupuncture group were lower significantly than that of model group.Conclusions:(1) Acupuncture can relieve the edema of the obstructive intestinal tissues,The chiu score and W/D ratio of intestinal mucosa injury,the Phyllips score of adhesive intestinum were all decreased.Acupuncture can relieve intestinal adhensive.(2) Acupuncture can improve the ultrastructure injury of the obstructive intestinal tissues,promote the recovery of both the function and morphology of the mitochondria and rough surface endoplasmic reticulum(RSER).The amounts of bacterium cytoryctes cell and rough endoplasmic reticulum rough endoplasmic reticulum cav were all decreased.(3)Acupuncture can decrease Ca2+ of intestinal epithelial cell and improve the function of chondriosome,lessen injury to IEC.(4) Acupuncture can anti-free radicals,decrease DAO and protect the the intestinal mucosa from adhesive intestinal obstruction injury.
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