| First:Literature StudyFrom traditional Chinese medicine and modern medicine on etiology, pathogenesis and treatment of adhesive intestinal obstruction, and so described; Relationship between intestinal mucosa barrier and AIO and, to explore release hot enema mixture of tongfu enema on adhesive ileus intestinal immunologic barrier protective mechanism, laying a solid theoretical foundation for clinical use.Second:Experimental StudyObjective:From the perspective of animal experiments to explore the protective mechanism of traditional Chinese medicine enema adhesive intestinal obstruction intestinal barrier.Methods:50Sprague Dawley(SD)rats were randomly divided into five groups: normal group, sham group, saline group, high dose group, low dose group. Normal group, sham group, saline group with0.9%saline enema; high dose group with10ml/kg Tongfu Xiere enema and low dose group5ml/kg. In the morning of one day after modeling to prepare retention enema, the enema temperature38℃, take on the8th of pediatric catheter for anal enema after emptying the faeces as much as possible, anal insertion depth about3-5cm, and slowly inject the enema, and the catheter pulled out after5min to minimize the leakage of the enema. By intraperitoneal injection of10%chloral hydrat for anesthesia, rats were drawn blood first, given intestinal adhesion Phyllips classification, and then taken the appropriate specimens to sent to the relevant department.Results:(One):The number of intraperitoneal adhesions in normal saline group was maximum with close sticking, part of the proximal bowel dilatation, the distal bowel coarctation of adhesive intestinal obstruction changes and enema;the peritoneal adhesions in the high dose group was less adhesive as film, easy to separate, while adhesions in the low dose group increased with bleeding after the separation of serous surface;there were not significant adhesions in the abdominal cavity in sham group and normal group.(Two):Saline solution group after2weeks treatment less effective, with low IL-10levels and enema with high-dose and low-dose group and operations group, IL-10in the group are normally higher than normal saline group, with statistical significance (P<0.05); Compared with the surgical group, Enema with high-dose and low-dose IL-10in the group level is slightly higher than the surgery group, no statistically significant; Saline group containing IL-10than surgical group, with statistical significance (P<0.05).(Three):After two weeks treatment, SIgA concentration in saline group was minimum, while it was significantly higher of SIgA contained concentrations than saline group in high dose group(P<0.01), low dose group, normal group and shame group (P<0.05). Compared with shame group, SIgA concentration wsa significantly higher in high dose group (P<0.01) and in low dose group (P<0.05), while lower in saline group (P<0.01).(Four):Saline group mucosa propria of a large number of chronic inflammatory cell infiltration, submucosa edema and more chronic inflammatory cell infiltration. Enema high dose group compared with saline solution group, lamina propria layer in a small number of chronic inflammatory cell infiltration, submucosa did not see edema and chronic inflammatory cell infiltration. Enema with low dose group compared with saline solution group, lamina propria layer in a small number of chronic inflammatory cell infiltration, submucosa edema, telangiectasias, small amounts of chronic inflammatory cell infiltration. Surgical group mucosa propria of a large number of chronic inflammatory cell infiltration, mucosal Telangiectasia, edema lower congestion and more chronic inflammatory cell infiltration. Normal group no significant anomalies.Conclusion:In this study, through the establishment of the rats of adhesive intestinal obstruction model, respectively, to give Tongfu Xiere sausage mixture and saline enema, found the Tongfu Xiere enema group nits intraperitoneal adhesions compared with the saline group decreased significantly after two weeks of treatment, ratsof serum IL-10, the intestinal contents of SIgA was significantly higher than the saline group, which proved the the Tongfu Xiere sausage mixture to a significant reduction in intestinal mucosal injury, and reduce the inflammatory reaction, and enhance intestinal barrier function, which described TongfuXiere enema mixture of adhesiv intestinal obstruction intestinal immune barrier function of the protection mechanism.Third: Clinical curative effect observationTwo Surgery, First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine in December2009to2011in December of adhesive intestinal obstruction cases to80cases, the results show that the the Tongfu Xiere sausage mixture has a good effect in the treatment of adhesive intestinal obstruct ion, it can effectively promote the recovery of gastrointestinal function, alleviate intestinal inflammation, shortening the time of anal exhaust defecation, etc., now select one of two typical cases were reported. |
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