谷参肠安胶囊对放射性肠炎的防治观察

放射性肠炎是腹、盆腔脏器的恶性肿瘤放射治疗所致肠粘膜一种非感染渗出性炎症。如何防治关系到放射治疗的顺利进行及患者的预后。我们对腹、盆腔放疗的42例患者运用谷参肠安胶囊口服收效较好,并与对照组36例患者进行对比观察,现报告如下。1　资料与方法1.1　临床资料:78例均为     

肠复康方对急性放射性肠炎大鼠一般情况及小肠黏膜炎性因子的影响

[目的]探讨肠复康方对急性放射性肠炎大鼠一般情况及小肠黏膜相关炎性因子的影响。[方法]以X线直线加速器给予实验大鼠全腹照射(DT9.0Gy),建立急性放射性肠炎大鼠模型。实验大鼠随机分成正常对照组(NC)、模型对照组(MC)、肠复康方低剂量治疗组(CFKD-LG)、肠复康方中剂量治疗组(CFKD-MG)、肠复康方高剂量治疗组(CFKD-HG)。造模成功后连续30d灌胃,期间观察对比大鼠精神状态、摄食进水、排便情况及体质量变化,处死后取相应部位的小肠用RT-PCR方法检测黏膜上皮细胞中炎性因子IL-1β、IL-6、TNF-αmRNA的表达。[结果]造模成功后肠复康方低、中、高剂量组精神状态、饮食进水、排便情况较模型对照组好;与模型对照组比较,肠复康方低、中、高剂量组大鼠体质量显著增加,肠复康方中剂量组效优(P<0.01)。肠复康方低、中、高剂量组小肠黏膜的炎性因子IL-1β、IL-6、TNF-αmRNA较模型对照组显著下调(P<0.01)。[结论]肠复康方低、中、高剂量组通过下调小肠黏膜上皮细胞中炎性因子IL-1β、IL-6、TNF-αmRNA的表达,改善小肠黏膜的炎症反应,促进急性放射性肠炎受损小肠黏膜的修复,以中剂量效优。     

放射性肠炎出血的治疗现状

放射性肠炎出血是放射治疗引起的一种严重并发症,传统的内科治疗疗效不佳。近年来局部应用硫糖铝悬液灌肠、局部喷洒4％福尔马林、高压氧等治疗方法为放射性肠炎出血提供了新的有效治疗手段。本文对放射性肠炎出血的治疗现状进行简要综述。     

放射性肠炎的高压氧治疗

近年来,随着腹盆腔恶性肿瘤的发病率增加、放射治疗技术的广泛开展,放射性肠炎发病率也在增加。其中慢性放射性肠炎治疗困难,需要联合多种不同方法治疗。高压氧治疗作为治疗放射性肠炎的手段之一越来越受到重视,此文就此作一综述。     

放射性肠炎出血的治疗现状

放射性肠炎出血是放射治疗引起的一种严重并发症,传统的内科治疗疗效不佳。近年来局部应用硫糖铝悬液灌汤、局部喷洒４％福尔马林、高压氧等治疗方法为放射性肠炎出血提供了新的有效治疗手段。本对放射性肠炎出血的治疗现状进行简要综述。     

安肠组方保留灌肠对大肠湿热型急性放射性肠炎患者生存质量及免疫微环境的影响分析

目的:分析大肠湿热型急性放射性肠炎患者用安肠组方治疗前后的生存质量及对患者免疫微环境的影响.方法:以2014年11月-2020年11月收治的68例大肠湿热型急性放射性肠炎患者为研究对象,给予患者安肠组方为基本方保留灌肠,2次/d,14 d为1个疗程.比较患者治疗前后的维也纳直肠镜评分(VAS),T淋巴细胞亚群CD3+、...     

唐古特大黄多糖组分1对大鼠急性放射性肠损伤的保护作用

目的探讨唐古特大黄多糖组分1(Rheum tanguticum polysaccharides,RTP1)对辐射所致大鼠急性肠黏膜损伤的保护作用。方法 RTP1灌胃给药(剂量200、400、800 mg/kg)7 d后,除正常组大鼠外,其余各组均接受10.0 Gy/只一次性全腹均匀X射线照射1次,3 d后处死动物,观察小肠黏膜病理形态改变,测定肠黏膜屏障功能、小肠组织氧化还原酶活性及血浆内毒素水平。结果RTP1预处理后可以改善肠黏膜损伤,升高SOD活性及GSH含量,降低MDA水平,抑制血浆中DAO、D-乳酸及内毒素水平,与IC组比较,差异具有统计学意义(P0.05)。结论 RTP1通过减轻肠黏膜屏障功能损害,增强抗氧化能力保护辐射所致肠黏膜损伤。     

微创介入技术治疗放射性肠炎的疗效

目的观察微创介入技术治疗放射性肠炎的临床疗效及其安全性。方法选择该院2011年5月至2014年11月收治的60例老年重症放射性肠炎患者作为观察对象,随机分为观察组和对照组。观察组30例,采用微创介入技术治疗;对照组30例,采用传统开腹手术治疗。观察两组患者手术时间、术中出血量和术后并发症发生情况,以及近期临床疗效。结果观察组:手术时间(130±22)min,术中出血量(79±25)ml,并发症发生率10.0%,总有效率100.0%;对照组:手术时间(178±23)min,术中出血量(330±60)ml,并发症发生率30.0%,总有效率100.0%。观察组手术时间、术中出血量和并发症发生率与对照组比较,差异有统计学意义(P0.05)。结论与传统开腹手术比较,微创介入技术治疗老年重症放射性肠炎可取得等同的临床治疗效果;同时可缩短手术时间,减少术中出血量和降低术后并发症发生率。     

慢性放射性肠炎并发肠梗阻的治疗

目的:探讨慢性放射性肠炎并发肠梗阻的治疗方法及疗效.方法:回顾分析21例慢性放射性肠炎并发肠梗阻的临床资料,对其进行总结.结果:7例保守治疗的病例中有5例复发,治愈率仅(28.6%,2/7),保守治疗效果不佳.14例手术患者总体疗效满意.10例行肠切除吻合术的患者,治愈率达(90.0%,9/10),可见手术治疗为慢性放射性肠炎并发肠梗阻的最佳方法.1例出现吻合口瘘的患者,再次手术证实为第1次手术切除肠管过少,残留病变肠管所致.结论:慢性放射性肠炎并发肠梗阻的最佳治疗方法为手术治疗,手术方式应尽量行肠切除一期吻合术,手术时应尽量切除全部病变肠管,避免出现吻合口瘘.同时肠造口术或旁路手术也是必要术式,应根据具体情况选择.     

Protective effects of terminal ileostomy against bacterial translocation in a rat model of intestinal ischemia/reperfusion injury

AIM: To investigate the effects of terminal ileostomy on bacterial translocation (BT) and systemic inflammation after intestinal ischemia/reperfusion (I/R) injury in rats.METHODS: Thirty-two rats were assigned to either the sham-operated group, I/R group, I/R + resection and anastomosis group, or the I/R + ileostomy group. The superior mesenteric artery was occluded for 60 min. After 4 h, tissue samples were collected for analysis. BT was assessed by bacteriologic cultures, intestinal permeability and serum levels of endotoxin; systemic inflammation was assessed by serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10, as well as by the activity of myeloperoxidase (MPO) and by intestinal histopathology.RESULTS: Intestinal I/R injury not only caused morphologic damage to ileal mucosa, but also induced BT, increased MPO activity and promoted the release of TNF-α, IL-6, and IL-10 in serum. BT and ileal mucosa injuries were significantly improved and levels of TNF-α and IL-6 in serum were decreased in the I/R + ileostomy group compared with the I/R + resection and anastomosis group.CONCLUSION: Terminal ileostomy can prevent the detrimental effects of intestinal I/R injury on BT, intestinal tissue, and inflammation.     

Mucosal protective effects of vitamin E and misoprostol during acute radiation-induced enteritis in rats

Cytotoxic effects of ionizing radiation on gastrointestinal epithelium may be mediated by oxygen free radicals. Therapeutic intervention directed toward oxidant scavenging and increasing tissue oxygen tension may provide a novel approach to management. We investigated the effects of a nonenzymatic oxygen radical scavenger (vitamin E) and an exogenous PGE₁ analog known to increase mucosal blood flow (misoprostol) on acute radiation enteritis. Rats were pretreated with: (1) vitamin E, (2) misoprostol, or (3) a combination of both agents prior to 10 Gy abdominal radiation. Three days following irradiation, net fluid absorption usingin vivo isolated loops, mucosal histology, and mucosal morphometry using a computerized videoplan were determined in jejunum, ileum, and colon. Nonirradiated control intestine demonstrated net fluid absorption in all segments, which was not altered by vitamin E and/or misoprostol treatment. Irradiation significantly reduced net fluid absorption in jejunum, ileum, and colon. Vitamin E administered prior to irradiation maintained jejunal, ileal, and colonic fluid absorption near control levels. In contrast misoprostol or a combination of vitamin E and misoprostol did not provide protection against the injury caused by abdominal irradiation. Alterations in intestinal fluid absorption occurred without significant changes in histologic or morphometric appearance. In conclusion, ionizing radiation reducesin vivo intestinal fluid absorption without significant changes in histologic or morphometric appearance. Treatment with vitamin E, but not misoprostol, protects gastrointestinal mucosa against radiation-induced absorptive injury.This work was supported in part by grants from the Alberta Heritage Foundation for Medical Research and the Canadian Foundation of Ileitis and Colitis.     

Chunggan extract,a traditional herbal formula,ameliorated alcohol-induced hepatic injury in rat model

AIM: To evaluate protective effects of Chunggan extract(CGX), a traditional herbal formula, under 4 wk of alcohol consumption-induced liver injury. METHODS: Male Sprague-Dawley Rats were orally administered 30% ethanol daily for 4 wk with or without CGX. The pharmaceutical properties were assessed through liver enzymes, histopathology, fibrogenic cytokines, and alcohol metabolism in hepatic tissues as well as by in vitro experiment using HSC-T6 cells. RESULTS: Four weeks of alcohol consumption notably increased liver enzymes and malondialdehyde levels in serum and hepatic tissue. CGX not only prevented the collagen deposition determined by histopathology and hydroxyproline content, but also normalized transforming growth factor-beta, platelet-derived growth factorbeta and connective tissue growth factor at the gene expression and protein levels in liver tissue. Moreover, CGX treatment also significantly normalized the abnormal changes in gene expression profiles of extracellular matrix proteins, matrix metalloproteinase and their inhibitors, alcohol metabolism, and inflammatory reactions. In the acetaldehyde-stimulated HSC-T6 cells, CGX considerably inhibited collagen production and normalized fibrogenic cytokines in both gene expression and protein levels. CONCLUSION: The present study evidenced that CGX has hepatoprotective properties via modulation of fibrogenic cytokines and alcohol metabolism in alcoholic liver injury.     

生长激素对实验性急性坏死性胰腺炎肠道细菌移居的影响

目的 探讨生长激素（ｇｒｏｗｔｈ ｈｏｒｍｏｎｅ,ＧＨ）对急性坏死性胰腺炎（ａｃｕｔｅ ｍｅｃｒｏｔｉｚｉｎｇｐａｎｃｒｅａｔｉｔｉｓ,ＡＮＰ）肠道细菌移居的 影响。方法 采用胆胰管内逆行注射５％牛碘胆酸钠溶液诱导大鼠ＡＮＰ模型。１３７只在鼠随机分成３组：假手术组（ｎ＝４１）、ＡＮＰ＋ＮＳ组（ｎ＝４８）和ＮＡＰ＋ＧＨ组（ｎ＝４８）。ＧＨ治疗组大鼠皮下注射０．７５Ｕ／ｋｇ体重基因重组ＧＨ。观察血清淀     

A simple taurocholate-induced model of severe acute pancreatitis in rats

AIM: To investigate gut barrier damage and intestinal bacteria translocation in severe acute pancreatitis (SAP),a simple rat model of SAP was induced and studied.METHODS: Pancreatitis was induced by uniformly distributed injection of 3.8% Na taurocholate (1 mL/kg) beneath the pancreatic capsule. Rats in the control group were injected with normal saline in the identical location.RESULTS: Serum amylase, plasma endotoxin, intestinal permeability, and pancreatitis pathology scores were all markedly higher in the pancreatitis group than in the control group ( P < 0.01). The bacterial infection rate was significantly higher in the SAP group than in the control group ( P < 0.01), observed in parallel by both bacterial culture and real-time polymerase chain reaction. Acute damage of the pancreas was observed histologically in SAP rats, showing interstitial edema, leukocyte infiltration, acinar cell necrosis and hemorrhage. The microstructure of the intestinal mucosa of SAP rats appeared to be destroyed with loose, shortened microvilli and rupture of the intercellular junction, as shown by electron microscopy.CONCLUSION: Significant gut barrier damage and intestinal bacterial translocation were definitely observed with few potential study confounders in this SAP rat model, suggesting that it may be an appropriate animal model for study of gut barrier damage and bacterial translocation in SAP.     

淤胆汤治疗急性淤胆型肝炎疗效观察

目的回顾性分析淤胆汤治疗急性淤胆型肝炎的临床疗效。方法选取本院2009年1月至2011年12月诊断为急性淤胆型肝炎的住院患者86例,根据治疗中是否应用中药"淤胆汤"分为单纯西药治疗组(A组,45例)和西药联合淤胆汤治疗组(B组,41例),观察治疗后8周两组中医症候评分,生化学指标改善情况和治疗有效率。结果 A、B两组患者中医症候评分下降分别为(26.99±2.02)分和(28.13±2.37)分,TBil下降中位数分别为242.45μmol/L和312.65μmol/L,GGT下降中位数分别为57.00 U/L和116.50 U/L,ALP下降中位数分别为68 U/L和91 U/L,TBA下降中位数分别为170.50μmol/L和191.50μmol/L,总有效率分别为80.00%和95.12%,差异有统计学意义(P=0.032、0.036)。A、B两组患者ALT下降中位数分别为645.50 U/L和613.25 U/L,差异无统计学意义(P=0.0897)。结论西药联合淤胆汤治疗急性淤胆型肝炎对中医症候积分的改善、生物化学指标的改善及有效率等方面优于纯西药治疗组。中医辩证施治,凉血活血、清热化湿法在治疗急性淤胆型肝炎方面值得积极推广。     

参麦注射液对急性胰腺炎大鼠的治疗作用及其机制研究

目的 观察参麦注射液对急性水肿性胰腺炎（AEP）大鼠的治疗作用,探讨其作用机制.方法 采用腹腔内注射雨蛙素连续7次、间隔1h的方法建立大鼠AEP模型.制模后1h,参麦组给予静脉滴注参麦注射液（5 ml·kg^-1 ·d^-1）治疗,AEP组给予等容积生理盐水.建模后1h及1、3、5、7d眼内眦交替采血,采用酶联免疫吸附法检测血清淀粉酶、血小板活化因子（PAF）、血管内皮生长因子（VEGF）的含量.术后7、14 d分两批处死大鼠,取胰腺组织.采用实时RT-PCR和蛋白质印迹法检测胰腺组织NF-κB mRNA和蛋白的表达量,以正常胰腺组织为对照.采用免疫组化法检测胰腺组织CD31的表达,计算微血管密度（MVD）.结果 两组造模后血清淀粉酶活性及PAF含量均升高,3d后逐渐下降,参麦组的下降较AEP组显著.造模后5d参麦组、AEP组的淀粉酶活性分别为（4569±158）、（5056±198） U/L,PAF分别为（25.30±4.76）、（36.06±5.57） μg/L,两组的差异均具有统计学意义（P值均＜0.05）.两组大鼠血清VEGF含量于造模后1d开始逐渐升高,3d后参麦组的升高较AEP组显著,5d时分别为（139.78±24.30）、（118.51±21.70） pg/ml,两组差异具有统计学意义（P＜0.05）.术后7d参麦组胰腺组织NF-κB mRNA和蛋白相对表达量分别为0.834±0.031和0.49±0.24,MVD为6.41±1.14;AEP组分别为1.000±0.059、0.93 ±0.45、3.62±0.89,两组差异均具有统计学意义（P＜0.05或＜0.01）.结论 参麦注射液治疗急性胰腺炎具有促进血管生成、改善微循环、减轻炎症递质瀑布反应的作用.     

放射性肠炎中微血管损伤机制及与内镜表现的关系

放射性肠炎内镜下常具有黏膜下毛细血管网减少,残留血管异常扩张等较特征性表现。本文主要介绍放射性肠炎中微血管损伤的机制,包括微血管密度下降、黏膜下纤维化、异常新生血管等与内镜下表现的关系,以期为临床治疗放射性肠炎提供新的思路。