加味四君子汤对巨结肠患儿肠屏障功能影响的临床观察

目的研究加味四君子汤对巨结肠患儿肠屏障功能是否有保护作用。方法 32例巨结肠患儿随机分为2组,治疗组(16例)于术前10天起每日除清洁灌肠外予加味四君子汤口服,对照组(16例)予清洁灌肠,于根治术中分别切取两组患儿病变结肠组织制成切片,免疫组化法检测结肠黏膜固有层浆细胞分泌型免疫球蛋白A(SIgA)水平,光镜下检测结肠黏膜腺体密度,电镜下观察结肠上皮间紧密连接、上皮微绒毛、线粒体和内质网等细胞器形态。结果治疗组高倍镜视野下结肠黏膜腺体数目平均值及黏膜下固有层浆细胞SIgA值均高于对照组,电镜下观察到治疗组结肠黏膜细胞器形态较对照组更完整。结论加味四君子汤可以通过改善肠黏膜细胞增殖以维持肠黏膜完整性,增强肠道局部免疫力,从而加强肠道的屏障功能,对先天性巨结肠患儿的肠屏障功能有一定保护作用。

Clinical Observation of Effects of Modified Sijunzi Decoction on the Intestinal Mucosal Barrier of Giant Colon Children Patients

Objective To study whether Modified Sijunzi Decoction(MSD) has protective effects on the intestinal mucosal barrier function of giant colon children.Methods Thirty-two giant colon children patients were randomly assigned to two groups.Patients in the treatment group(16 cases) took MDS after cleaning edema,while cleaning enema was given to those in the control group 10 days before operation.The affected colon tissues were cut out during the radical correction and made into slices.The secreted immunoglobulin A(SIgA) level of colonic mucosal lamina propria plasma cells was detected using immunohistochemical assay.The colonic mucosal gland density was detected under the light microscope.The tight junction between the colon epitheliums,the epithelium microvilli,the morphologies of organelles such as mitochondria,and endoplasmic reticulum,etc.were observed under the electron microscope.Results The average number of colonic mucosal glands and the SIgA value of submucosal lamina propria plasma cells were higher in the treatment group than in the control group under the high power field.Compared with the control group,more intact morphologies of organelles were observed under the electron microscope.Conclusion MSD could strengthen the intestinal mucosal barrier function of giant colon children and play certain roles in protecting its functions through improving the proliferation of the intestinal mucosa cells and maintaining the integrity of the bowel mucosa,as well as enhancing the local intestinal immunity.