思密达灌肠联合美沙拉嗪喂服治疗大鼠溃疡性直肠炎疗效的实验研究  

Therapeutic effects of smecta enema combined with mesalazine in treating Wistar rats with ulcerative proctitis

作　　者：江学良[1] 董玉昕 江馨怡 

机构地区：[1]济南军区总医院消化科,250031 [2]山东省济南市槐荫人民医院内科,250021

出　　处：《中华消化病与影像杂志（电子版）》2015年第4期26-30,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：IDF腹泻基金资助项目(IDF201301)

摘　　要：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�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 mucopurolent 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. Resets 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 （ 5

关 键 词：直肠炎 思密达 美沙拉嗪 治疗结果 

分 类 号：R574.63[医药卫生—消化系统]