泻剂引起结肠壁形态学改变的临床意义

The clinical significance of rhubarb causing the morphological changes in colon wall

目的:探讨长期使用泻剂后便秘加重的形态学基础。方法:通过建立大鼠长期使用泻剂大黄后形成的泻剂结肠模型,观察了结肠肠壁结构,特别是肌间神经丛和Cajal间质细胞在光镜和电镜下的形态学变化。结果:大黄引起肠壁出现广泛的慢性炎症,全层嗜酸性粒细胞浸润,粘膜下层明显水肿,肌间神经丛神经元变性,Cajal间质细胞消失。结论:长期使用大黄所引起的肠壁神经系统损害、结肠慢波起搏细胞消失以及超敏炎症反应是泻剂加重慢传输型便秘的结构基础之一。

To investigate the morphological basis of progressing constipation after a long-period treatment with rhubarb. Methods: By establishing a cathartic colon model in rats after a continuous oral administration of rhubarb in two months, light and electron microscopies were used to observe the morphologic changes in colon wall. Results: Rhubarb caused extensive chronic inflammation, eosinophilic granulocytes infiltration, neurons degenerating damage and Cajal interstitial cells disappearance. Conclusions: Rhubarb can damage the nervous system in colon, cause the disappearance of pacemaker Cajal interstitial cells, and lead to extensive inflammation in the colon. These morphologic changes may worsen the initial constipation and speed up the disease progress.