通腑泻热灌肠合剂对术后肠粘连的预防的实验研究

Preventive Treatment of Postoperative Intestinal Adhesions with “Tong Fu Xie Re”Enteroclysis—An Exprimental Study Cui Xuejiao,et al

腹腔手术后肠粘连，占各类肠梗阻的３７～６４％。为探讨通腑泻热灌肠合剂对术后肠粘连的作用机制，本实验采取大白鼠小肠浆膜镊子夹取损伤的方法制成肠粘连模型，将模型随机分成三组：通腑泻热合剂灌肠组，生理盐水灌肠组和空白对照组，术后连续灌肠２天，术后第６天检测结果。实验结果表明：通腑泻热合剂灌肠组与生理盐水灌肠组及对照组比较，能够明显减少肠粘连的处数（Ｐ＜０．０１），降低纤维蛋白原的含量（Ｐ＜０．０５），同时提高血谷胱甘肽歧化酶（ＧＳＨ－Ｐｘ）的含量（Ｐ＜０．０５），而血超氧化物歧化酶（ＳＯＤ）的含量无显著差异。结果提示：通腑泻热灌肠合剂能够降低纤维蛋白原，抑制纤维蛋白产生，降低组织炎症反应；同时，提高ＧＳＨ－Ｐｘ的含量，减少强氧化性的自由基对组织的损伤，加强机体防御自由基损伤的第二道防线，防止炎症的发生，从而达到预防粘连的目的。

The aim of this study was to characterize the mechanism of preventive treatment of postoperative intestinal obstruction with“Tong Fu Xie Re”enteroclysis.Study was performed using the model intestinal adhesions of SD rat,in which intestine tunica serosa of rat were clippered by forceps.Rats were divided into 3 groups at random:enema with“Tong Fu Xie Re”enteroclysis(T group),enema with normal saline(S group)and control group (C group).T group and Sgroup were postoperative enemaed for 2 days and 4 indexs(points of adhesions,contents of fibrinogen(Fig), contents of blood glutathione peroxidase(GSH Px),content of blood Super oxide dismultase (SOD))were detected in the 6th day after operation The result showed that the points of adhesions and Fig in T geoup were lower than that in the other group( P <0.01 and P <0.05),while GSH Px were higher than that in the other two groups( P <0.05).As far as SOD was concerned,no significant difference were fond among the 3 groups.It suggested the T group could lower Fig and cut down fibrin and so lessen in flammatory change in tissue .On the other hand,it increased GSH Px content which was against the destrory of strong oxidative free radical to tissues and strengthened the second line of defence against free radical.All these effects contributed to the prevention of inflammatory and preventive OF postoperative intestinal adhesions