冬虫夏草对肠外瘘病人肠黏膜屏障功能的影响

Effects of Cordyceps sinensis on barrier function of intestine mucosa in patients with enterocutaneous fistula

目的:探讨冬虫夏草对肠外瘘病人肠黏膜屏障功能的影响。方法:选择肠外瘘病人17例,随机分为肠内营养(EN)组8例和EN+百令胶囊组9例。入院次日,病人给予1.5 REE(静息能量消耗)热量的EN液,研究组增给百令胶囊鼻饲,每天3 g,连用10 d。营养支持与方法在整个研究期间不变,分别于研究的第0、5、10天经小肠瘘口取肠黏膜标本,检测小肠黏膜细胞增殖指数、免疫组化标记增殖细胞核抗原、流式细胞仪计数IEL(CD3、CD45双标记),并分析其亚型CD4和CD8阳性细胞比例。结果:EN组和EN+百令胶囊组病人的的小肠黏膜细胞增殖指数及增殖细胞核抗原的比例在第10天时与0天比有显著性差异(P<0.05)。两组肠上皮内淋巴细胞比例及其亚型第5天即出现明显变化(P<0.05)。结论:冬虫夏草不仅可促进肠瘘病人肠黏膜细胞的增殖,而且还能增强肠黏膜的免疫屏障功能。

Objective： To study the effects of Cordyceps sinensis on barrier function of intestine mucosa in patients with enterocutaneous fistula. Methods： 17 patients with enterocutaneous fistula were randomly divided into two groups ： enteral nutrition group and enteral nutrition ＋ Cordyceps sinensis treated group （3 g/d intragastric administration, qd × 10）. The proliferation index（PI） of intestinal muco- sal cell was detected by the flow cytometry, and intestinal cells proliferating cell nuclear antigen （PCNA） was studied by immunohistochemical staining. The intraepithelial lymphocyte（IEL） and CD4＋/CD8 ratio of intestinal mucosa were studied by using image analysis and immunohistochemical technique. Results ：The intestinal cell proliferation index （PI）, proliferating cell nuclear antigen, intraepithelial lymphocyte（IEL） and CD4＋/CD8 ratio showed obvious difference between the enteral nutrition group and enteral nutrition ＋ Cordyceps sinensis treated group （ P 〈 0. 05 ）. Conclusion ： Cordyceps sinensis may promote the proliferation of intestinal cells in patients with enterocutaneous fistula, and enhance immune function of intestine mucosal barrier.