清热解毒方和凉血活血方防治大鼠术后腹腔粘连的组织形态学研究

Morphological Study on Prevention of Qingre Jiedu Herbs and Liangxue Huoxue Herbs for Postoperative Abdominal Adhesion in Rats

目的:观察清热解毒方和凉血活血方对大鼠术后腹腔粘连的防治效果并探索其机制。方法:健康雄性Wistar大鼠120只随机分为6组,采用十二指肠钳夹法制作大鼠腹腔粘连模型,分别治疗7d并记录生存情况。术后14天时处死剖验并对粘连情况评分,取粘连组织进行HE染色和苦味酸-天狼星红染色,镜下观察并摄片,对粘连组织纤维化、炎症、血管增殖及Ⅰ、Ⅲ型胶原含量进行评价。结果:4个治疗组的生存情况与模型组无明显差异(P>0.05)。清热解毒方组术后腹腔粘连范围、强度评分,纤维化评分,血管增殖评分,Ⅰ、Ⅲ型胶原含量均低于其他治疗组(P<0.05)。炎症评分无统计学差异(P>0.05),结论:清热解毒方、凉血活血方均有良好的抗粘连效果,以清热解毒方为优;抗粘连机理可能与中药的抗炎作用,促进术后肠蠕动恢复,减轻炎症渗出及纤维蛋白基质沉积有关。

Objective To observe the prevention of Qingre Jiedu Herbs and Liangxue Huoxue Herbs on postoperative abdominal adhesion in rats and explore the mechanism. Methods The healthy Wistar rats(120 cases) were randomly divided into 6 groups and then made into postoperative abdominal adhesion model by duodenum clamped. The protective measures or medicines were given respectively for 7 d, and the survival rate was recorded. Adhesions were evaluated on day 14 post-surgical, specimens were collected for histological staining and grading. Results There was no difference in survival rate of 4 treatment groups and model group(P>0.05). The scores of adhesion range and strength, the fibrosis and neovascularization and the content of type Ⅰ and Ⅲ collagen of Qingre Jiedu group were lower than those in other treatment groups(P<0.05). The inflammation had no statistical difference(P>0.05) Conclusion Qingre Jiedu Herbs and Liangxue Huoxue Herbs can both decrease the postoperative abdominal adhesion formation, and the effect of Qingre Jiedu Herbs was better. The reason may be that these herbs can suppress inflammatory, promote the recovery of bowel movement, reduce the inflammatory exudation and fibrin substrate transformation after the operation.