【作者】 崔淑华；

【导师】 焦君良；

【作者基本信息】 河北医科大学 ， 中西医结合临床， 2005， 硕士

【摘要】 目的:溃疡性结肠炎（Ulcerative colitis,UC）是一种原因未明的炎症性肠病,是以结肠和直肠粘膜慢性炎症和溃疡形成为病理特点的消化道疑难病。现代医学认为UC 发病与遗传、环境、精神、免疫、感染等因素有直接或间接的关系,目前多趋向于免疫紊乱和炎症介质损伤等发病学说。研究表明:UC 与免疫机能异常和炎症介质生成增多有密切关系,阻断或抑制免疫反应及特异受体作用,减少炎症介质生成,均可使病情缓解。西医治疗药物主要有氨基水杨酸类、皮质类固醇、免疫抑制剂、抗生素等。这些药物虽可使病情缓解,但副作用大,停药后复发率高,因而限制了其临床应用。祖国医学认为溃疡性结肠炎的病机是以脾肾亏虚为本,气滞、血瘀、湿热为标。本病表现为整体多虚,局部多实;缓解期多虚,发作期多实。治疗中多虚实并调,整体与局部兼顾。本人导师焦君良教授根据长期临床实践及中医理论研究,创立了从“内痈“论治的学说,研制了中药制剂溃结康胶囊,具有解毒化瘀扶正的作用,临床治疗UC 疗效肯定,且无明显的毒副作用。已有大量研究证明免疫异常对UC 发病的影响,但炎症介质在UC 发病中的复杂机理尚不十分清楚,而且研究关于中医药治疗UC 对炎症介质影响的报道更属少数。本实验旨在用解毒化瘀扶正中药溃结康胶囊治疗UC,结合现代药理及生化,研究溃结康对前列腺素E₂更多还原

【Abstract】 Objective:Ulcerative Colitis（UC） is a type of inflammatory bowel disease with uncertain cause. It is characterized pathologically by the chronic inflammation and ulcer of the colon and the rectum mucosa, and is difficult to be cured. In Western Medicine, UC is considered having links with inheritance, environment, spirit, immunity, infection etc , directly or indirectly. About the pathogenesis of UC, most scholars tend to agree with immunity disorder and inflammatory mediators damage. Some studies show that abnormal immunity and increased formation of inflammatory mediators are connected with UC intimately. The manifestation of UC can be eased up by blocking or inhibiting the immunoreaction, the effect of the corresponding receptors or decreasing the formation of the inflammatory mediators. In Western Medicine, the drugs which are used to treat UC include antibiotic, aminosalicylic acid, corticosteroid and immunosuppressor etc. Although these drugs can achieve certain curative effect, there are some serious side-effect. Besides, the relapsing rate is high. The reasons mentioned above limit the application of these drugs. According to the theroy of Traditional Chinese Medicine, the fundamental cause of ulcerative colitis is Insufficiency of Spleen and Kidney while Qi Stagnancy, Blood Stasis and Damp-Heat are but the out manifestations. The disorder is characterized by the following features: the overall condition of the patient points to Insufficiency despite the local findings suggesting Excess; Insufficiency predominates in the picture during remissions though the manifestations at attack may suggest Excess. While designing the treatment scheme , therefore, it is important to take into consideration both the fundamental Insufficiency and the outward Excess and both the overall condition and the local manifestations. My tutor, professor Jiao Jun-Liang based on long term clinic practices and theory studies, put forward the theory of Treating the disease as “internal carbuncle”. He developed KUIJIEKANG capsule which was made of Chinese herbs. The preparation is provided with the effect of Detoxifying, Blood Stasis Removing and Body Strengthening. The curative effect of KUIJIEKANG capsule is remarkable, and there is no obvious toxicity and side effect. Lots of researches have proved the effect of abnormal immunoreaction during the pathogenesis course of UC. However, the complicated mechanism of inflammatory mediators inducing UC is ambiguous yet. Reports about the influence on the inflammatory mediators by Chinese herbs in the treatment of UC are rare. The purpose of the experiment is to study the effect ofKUIJIEKANG capsule on the inflammatory mediators with modern pharmacology and biochemistry knowledge to explore the pharmaceutical mechanism, to study the influence of KUIJIEKANG capsule on the inflammatory mediators,such as Prostaglandin E₂ （PGE₂）, Platelet activating factor（PAF） and Nitrogen monoxide （NO）,and to analyse the pathogenesis of UC at the angle of microcosmic. Methods:50 healthy male Wistar rats weighed 180-220 gram were devided into four groups randomly: normal control group, model control group, KUIJIEKANG group and Salicylazosulfa-Pyridine（SASP） group. The number of each group is 11,15,12,and 12 respectively. The rats in the latter three groups were induced to ulcerative colitis models with 2,4-dinitrochlorobenzene（DNCB）. The detailed method as follows: The rats were denuded with 10% Na2S at scruff first. Then they were incured to allergy by dripping 2% DNCB acetone solution to the denuded places once every day, each rat five drops every time, lasting for 18 successive days. The experiment continued after pausing one day. A catheter was inserted into the colon, about 6cm above anus. The rats were clysterized with 0.1% DNCB 50% ethanol solution for 4 days, 0.35ml each rats every day. The experiment went on after the models were ensured to be successful. 3 days later, the rats were perfused with drugs through mouth according to their weight. The doses of SASP group and KUIJIEKANG group are 0.3g/kg/d更多还原