| IntroductionUlcerative colitis (UC) is a recurrent attack chronic non—specificity inflammation disease. The death rate of the explosion type is high, and the chronic persistence is easy to be cancer. At present, this disease is listed a modern refractoriness disease. In our country, the incidence of the disease is going up year by year, therefore illuminating the etiological factor and the nosogenesis of UC and finding the effective therapertic method is a worried problem.Setting up a ideal animal model is important for illuminating the etiological factor and the nosogenesis and observation of medicine therapeutic effect. Because the etiological factor and the nosogenesis of UC is complicated setting up a animal model is difficult. At present, Derivation of rat intestinal mucous membrane immune reaction by extrinsic source chemical stimulus is a commonly used method for setting up a inflammatory bowel disease animal model.The commonly used medicines of Western medicine include Amin-osalicylic medicine, corticosteroid medicine, mediating immune system medicine, Anti — infective and so on. Recently many new medicines is used, and at the same time many experiences of using some common medicines are obtained, but ail in all the therapeutic effect of UC is not satisfactory. In the condition that the Western medicine therapeutic effect of UC is not satisfactory, many researches of Chinese medicines have been done. A lot of records have reported that the Chinese medicine therapeu-tic effect of UC is satisfactory, but simplex Chinese medicine therapeutic effect of UC is not satisfactory for the explosion type patients. At present , finding combination of Western medicine and Chinese medicine colo-clysis treatment of UC is research direction for this reason.In the early 1980's, the department of digest internal medicine of No. 2 hospital affiliated China Medical University began treating UC by colo-clyster of Xileisan, berberie or Gentamicin, and Metasolon, and good effects have been obtained. But in the process of using this method for many years, the therapeutic effect of the association of this three types of medicine has not been inspected systematically and objectively. This research has analyzed the hospital patients from 1995 to 2003 with diseases of UC treated by coloclysis using Western medicine and Chinese medicine , and then we set up inflammatory bowel disease animal models of rat by the extrinsic source chemical stimulus of Dextran sulfate sodium, ox-azolone, 2,4,6 — trinitrobenzene sulfonic acid, and found the suitable animal model of UC. Eventually, we have done the control research of this prescription so that we can study the therapeutic effect of this prescription and the matching of dos, and at the same time, we have studied the nosogenesis of UC initially.Purpose1. To retrospectively study 179 hospital patients in our department from 1995 to 2003, and to study the method of treatment to UC by coloclysis using Western medicine and Chinese medicine, and to summarize the clinical feature of UC.2. To set up inflammatory bowel disease animal models of rat by the extrinsic source chemical stimulus of Dextran sulfate sodium, oxazolone, 2,4,6 — trinitrobenzene sulfonic acid, and found the suitable animal model of UC, and study the nosogenesis of UC initially.3. To study the therapeutic effect of treating UC by coloclyster of Xileisan, berberie or Gentamicin, and Metasolon and the matching of dosby control animal experiment research, and at the same time to study the mechanism of the effect.Materials and Methods1. All the 179 hospital patients from 1995 to 2003 with diseases of UC are in line with the standard for diagnosis and evaluating effect of treatment enacted in the meeting conducted in 1993 in Taiyuan city, and all the patients are in the active stage of disease. The experiment animals that we adopted are female BALB/C mouse which are from 6 to 8 years old and the body weight of these mouse are from 20 tO 25g.All the agents of Dextran sulfate sodium, oxazolone, 2,4,6 — trini-trobenzene sulfonic acid are provided by the Sigma company. All the medicines of Xileisan, berberie , Gentamicin, and Metasolon are provided by the pharmaceutical preparation section of No. 2 hospital affiliated China Medical University. All the kits of interleukin —4 and interferon —7 are provided by Shanghai Shenxiong Company.2. To retrospectively study 179 hospital patients in our department from 1995 to 2003, and to study the method of treatment to UC by colo-clysis using Western medicine and Chinese medicine, and to summarize the clinical feature of UC.3. BALB/C mouse inflammatory bowel disease animal models of rat by the most frequent the extrinsic source chemical stimulus of Dextran sulfate sodium, oxazolone, 2,4,6 — trinitrobenzene sulfonic acid were set up. The preparations of mouse large intestine were embeded with paraffin, and sliced, and hematoxylin—eosin stained. Then the pathologic histology changes of all the microtome section were given a mark. The contents of interleukin — 4 and interferon — 7 in mouse large intestine were determined by ABC—ELISA. Our purposes are to find the suitable animal model of UC and CD, and study the nosogenesis of inflammatory bowel disease initially.4. To do the animal experiment control research of treatment to UCby coloclysis using Western medicine and Chinese medicine using found the suitable animal model of UC, and determine the contents of interleu-kin—4 and interferon— 7 in mouse large intestine by ABC— ELISA, and study the mechanism of the prescription's effect.Results1. The results of the first part of the thesis are as followed. Among all the 169 hospital patients from 1995 to 2003 with diseases of UC treated by coloclysis using Western medicine and Chinese medicine, 26 patients were transmitted to the surgery department for operation, and 7 patients voluntarily discharged. Among all the rest 136 hospital patients, 5 patients were not healed well, and 131 patients took a turn for the better. There were not dead patients, and no manifest side effects were seen. The total effective rate is 77. 5%. Among all the 169 hospital patients, 118 patients with pathological changes in proximal end of colon were treated by coloclysis using Western medicine and Chinese medicine, and 101 patients took a turn for the better. The effective rate is 85. 6%. 51 patients with pathological changes in all colon were treated by coloclysis, and 30 patients took a turn for the better. The effective rate is 58. 8%. Among all the 169 hospital patients, 33 patients with UC for the first time were treated by coloclysis using Western medicine and Chinese medicine, and 22 patients took a turn for the better. The effective rate is 66. 7%. 79 patients with UC of the chronic recurring type were treated by coloclysis using Western medicine and Chinese medicine, and 70 patients took a turn for the better. The effective rate is 88. 6%. 57 patients with UC of the chronic keeping type were treated by coloclysis using Western medicine and Chinese medicine, and 39 patients took a turn for the better. The effective rate is 68. 4%. Among all the 169 hospital patients, 45 Var. mitis patients were treated by colociysis using Western medicine and Chinese medicine, and 39patients took a turn for the better. The effective rate is 86. 7%. 37 midrange patients with UC were treated by coloclysisusing Western medicine and Chinese medicine, and 31 patients took a turn for the better. The effective rate is 83. 8%. 87 heavy patients with UC were treated by coloclysis using Western medicine and Chinese medicine, and 61 patients took a turn for the better. The effective rate is 70.2. The results of the second part of the thesis are as followed. The general state of health of all mouse groups after administration is as followed. The mouse of oxazolone group, TNBS group, DSS group appeared loose stools and obvious body weight degression after 2,3,3 days respectively, and in the oxazolone group, 4 mouse appeared bloody stools, 4 mouse appeared occult blood of stools masculine. In the TNBS group, 7 mouse appeared bloody stools, 3 mouse appeared occult blood of stools masculine. In the DSS group, 3 mouse appeared bloody stools, 5 mouse appeared occult blood of stools masculine. The mouse of A control group appeared loose stools after 1 day, but after 7 day, the stools were normal on the whole. Among the mouse of A control group, 5 mouse appeared little body weight degression. Among the mouse of B control group, only 2 mouse appeared little body weight degression.The macroscopic form of all mouse groups after administration is as followed. The mucosa pathological changes of the mouse of oxazolone group and DSS group developed from the side of anus upward consecutively, and the pathological changes were lightened gradually. The mucosa pathological changes are the most serious, and proximal end of colon is almost normal. The mucosa in the part with pathological changes appeared middle or high dropsy, and there were erosioes and superficial ulcers. The most mucosa pathological changes of the mouse of TNBS group were in terminatio end of colon, but they can reach proximal end of colon. Mucosa pathological changes of two mouse reached proximal end of colon. There were dropsy, erosion, necrosis and ulcers in the affection part. The ulcer was deep and big. The necrosis was serious. Enteric cavity in the affection part was narrow. The colon mucosa of A control group and B control group was normal on the whole.The form under light microscope of all mouse groups after administration is as followed. There were middle and high congestion and dropsy , erosioes and superficial ulcers in all the mouse of oxazolone group and DSS group, and there were deep ulcers in only one mice of oxazolone group. The major part of infiltrated cells was lymph cells in mucosa and submucosa of mouse of oxazolone group, and the major part of infiltrated cells was neutrophilic leukocyte in mucosa and submucosa of mouse of DSS group. There were congestion and dropsy, epithelium defluxion, necrosis and ulcers in all the mouse of TNBS group, and there were some deep ulcers to placenta percreta. The major part of infiltrated cells was neutrophilic leukocyte in mucosa and submucosa of mouse of TNBS group. There was light cell infiltration in mucosa and submucosa of 4 mouse of A control group. There was light cell infiltration in mucosa and submucosa of 2 mouse of B control group.The contents of interleukin —4 and interferon—7 in mouse large intestine by ABC—ELISA are as followed. The contents of interleukin—4 in mouse large intestine of oxazolone igroup were higher than the contents of interleukin—4 in mouse large intestine of A control group (p0. 05).Conclusions1. The prescription of Xileisan, berberie or Gentamicin, and Metaso-lon treats UC by coloclyster is effective, and no manifest side effects appear.2. The therapeutic effect of treating patients with pathological changes in proximal end of colon by coloclyster with Xileisan, berberie or Gentamicin, and Metasolon is better than that of treating patients with pathological changes in all colons.3. The therapeutic effect of treating patients with UC of chronic recurring type by coloclyster with Xileisan, berberie or Gentamicin is better than that of treating patients with chronic keeping type.4. The therapeutic effect of treating patients with UC of slight type by coloclyster with Xileisan, berberie or Gentamicin is better than that oftreating patients with UC of gravis type.5. The inflammatory bowel disease animal model of rat set up by coloclyster of 0.15ml 1% oxazoione 50% alcoholic solution after sensibili-zation is similar to UC of mankind. In this animal model, the content of interleukin — 4 increases, and the content of interferon — T decreases which is mainly mediated by Th2 cell.6. The inflammatory bowel disease animal model of rat set up by giving mouse 5% DSS distilled water solution for freely and continuously drinking for 7 days is similar to UC of mankind. In this animal model, the content of interleukin — 4 and interferon — 7 increases which is atypical Thl and Th2 reaction.7. The inflammatory bowel disease animal model of rat set up by coloclyster of 0. lml 2% TNBS 50% alcoholic solution is similar to CD of mankind. In this animal model, the content of interleukin —4 decreases, and the content of interferon — 7 increases which is mainly mediated by Thlcell.8. The therapeutic effect of treating patients with UC by coloclyster with medium dosage of Xileisan, berberie or Gentamicin , and Metasolon is better than that of treating patients by coloclyster with low dosage and sulfasalazine. The therapeutic effect of treating patients with high dosage of Xileisan, berberie or Gentamicin, and Metasolon is equal to that of treating patients with low dosage. There is no side effect in the treatment with low, medium and high dosage.9. Treating patients with UC by coloclyster of Xileisan, berberie or Gentamicin, and Metasolon maybe educe its therapeutic effect by adjusting interleukin—4 , interferon —7 and the balance of Thl cell and Th2 cell.
|
PDF Full Text Request