Clinical And Experimental Researches On Prevention Of Postoperative Peritoneal Adhesion With "TongFuXieRe"Enteroclysis

lntra-abdominal adhesions remain a common problem in general surgical practice. In order to investigate the preventive mechanism in the postoperative pcritoneal adhesion with "ToiigFiiXieRe" Eiiteroclysis, tim researehes arc mile in lie aspects of cell factor and histolo ical tnorphl(dujy Cli meal prospective rattdomii.ed controlled ade tn 42 case abdominal post-operation. 42 cases arc divided into 2 groups at randenv cases treated with 250rn1 "TongFuXieRe"enteroclysis for 2 days and two times per day after operation, the others not treated with the enteroclysis. Some indexes including in the times of bowel sound after operation ,contents of blood IL-6,IL-8 and TNF-α in the first day and the third day after operation respectively are detected. The results show that in the treated group the time of bowel sound recorded after operation is 37.48±3.34 hours, the content of TNF-α is 29.292±26.582Pg/ml with significant differences compared with control group, while contents of IL-6 record as 56.344± 90.448Pg/ml and the contents of IL-8 record as 262.128±435.6O5Pg/ml, without si~nifieant differences between treated group and control group. It suggests that enemaed with "TongFuXierRe"enteroclysis after abdominal operation can promote gastrointestinal motility in earlier after operation and inhibit reaction of inflammatory cells by TNF-α in early inflammatory passage and so decrease the mediated role of releasing PAl by human peritoneal mesothelial cells during peritoneal inflammation. All these effects contribute to the preventive of inflammatory and preventive of postoperative peritoneal adhesion. To investigate the prophylactic effects of "TongFuXieRe"enteroelysis on peritoneal adhesions in the model postoperative peritoneal adhesions of SD rat with ileum trauma clippeded by forceps, Rats are divided into 6 groups at random: 3 groups enemaed with different dose of "TongFuXieRe"enteroclysis, enemaed with normal saline, enemaed with Fibrin glue and control group. The results show that: 1 ."TongFuXieRe"enteroclysis inhibits the peritoneal adhesion formation. The scores of peritoneal adhesion in "TongFuXieRe"enteroclysis groups are significantly lower than that in the other groups, while the scores of peritoneal adhesion are not different obviously among "TongFuxXieRe"enteroclysis groups in different doses. 2. "TongFuxXieRe"enteroclysis decreases the levels of blood TNF-α significantly. There were marked difference between the blood TNF-α of "TongFuxXieRe" enteroclysis group and control group in the third day after operation. The correlation between the blood TNF-α and the scores of peritoneal adhesion is significant at the 0.05 level. The blood TNF-α levels may be important indicator of predicting and prognosis of peritoneal adhesive severity.3. The total collagen and collagen type Ⅰ and Ⅲ are showed distinctly by picrosirius red and polarization microscopy, VG staining and morphometrics analysis. "TongFuxXieRe"enteroclysis decreases the contents of the total collagen and collagen type Ⅰ and inhibits the collagen systhesis in the peritoneal adhesive tissues. 4. The expression of TGF-β1 in the peritoneal adhesion tissues during the different period after operation appears to be regularly in pattern with irnmunohistochemical method. There are positive signal showed in fibroblasts, vascular endothelium cells and macrophages. The positive level of TGF- β1 in fibroblasts is found to be significantly higher in "TongFuxXieRe"enteroclysis group than that in control group in the forth day and the...